益气复脉注射液联合瓜蒌薤白半夏汤治疗气虚痰瘀型冠心病的效果及对左心室结构与功能及血清NT-proBNP的影响  

Efficacy of Yiqi Fumai Injection combined with Gualou Xiebai Banxia Decoction in the treatment of coronary heart disease of Qi-asthenia phlegm stagnant type and its influence on left ventricular structure and function,as well as serum NT-proBNP

作　　者：王卫国 石云霄 王慧玲 寇绍杰 WANG Wei-guo;SHI Yun-xiao;WANG Hui-ling;KOU Shao-jie(Department of Cardiology,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475001,Henan,CHINA;Department of Traditional Chinese Medicine Internal Medicine,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475001,Henan,CHINA;Department of Psychosomatic Medicine,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475001,Henan,CHINA)

机构地区：[1]开封市中医院心病科,河南开封475001 [2]开封市中医院中医内科,河南开封475001 [3]开封市中医院身心医学科,河南开封475001

出　　处：《海南医学》2024年第2期168-173,共6页Hainan Medical Journal

基　　金：2022年度河南省中医药科学研究专项课题(编号:2022ZY1187)。

摘　　要：目的 观察益气复脉注射液联合瓜蒌薤白半夏汤治疗气虚痰瘀型冠心病(CHD)的疗效,并探讨其对患者左心室结构与功能及血清N末端B型脑钠尿肽前体(NT-proBNP)的影响。方法 选取2021年4月至2022年5月开封市中医院收治的106例气虚痰瘀型CHD患者作为研究对象,按随机数表法分为对照A组35例、对照B组35例和联合组36例。三组患者均给予西医常规治疗,在此基础上,对照A组给予益气复脉注射液治疗,对照B组给予瓜蒌薤白半夏汤治疗,联合组给予益气复脉注射液联合瓜蒌薤白半夏汤治疗,疗程两周。治疗两周后比较三组患者的临床疗效,以及治疗前后的中医证候积分、心电图指标[心率变异性频域指标高频成分(HF)/低频成分(LF)比值、时域指标期间标准差(SDNN)、均值标准差(SDANN)、差值均方的平方差(RMSSD)]、左心室结构与功能[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)、E波与A波峰值速度(E/A)比值]和血清NT-proBNP水平,同时比较两组患者治疗期间的不良反应发生情况。结果 联合组患者的临床治疗总有效率为94.44%,明显高于对照A组的72.29%和对照B组的72.29%,差异均有统计学意义(P<0.05);三组患者治疗两周后的心悸、气短、胸痛积分较治疗前下降,且联合组患者的心悸、气短、胸痛积分分别为(1.02±0.16)分、(1.13±0.16)分、(0.83±0.13)分,均明显低于对照A组[(1.34±0.23)分、(1.46±0.22)分、(1.10±0.19)分]和对照B组[(1.31±0.20)分、(1.44±0.25)分、(1.08±0.21)分],差异均有统计学意义(P<0.05);治疗两周后,三组患者的HF/LF比值较治疗前下降,且联合组患者的HF/LF比值为1.03±0.22,明显低于对照A组的1.45±0.28和对照B组的1.48±0.31,而SDNN、SDANN、RMSSD、LVEF、E/A比值均较治疗前升高,且联合组患者分别为(118.79±13.51) ms、(106.68±15.13) ms、(45.48±10.47) ms、(47.38±3.26)%、1.18±0.15,明显高于对照A组[(109Objective To observe the efficacy of Yiqi Fumai Injection combined with Gualou Xiebai Banxia Decoction in the treatment of coronary heart disease(CHD)of Qi-asthenia phlegm stagnant type,and to explore its ef-fects on the structure and function of the left ventricle and serum N-terminal pro-brain natriuretic peptide(NT-proBNP).Methods A total of 106 patients with CHD of Qi-asthenia phlegm stagnant type admitted to Kaifeng Hospital of Tradi-tional Chinese Medicine from April 2021 to May 2022 were selected as the research objects.According to the random number table method,they were divided into three groups:control group A(n=35),control group B(n=35),and com-bined group(n=36).All the three groups were given conventional Western medical treatment.On this basis,the patients in the control group A were treated with Yiqi Fumai Injection,the patients in the control group B were treated with Gua-lou Xiebai Banxia Decoction,and the patients in the combined group were treated with Yiqi Fumai Injection combined with Gualou Xiebai Banxia Decoction,all for 2 weeks.After 2 weeks of treatment,the clinical efficacy was compared among the three groups of patients,as well as the TCM syndrome scores,electrocardiogram indicators[high-frequency component(HF)/low-frequency component(LF)ratio of frequency domain indicators of heart rate variability,standard deviation of normal to normal(SDNN),standard deviation of all normal to normal(SDANN),root mean square of suc-cessive differences(RMSSD)],left ventricular structure and function[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),E/A ratio of peak velocity],and serum NT-proBNP levels before and after treatment.The incidence of adverse reactions during treatment was compared between the two groups.Results The total clinical efficacy rate of patients in the combined group was 94.44%,which was significantly higher than 72.29%in the control group A and 72.29%in the control group B(P<0.05).After 2 weeks of

关 键 词：冠心病 气虚痰瘀型 益气复脉注射液 瓜蒌薤白半夏汤 心电图 左心室结构与功能 N末端B型脑钠尿肽前体 

分 类 号：R541.4[医药卫生—心血管疾病]