坎离煎通过调节铁稳态治疗慢性心力衰竭伴贫血临床研究  

Clinical study of Kanlijian on chronic heart failure with anemia:By means of regulating iron homeostasis

作　　者：曾莉[1] 姜升阳 葛俊炜 张璇 鲁成[1] 庄少伟 徐迎辉 居海宁[1] ZENG Li;JIANG Shengyang;GE Junwei;ZHANG Xuan;LU Cheng;ZHUANG Shaowei;XU Yinghui;JU Haining(Department of Cardiology,Shanghai Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200137)

机构地区：[1]上海中医药大学附属上海市第七人民医院心内科,上海200137

出　　处：《河北中医》2023年第8期1274-1278,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市卫生健康委员会科学研究项目(编号:201940461);浦东新区科技发展基金(编号:PKJ2018-Y15)。

摘　　要：目的观察坎离煎治疗慢性心力衰竭(CHF)伴贫血的临床疗效。方法将80例CHF伴贫血患者按照随机数字表法分为2组,对照组40例予常规治疗,治疗组40例在对照组治疗基础上加服坎离煎治疗。2组均治疗4周。比较2组治疗前后血常规[血红蛋白(Hb)、红细胞计数(RBC)、红细胞比容(HCT)、平均红细胞体积(MCV)、平均血红蛋白含量(MCH)]、铁代谢相关指标[血清铁(SI)、总铁结合力(TIBC)、铁蛋白(SF)、转铁蛋白饱和度(TSAT)]、C反应蛋白(CRP)、B型钠尿肽(BNP)及左室射血分数(LVEF),并统计2组心功能疗效及临床疗效。结果治疗组心功能总有效率95.0%(38/40),对照组总有效率87.5%(35/40),治疗组的心功能疗效优于对照组(P<0.05)。治疗组临床总有效率95.0%(38/40),对照组总有效率80.0%(32/40),治疗组的疗效优于对照组(P<0.05)。治疗组治疗后Hb、RBC、MCH均较本组治疗前升高(P<0.05),HCT降低(P<0.05),对照组治疗后Hb升高(P<0.05),且治疗后治疗组Hb高于对照组(P<0.05),HCT低于对照组(P<0.05)。治疗组治疗后SI、TSAT均较本组治疗前升高,CRP、SF降低(P<0.05),对照组SI升高(P<0.05)。2组治疗后组间CRP及各项铁代谢指标比较差异无统计学意义(P>0.05)。2组治疗后BNP均较本组治疗前降低(P<0.05),LVEF均升高(P<0.05),且治疗组治疗后BNP低于对照组(P<0.05),2组治疗后LVEF比较差异无统计学意义(P>0.05)。结论坎离煎可能是通过减轻CHF伴贫血患者炎症状态及纠正血铁含量,从而起到治疗贫血的作用。Objective To observe the clinical efficacy of Kanlijian in the treatment of chronic heart failure(CHF)with anemia.Methods A total of 80 CHF patients with anemia were randomly allocated to control group(n=40)and treatment group(n=40).The patients of the treatment group were additionally treated with Kanlijian on the basis of conventional treatment.A 4-week treatment was performed in the both groups.The blood routine(hemoglobin[Hb],red blood cell count[RBC],hematocrit[HCT],mean corpuscular volume[MCV],mean hemoglobin content[MCH]),iron metabolism-related indexes(serum iron[SI],total iron binding capacity[TIBC],ferritin[SF],transferrin saturation[TSAT]),C-reactive protein(CRP),B-type natriuretic peptide(BNP)and left ventricular ejection fraction(LVEF)were included as comparators between groups before and after treatment,and the cardiac function and clinical efficacy were counted.Results The efficacy rate of cardiac function in the treatment group was significantly better than that in the control group(95.0%[38/40]vs 87.5%[35/40],P<0.05).The curative effect in the treatment group was significantly better than that in the control group(95.0%[38/40]vs 80.0%[32/40],P<0.05).After treatment,Hb,RBC,and MCH in the treatment group were significantly higher than those before treatment(P<0.05),and HCT was significantly lower(P<0.05).Hb in control group was significantly higher than that before treatment(P<0.05),the differences were significant in Hb and HCT between groups after treatment(both P<0.05).After treatment,SI and TSAT in the treatment group were significantly higher than those before treatment,CRP,SF were significantly lower(P<0.05),and SI in the control group was significantly higher(P<0.05).There was no significant difference in CRP and iron metabolism-related between groups after treatment(P>0.05).After treatment,BNP was significantly decreased in the both groups(P<0.05),LVEF was significantly increased(P<0.05),BNP in the treatment group was lower than that in the control group(P<0.05),but the difference of LVEF w

关 键 词：慢性心力衰竭 贫血 中药疗法 

分 类 号：R541.61[医药卫生—心血管疾病] R556.053.1[医药卫生—内科学]