生脉饮合升陷汤加减治疗慢性心力衰竭的临床效果研究  

Clinical effect of Shengmai Yin combined with modified Shengxian Decoction in the treatment of chronic heart failure

作　　者：张曼 陈珂 杨晓红 陈爱莲 ZHANG Man;CHEN Ke;YANG Xiao-hong;CHEN Ai-lian(Department of Cardiology,Puyang Traditional Chinese Medicine Hospital,Puyang 457000,Henan,CHINA;Arrhythmia Ward 2,Fuwai Huazhong Cardiovascular Hospital,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]濮阳市中医医院心内科,河南濮阳457000 [2]阜外华中心血管病医院心律失常二病区,河南郑州450000

出　　处：《海南医学》2023年第24期3508-3513,共6页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建立项目(编号:LHGJ20201080)。

摘　　要：目的基于左心功能、血清半乳糖凝集素-3(Gal-3)蛋白、血管紧张素Ⅱ(AngⅡ)水平探究生脉饮合升陷汤加减治疗慢性心力衰竭(CHF)的临床效果。方法选取2020年6月至2022年6月濮阳市中医医院收治的92例CHF患者作为研究对象,按随机数表法分为对照组和观察组各46例。对照组患者给予常规西药治疗,观察组患者给予生脉饮合升陷汤加减联合常规西药治疗,均持续治疗3个月。治疗结束后,比较两组患者的治疗效果,以及治疗前、治疗1个月和3个月后的左心功能、血浆氨基末端脑钠肽前体(NT-proBNP)水平、血清Gal-3蛋白、AngⅡ水平、运动耐力[6 min步行距离(6 MWD)]、心衰症状(Lee氏心衰评分)和生活质量[明尼苏达心力衰竭生活质量量表(MLHFQ)评分],并统计两组患者治疗期间的药物不良反应发生情况。结果观察组患者的治疗总有效率为93.48%,明显高于对照组的78.26%,差异有统计学意义(P<0.05);观察组患者治疗1个月和3个月后的左室射血分数(LVEF)明显高于对照组,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、血浆NT-proBNP水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者治疗1个月和3个月后的血清Gal-3蛋白、AngⅡ水平明显低于对照组,差异均有统计学意义(P<0.05);观察组患者治疗1个月和3个月后的6 MWD分别为(460.28±71.82)m、(512.36±87.39)m,明显长于对照组的(406.73±65.91)m、(452.18±79.62)m,Lee氏心衰评分、MLHFQ评分分别为(6.71±1.46)分、(5.19±1.22)分和(47.26±6.35)分、(38.71±5.82)分,明显低于对照组的(7.68±1.62)分、(6.34±1.35)分和(52.04±6.81)分、(45.19±6.43)分,差异均有统计学意义(P<0.05);观察组患者治疗期间的不良反应总发生率为10.87%,略低于对照组的15.22%,但差异无统计学意义(P>0.05)。结论采用生脉饮合升陷汤加减治疗CHF能更有效改善患者的左心功能,下调血清Gal-3蛋白、AngⅡ水平,临床应Objective To explore the clinical efficacy of Shengmai Yin combined with modified Shengxian Decoction in the treatment of chronic heart failure(CHF)based on left ventricular function,serum galectin-3(Gal-3)protein,and angiotensinⅡ(AngⅡ)levels.Methods A total of 92 patients with CHF received by Puyang Traditional Chinese Medicine Hospital from June 2020 to June 2022 were selected and randomly divided into a control group and an observation group,each with 46 cases.The patients in the control group were treated with conventional western medicine,while the patients in the observation group were treated with Shengmai Yin combined with modified Shengxian Decoction and conventional western medicine,both for 3 months.After the treatment,the therapeutic effects of the two groups of patients were compared,as well as the left ventricular function,plasma NT-proBNP level,serum Gal-3 protein,AngⅡlevel,exercise tolerance[6-minute walk distance(6 MWD)],heart failure symptoms(Lee's heart failure score),and quality of life[Minnesota Living with Heart Failure Quality of Life Scale(MLHFQ)score]before treatment,at 1 month after treatment,and at 3 months after treatment.The adverse drug reactions during the treatment period were also statistically analyzed in both groups of patients.Results The total effective rate of treatment in the observation group was 93.48%,which was significantly higher than 78.26%in the control group(P<0.05).The left ventricular ejection fraction(LVEF)in the observation group at 1 month and 3 months after treatment was significantly higher than that in the control group,while the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and plasma NT-proBNP level were significantly lower than those in the control group,with statistically significant differences(P<0.05).The serum Gal-3 protein and AngⅡlevels in the observation group at 1 month and 3 months after treatment were significantly lower than those in the control group(P<0.05).At 1 month and 3 months after tr

关 键 词：慢性心力衰竭 生脉饮合升陷汤 左心功能 半乳糖凝集素-3蛋白 血管紧张素Ⅱ 疗效 

分 类 号：R541.6[医药卫生—心血管疾病]