温阳益气活血汤对老年射血分数正常的心力衰竭阳气亏虚血瘀兼痰饮证患者炎症反应及运动耐力的影响  

Effect of Wenyang Yiqi Huoxue Decoction on inflammatory response and exercise endurance in elderly patients with heart failure with normal ejection fraction of yang-qi deficiency and blood stasis and phlegm retention syndrome

作　　者：安敬芝 徐静 杨劼[1] 宋岩[3] 步玮[4] AN Jingzhi;XU Jing;YANG Jie;SONG Yan;BU Wei(Department of Clinical Pharmacy,the Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050051;Department of Cardiology,Dongguang County Hospital,Donggua,Hebei 061600;Department of Radiology,the Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051;Department of Neurosurgery,the Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050051)

机构地区：[1]河北医科大学第三医院临床药学部,河北石家庄050051 [2]河北省东光县医院心内科,河北东光061600 [3]河北医科大学第三医院放射科,河北石家庄050051 [4]河北医科大学第三医院神经外科,河北石家庄050051

出　　处：《河北中医》2023年第6期957-960,964,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2020年度中医药类科研计划课题(编号:2020182)。

摘　　要：目的 观察温阳益气活血汤对老年射血分数正常的心力衰竭(HFNEF)阳气亏虚血瘀兼痰饮证患者炎症反应及运动耐力的影响。方法 选取122例老年HFNEF阳气亏虚血瘀兼痰饮证患者,按照随机数字表法分为对照组和治疗组,各组61例。对照组予西医常规治疗,治疗组在对照组治疗基础上加温阳益气活血汤治疗,2组均治疗60天后统计疗效。比较2组治疗前后心脏舒张功能[左心房容积指数(LAVI)、左室等容舒张时间(IVRT)、二尖瓣口舒张早期充盈峰值速度(E峰)、二尖瓣口舒张末期充盈峰值速度(A峰)、E/A值]、运动耐力[最大运动功率(Wmax)、最大运动时间(Tmax)、无氧阈氧耗量(VO_(2)AT)、峰值氧耗量(Peak VO_(2))]、炎症相关因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]及N末端B型利钠肽原(NT-proBNP)变化。结果 治疗组总有效率为91.15%(56/61),高于对照组的78.69%(48/61)(P<0.05)。治疗后,2组LAVI、IVRT、A峰均较本组治疗前降低(P<0.05),且治疗组显著低于对照组(P<0.05);治疗后,2组E峰、E/A值均较本组治疗前升高(P<0.05),且治疗组显著高于对照组(P<0.05)。治疗后,2组运动耐力参数Peak VO_(2)、VO_(2)AT、Wmax、Tmax均较本组治疗前升高(P<0.05),且治疗组显著高于对照组(P<0.05)。治疗后,2组NT-proBNP、TNF-α、hs-CRP水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。结论 温阳益气活血汤治疗老年HFNEF阳气亏虚血瘀兼痰饮证患者可有效改善临床症状,提升运动耐力,减轻机体炎症,控制病情进展。Objective To explore the effect of Wenyang Yiqi Huoxue Decoction on inflammatory response and exercise endurance in elderly patients with heart failure with normal ejection fraction(HFNEF)of yang-qi deficiency and blood stasis and phlegm retention syndrome.Methods A total of 122 elderly patients with HFNEF(yang-qi deficiency and blood stasis and phlegm retention syndrome)were randomly assigned into the treatment group(n=61)and the control group(n=61).All patients were managed by conventional therapy,and those in the treatment group were additionally treated with Wenyang Yiqi Huoxue Decoction.The curative effect of the two groups was counted after 60 days of treatment.The cardiac diastolic function(Left atrial volume index[LAVI],left ventricular isovolumic relaxation time[IVRT],mitral early diastolic inflow peak velocity[E],late diastolic filling peak velocity[A],ratio of[E/A]),exercise endurance(maximum power output[Wmax],maximal exercise time[Tmax],oxygen consumption at anaerobic threshold[VO_(2)AT],peak oxygen consumption[Peak VO_(2)]),inflammation-related factors(high-sensitivity C-reactive protein[hs-CRP],tumor necrosis factor-α[TNF-α],N-terminal pro-B-type natriuretic peptide[NT-proBNP])were included as comparisons between groups before treatment and after treatment.Results The total effective rate in the treatment group was higher than that in the control group(91.15%[56/61]vs 78.69%[48/61],P<0.05).After treatment,LAVI,IVRT,and peak A values in the two groups were lower than those before treatment,while peak E and E/A values were higher than those before treatment,the treatment group was significantly better than the control group for LAVI,IVRT,peak A values,as well as peak E and E/A values(all P<0.05).The levels of Peak VO_(2),VO_(2)AT,Wmax,and Tmax in the two groups were all increased compared with those before treatment(P<0.05),and which were significantly higher in the treatment group than in the control group(P<0.05).The levels of NT-proBNP,TNF-αand hs-CRP in the two groups were lower than those bef

关 键 词：心力衰竭 射血分数 老年 阳虚 血瘀 痰饮 炎症反应 中医药疗法 

分 类 号：R541.610.531[医药卫生—心血管疾病]