强心方联合沙库巴曲缬沙坦对慢性心力衰竭患者中医症候、心室重构及运动耐力的影响  

Effects of Qiangxin decoction combined with shakubactril valsartan on TCM symptoms,ventricular remodeling and exercise tolerance in patients with chronic heart failure

作　　者：陆滢屹 陈丽雯 柴钰 翁嘉灏[1] 邢健东[1] LU Yingyi;CHEN Liwen;CHAI Yu;WENG Jiahao;XING Jiandong(Department of Cardiology,Municipal Hospital of Traditional Chinese Medicine of Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院心病科,上海200071

出　　处：《陕西中医》2023年第8期1052-1055,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82104758)。

摘　　要：目的:探究强心方联合沙库巴曲缬沙坦对慢性心力衰竭气虚阳衰证患者中医症候、心室重构及运动耐力的影响。方法:将92例慢性心力衰竭气虚阳衰证患者随机分为观察组和对照组,每组46例。两组均进行常规西医规范治疗,对照组给予沙库巴曲缬沙坦,观察组采用强心方联合沙库巴曲缬沙坦。比较两组治疗前、治疗2个月后中医症候积分、心室重构情况[左室舒张末内径(LVEDD)、左室射血分数(LVEF)、左室收缩末内径(LVESD)]、血清心肌损伤因子[血N末端B型钠尿肽前体(NT-proBNP)、心肌钙蛋白(cTnI)、核转录因子(NF-κB)]、运动耐力[6 min步行试验(6MWT)]。结果:治疗后,两组中医症候积分、LVEDD、LVESD、血清NT-proBNP、cTnI、NF-κB水平均显著降低,且观察组低于对照组,差异有统计学意义(均P<0.05);治疗后,两组LVEF、6MWT水平均显著升高,且观察组高于对照组,差异有统计学意义(均P<0.05)。结论:强心方联合沙库巴曲缬沙坦可有效改善CHF患者临床症状,提高运动耐力,减轻心室重塑和心肌损伤。Objective:To explore the effects of Qiangxin decoction combined with sacubitril valsartan on TCM syndromes,ventricular remodeling and exercise tolerance in treating chronic heart failure qi deficiency and yang decline syndrome.Methods:92 patients with chronic heart failure qi deficiency and yang decline syndrome were selected as the observation subjects,and they were divided into observation group and control group by stratified randomization method,with 46 cases in each group.Both groups were treated with conventional western medicine standardized treatment,and the control group was given sacubitril valsartan,and the observation group was given Qiangxin decoction combined with sacubitril valsartan.TCM syndromes scores,ventricular remodeling[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)],serum myocardial injury factors[blood N-terminal pro-B-type natriuretic peptide(NT-proBNP),cardiac troponin(cTnI),nuclear transcription factor(NF-κB)]and exercise tolerance[6 minute walking test(6MWT)]were compared between the two groups before treatment and after 2 months of treatment.Results:After treatment,the TCM syndromes scores,LVEDD,LVESD,serum NT-proBNP,cTnI and NF-κB levels in both groups were significantly decreased,and the above indicators in observation group were lower than those in control group,the difference was statistically significant(all P<0.05).The LVEF and 6MWT in the two groups were significantly increased after treatment,and the indicators in observation group were higher than those in control group,the difference was statistically significant(all P<0.05).Conclusion:Qiangxin decoction combined with shakubactril valsartan can effectively improve clinical symptoms,improve exercise endurance,reduce ventricular remodeling and myocardial injury in patients with chronic heart failure.

关 键 词：慢性心力衰竭 强心方 沙库巴曲缬沙坦 气虚阳衰 心肌损伤因子 运动耐力 

分 类 号：R575.1[医药卫生—消化系统]