参芪健心方治疗射血分数中间值心力衰竭患者临床观察  

Clinical Effect of Shenqi Jianxin Prescription in Treatment of Patients with Heart Failure with Mid-range Ejection Fraction

作　　者：左强[1,2] 杨帆 桂青[1,2] 梁国庆 王银燕 冉永玲[1,2] 黄平 戴小华[1,2] ZUO Qiang;YANG Fan;GUI Qing;LIANG Guoqing;WANG Yinyan;RAN Yongling;HUANG Ping;DAI Xiaohua(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;Subcenter of National Clinical Research Center for Chinese Medicine Cardiology,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031 [2]国家中医心血管病临床医学研究中心分中心,安徽合肥230031

出　　处：《安徽中医药大学学报》2023年第2期13-17,共5页Journal of Anhui University of Chinese Medicine

基　　金：国家重点研发计划专项(2017YFC1700306);安徽省中医药领军人才项目(中医药发展秘〔2018〕23号);安徽省自然科学基金青年项目(2008085QH387)。

摘　　要：目的观察参芪健心方治疗射血分数中间值心力衰竭(heart failure with mid-range ejection fraction,HFmrEF)的临床疗效。方法将60例HFmrEF患者按随机数字表法平均分为两组,观察组30例患者在西医基础治疗的同时,给予参芪健心方治疗,每日1剂;对照组30例患者仅接受西医基础治疗;疗程均为4周。比较两组患者治疗前后脑钠肽(B-type natriuretic peptid,BNP)、左心室舒张末内径(left ventricular end-diastolic dimension,LVEDD)、左心室射血分数(left ventricular ejection fraction,LVEF)、6分钟步行距离(6 minutes walking distance,6MWD)、中医证候积分,基于纽约心脏病协会(New York Heart Association,NYHA)心功能分级的临床疗效及主要心血管不良事件(major adverse cardiovascular events,MACE)发生情况。结果与治疗前比较,两组患者治疗后BNP均显著下降(P<0.05),LVEF、6MWD均显著提升(P<0.05);观察组BNP下降幅度和LVEF、6MWD提升幅度均大于对照组(P<0.05)。与治疗前比较,两组患者各项证候积分治疗后均显著下降(P<0.05),且观察组患者治疗后喘息和(或)气短、心悸、乏力、倦怠少言、自汗、语声低下评分下降程度显著大于对照组(P<0.05)。观察组疗效优于对照组(P<0.05)。两组治疗周期内均未出现严重不良反应及MACE。结论参芪健心方通过纠正心力衰竭气虚血瘀证患者的病理状态,在改善临床症状、提升心功能方面,显示出良好的临床获益。Objective To investigate the clinical effect of Shenqi Jianxin Prescription in the treatment of heart failure with mid-range ejection fraction(HFmrEF).Methods A total of 60 patients with HFmrEF were averagely divided into observation group and control group using a random number table,with 30 patients in each group.The patients in the observation group were given Shenqi Jianxin Prescription,1 dose a day,in addition to basic Western medicine treatment,while those in the control group were given basic Western medicine treatment alone;the course of treatment was 4 weeks for both groups.The two groups were compared in terms of brain natriuretic peptide(BNP),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),traditional Chinese medicine(TCM)syndrome score,clinical outcome based on NYHA class,and major adverse cardiovascular events(MACE).Results After treatment,both groups had a significant reduction in BNP(P<0.05)and significant increases in LVEF and 6MWD(P<0.05),and compared with the control group,the observation group had a significantly greater reduction in BNP and significantly greater increases in LVEF and 6MWD(P<0.05).After treatment,both groups had significant reductions in syndrome scores(P<0.05),and compared with the control group,the observation group had significantly greater reductions in the scores of wheezing and/or short breath,palpitation,weakness,fatigue,spontaneous sweating,and low voice(P<0.05).The observation group had a significantly better treatment outcome than the control group(P<0.05).No serious adverse events or MACE were observed in either group during treatment.Conclusion Shenqi Jianxin Prescription can correct the pathological state of patients with heart failure with Qi deficiency and blood stasis syndrome and shows good clinical benefits in improving clinical symptoms and cardiac function.

关 键 词：射血分数中间值心力衰竭 参芪健心方 脑钠肽 心功能 中医证候积分 

分 类 号：R541.6[医药卫生—心血管疾病]