温和灸联合药物治疗扩张型心肌病气虚血瘀证疗效观察及对血清POSTN、cMyBP-C的影响  

Efficacy observation of mild moxibustion plus medications for dilated cardiomyopathy due to Qi deficiency and blood stasis and its effects on serum POSTN and cMyBP-C

作　　者：张洁[1] 刘瑾[1] ZHANG Jie;LIU Jin(Wuhan Hospital of Traditional Chinese and Western Medicine,Wuhan 430022,China)

机构地区：[1]武汉市中西医结合医院,武汉430022

出　　处：《上海针灸杂志》2023年第1期1-5,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：武汉市医学科研项目(WZ21C39)。

摘　　要：目的观察温和灸联合药物治疗扩张型心肌病(dilated cardiomyopathy,DCM)气虚血瘀证的临床疗效及对血清骨膜蛋白(periostin,POSTN)、心肌肌球蛋白结合蛋白-C(cardiac myosin binding protein-C,cMyBP-C)的影响。方法将80例DCM气虚血瘀证患者随机分为对照组和观察组,每组40例。对照组予常规药物治疗,观察组在此基础上予温和灸。比较两组治疗前后血清N端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平、6 min步行距离、明尼苏达心力衰竭生活质量量表(Minnesota living with heart failure questionnaire,MLWHFQ)评分、左室舒张末径(left ventricular end-diastolic dimension,LVEDD)、左室射血分数(left ventricular ejection fraction,LVEF)、左室短轴缩短率(fractional shortening,FS)及血清POSTN和c My BP-C水平,并比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组血清NT-proBNP水平均降低(P<0.05),6 min步行距离均增加(P<0.05),MLWHFQ评分均降低(P<0.05);且观察组均优于对照组(P<0.05)。治疗后,对照组LVEDD和FS无明显变化(P>0.05),LVEF升高(P<0.05);观察组LVEDD降低(P<0.05),LVEF和FS升高(P<0.05),且均优于对照组(P<0.05)。治疗后,对照组血清POSTN和cMyBP-C水平无明显变化(P>0.05);观察组血清POSTN和c MyBP-C水平均降低(P<0.05),且低于对照组(P<0.05)。结论温和灸联合药物治疗扩张型心肌病气虚血瘀证的疗效显著,可改善患者心脏功能,提升运动耐力及生活质量,延缓心室重构,这可能与其降低血清POSTN和c My BP-C水平有关。Objective To observe the clinical efficacy of mild moxibustion plus medications in treating dilated cardiomyopathy(DCM)due to Qi deficiency and blood stasis and its effects on serum periostin(POSTN)and cardiac myosin binding protein-C(cMyBP-C).Method Eighty patients with DCM due to Qi deficiency and blood stasis were randomized into a control group and an observation group,with 40 cases in each group.The control group was given conventional medications,and the observation group received additional mild moxibustion treatment.The level of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),6-min walk distance(6 MWD),Minnesota living with heart failure questionnaire(MLWHFQ)score,left ventricular end-diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF),left ventricular fractional shortening(FS),and serum levels of POSTN and cMyBP-C in the two groups were compared before and after the treatment.The two groups’clinical efficacy was also compared.Result The total effective rate in the observation group was higher than that in the control group(P<0.05).After the treatment,both groups showed declined serum NT-proBNP level(P<0.05),extended 6 MWD(P<0.05),and decreased MLWHFQ score(P<0.05),and the observation group was superior to the control group(P<0.05).In the control group,neither the LVEDD nor FS showed a significant change(P>0.05),while the LVEF increased(P<0.05);in the observation group,the LVEDD decreased(P<0.05),and the LVEF and FS increased(P<0.05),showing significant advantages compared with the control group(P<0.05).There were no significant changes in the levels of serum POSTN and c My BP-C in the control group(P>0.05);the serum levels of POSTN and c My BP-C dropped in the observation group(P<0.05)and were lower than in the control group(P<0.05).Conclusion Mild moxibustion combined with medications can produce notable efficacy in treating DCM due to Qi deficiency and blood stasis;it can improve heart function,enhance exercise endurance and quality of life,and prolong ventricular reconstruc

关 键 词：灸法 艾条灸 心肌病 扩张型 气虚血瘀 骨膜蛋白 心肌肌球蛋白结合蛋白-C 

分 类 号：R246.1[医药卫生—针灸推拿学]