强心方加减联合西药治疗慢性心力衰竭患者的疗效及对其心功能指标、心肌重塑的影响  

Effect of Modified Qiangxin Formula and Western Medicine on Cardiac Function Indexes and Myocardial Remodeling in Patients with Chronic Heart Failure

作　　者：翁嘉灏[1] 胡晓贞[1] WENG Jia-hao;HU Xiao-zhen(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200071)

机构地区：[1]上海市中医医院,上海200071

出　　处：《世界中西医结合杂志》2022年第12期2475-2480,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市卫生健康委员会科研课题(202040259)。

摘　　要：目的观察强心方加减联合西药治疗慢性心力衰竭(心衰)的临床疗效及其对心功能指标、心肌重塑的影响。方法选取2018年1月—2020年6月期间上海市中医医院收治的118例气阳虚衰水泛血瘀型慢性心衰患者作为研究对象,运用随机数字表法将患者分为对照组和治疗组,每组各59例。对照组患者采用常规西医治疗,治疗组患者采用强心方加减联合常规西医治疗。治疗1个月后,观察比较两组患者临床疗效、不良反应、再入院率,治疗前后中医证候积分(呼吸困难、畏寒肢冷、尿少、面浮肢肿、心悸/气短、胸闷痛、咳嗽、腹胀)、心肌重塑指标[左室舒张末内径(Left ventricular end diastolic dimension,LVEDD)、左室射血分数(Left ventricular ejection fraction,LVEF)和左室收缩末内径(Left ventricular end diastolic diameter,LVESD)]、心功能指标[6 min内步行最远距离(6 minute walking test,6MWT)及血清N末端前体脑利钠肽(N-terminal probrain natriuretic peptide,NT-proBNP)水平]。结果治疗后治疗组总有效率94.55%(52/55)明显高于对照组78.57%(44/56),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05),且治疗组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者LVEDD和LVESD指标均较治疗前明显降低,LVEF指标均较治疗前明显升高,差异有统计学意义(P<0.05);且治疗组LVEDD和LVESD指标均较对照组明显降低,LVEF较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者6MWT水平均较治疗前明显升高,NT-proBNP水平均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组6MWT水平较对照组明显升高,NT-proBNP水平较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗3、6个月后再入院率比较,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.0Objective To investigate theeffect of modified Qiangxin Formula combined with western medicine on cardiac function indexes and myocardial remodeling in patients with chronic heart failure.Methods A total of 118 patients with chronic heart failure of qi-yang deficiency,water diffusion,and blood stasis type who were treated in Shanghai Municipal Hospital of Traditional Chinese Medicine from January 2018 to June 2020 were included and randomized into the control group(n=59)and treatment group(n=59)according to a random number table.The control group was treated with conventional western medicine,and the treatment group with modified Qiangxin Formula and conventional western medicine.The treatment lasted one month for both groups.Then,the clinical efficacy,adverse reactions,readmission rate,score of traditional Chinese medicine(TCM)syndrome(dyspnea,fear of cold and chilly limbs,oliguria,puffy face and swollen limbs,palpitation/shortness of breath,chestpain,cough,abdominal distension),myocardial remodeling indicators[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and left ventricular-end systolic diameter(LVESD)],and cardiac function indexes[6-min walk test(6MWT),serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP)]were compared between the two groups.Results After one month of treatment,the total effective rate in the treatment group was 94.55%(52/55),which was higher than the 78.57%(44/56)in the control group(P<0.05).After treatment,the TCM syndrome scorewas lower than that before treatment in both groups(P<0.05),and thescore in the treatment group was lower than that in the control group(P<0.05).After treatment,LVEDD and LVESD were lower than those before treatment,and LVEF was higher than that before treatment in both groups(P<0.05).After treatment,LVEDD and LVESD in the treatment group were lower than those in the control group,and LVEF in the treatment group was higher than that in the control group(P<0.05).After treatment,the level of 6MWT was higher than t

关 键 词：慢性心力衰竭 强心方 气阳虚衰 水泛血瘀 中西医结合 

分 类 号：R541.6[医药卫生—心血管疾病]