益气活血方联合穴位贴敷治疗气虚血瘀型充血性心力衰竭患者的疗效及对NT-proBNP、IL-6、hs-CRP的影响  

Efficacy of Yiqi Huoxue Recipe combined with acupoint application in treating heart failure patients with Qi-defificiency and blood-stasis syndrome and its influence on NT-proBNP,IL-6 and hs-CRP

作　　者：王凤 周梦洋 刘朝焕 刘路路 张伟 闫玲玲 王朝亮 曹佑德 WANG Feng;ZHOU Meng-yang;LIU Chao-huan(Jieshou Traditional Chinese Medicine Hospital,Fuyang 236502,China)

机构地区：[1]界首市中医院,236502 [2]安徽中医药大学附属太和中医院,236699

出　　处：《中国实用医药》2023年第18期11-15,共5页China Practical Medicine

基　　金：安徽省第二批名中医学术继承项目(项目编号:皖中医药发[2018]3号);阜阳市卫健委科研立项课题(项目编号:FY2019-116)。

摘　　要：目的分析益气活血方联合穴位贴敷治疗气虚血瘀型充血性心力衰竭患者的效果及对氨基末端脑利钠肽前体(NT-proBNP)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)的影响。方法120例气虚血瘀型充血性心力衰竭患者,随机分成对照组和试验组,每组60例。对照组患者采用常规西医治疗,试验组患者在对照组基础上采用益气活血方联合穴位贴敷治疗。比较两组患者临床疗效,中医证候改善情况,治疗前后6 min步行距离、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]及血清NT-proBNP、IL-6、hs-CRP水平,分析不良反应发生情况。结果试验组脱落5例,对照组脱落3例。试验组治疗总有效率83.64%明显高于对照组的56.14%,差异具有统计学意义(P<0.05)。试验组中医证候改善总有效率92.73%明显高于对照组的56.14%,差异具有统计学意义(P<0.05)。治疗后,两组6 min步行距离、血清NT-proBNP水平均优于治疗前,且试验组6 min步行距离(579.26±85.74)m、血清NT-proBNP水平(734.34±613.66)pg/ml均优于对照组的(387.36±89.52)m、(1197.67±940.21)pg/ml,差异具有统计学意义(P<0.05)。治疗后,两组IL-6、hs-CRP水平均低于治疗前,且试验组IL-6水平(46.83±17.67)pg/ml、hs-CRP水平(1.12±0.64)mg/L均低于对照组的(67.45±9.76)pg/ml、(4.11±1.42)mg/L,差异具有统计学意义(P<0.05)。治疗后,两组LVEF、LVESD、LVEDD均优于治疗前,且试验组LVEF(50.29±5.31)%、LVESD(39.86±4.23)mm、LVEDD(50.65±4.31)均优于对照组的(40.27±4.34)%、(46.78±5.12)mm、(56.18±5.63)mm,差异具有统计学意义(P<0.05)。结论益气活血方联合穴位贴敷治疗气虚血瘀型充血性心力衰竭患者疗效显著,可有效改善患者的临床症状及心功能指标,增加其运动耐量,降低炎症因子水平,临床安全性较高。Objective To analyze the effect of Yiqi Huoxue Recipe combined with acupoint application in treating heart failure patients with Qi-defificiency and blood-stasis syndrome and its influence on N-terminal pro-brain natriuretic peptide(NT-proBNP),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP).Methods A total of 120 cases of heart failure patients with Qi-defificiency and blood-stasis syndrome were randomly divided into control group and experimental group,with 60 cases in each group.The control group was treated with conventional Western medicine,and the experimental group was treated with Yiqi Huoxue Recipe and acupoint application on the basis of the control group.Both groups were compared in terms of clinical efficacy,improvement of traditional Chinese medicine syndrome,6-min walking distance,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end�diastolic diameter(LVEDD)]and serum levels of NT-proBNP,IL-6 and hs-CRP before and after treatment.The occurrence of adverse reactions was analyzed.Results There were 5 drop-out cases in the experimental group and 3 drop-out cases in the control group.The total effective rate of 83.64%in the experimental group was significantly higher than that of 56.14%in the control group,and the difference was statistically significant(P<0.05).The total effective rate of traditional Chinese medicine syndrome improvement in the experimental group was 92.73%,which was significantly higher than that of 56.14%in the control group,and the difference was statistically significant(P<0.05).After treatment,the 6-min walking distance and serum level of NT-proBNP in both groups were better than those before treatment in this group;the 6-min walking distance of(579.26±85.74)m and serum level of NT-proBNP of(734.34±613.66)pg/ml in the experimental group were better than those of(387.36±89.52)m and(1197.67±940.21)pg/ml in the control group;the differences were statistically significant(P<0.05).Af

关 键 词：益气活血方 穴位贴敷 心力衰竭 气虚血瘀 炎症因子 

分 类 号：R259[医药卫生—中西医结合]