增免扶正方联合沙库巴曲缬沙坦片治疗慢性心力衰竭气血两虚证临床研究  

Effect of ZengmianFuzhengFormula combined with sacubitril/valsartan on chronic heart failure of deficiency of Qi and blood

作　　者：庞可心 韦红艳 刘艳梅 韩红军 PANG Kexin;WEI Hongyan;LIU Yanmei;HAN Hongjun(Department of Emergency,Fuyang Traditional Chinese Medicine Hospital,Fuyang,Anhui 236000;Department of Neurology,Fuyang Traditional Chinese Medicine Hospital,Fuyang,Anhui 236000;Department of Cardiovascular Medicine,Fuyang Traditional Chinese Medicine Hospital,Fuyang,Anhui 236000;Department of Orthopedics,China Railway Fuyang Hospital,Fuyang,Anhui 236000)

机构地区：[1]安徽省阜阳市中医医院急诊科,安徽阜阳236000 [2]安徽省阜阳市中医医院神经内科,安徽阜阳236000 [3]安徽省阜阳市中医医院心血管内科,安徽阜阳236000 [4]中铁阜阳医院骨科,安徽阜阳236000

出　　处：《河北中医》2024年第4期552-557,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：阜阳市卫生健康委员会科研课题(编号:FY2019-077)。

摘　　要：目的观察增免扶正方联合沙库巴曲缬沙坦片治疗慢性心力衰竭(CHF)气血两虚证的临床疗效。方法选择2018年12月至2022年6月收治的100例CHF气血两虚证患者作为研究对象,按照随机数字表法分为2组,对照组50例予沙库巴曲缬沙坦片治疗,治疗50例予增免扶正方联合沙库巴曲缬沙坦片治疗。2组均治疗8周后统计疗效,比较2组治疗前后中医症状(包括心悸、气短、神疲乏力、胸闷胸痛、面色无华、自汗、眩晕、耳鸣及水肿)评分、左心室重构指标[包括左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及左心室射血分数(LVEF)]及实验室指标[包括血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、N末端B型利钠肽原(NT-proBNP)及前白蛋白(PA)]水平变化情况,观察2组治疗期间不良反应发生情况。结果治疗组总有效率90.00%(45/50),对照组总有效率72.00%(36/50),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状心悸、气短、神疲乏力、胸闷胸痛、面色无华、自汗、眩晕、耳鸣及水肿评分均降低(P<0.05),且治疗组治疗后中医症状各项评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后左心室重构指标LVEDD及LVESD均减小(P<0.05),LVEF均升高(P<0.05),且治疗组治疗后LVEDD及LVESD均小于对照组(P<0.05),LVEF高于对照组(P<0.05)。与本组治疗前比较,2组治疗后实验室指标PLR、NLR及NT-proBNP水平均降低(P<0.05),PA水平均升高(P<0.05),且治疗组治疗后PLR、NLR及NT-proBNP水平均低于对照组(P<0.05),PA水平高于对照组(P<0.05)。治疗组不良反应总发生率4.00%(2/50),对照组不良反应总发生率6.00%(3/50),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论增免扶正方联合沙库巴曲缬沙坦片治疗CHF气血两虚证临床疗效确切,可进一步促进患者中医症状缓解,降低NLR及PLR水平,下调血清NT-proBNP�Objective To observe the clinical efficacy of Zengmian Fuzheng Formula combined with sacubitril/valsartan on chronic heart failure(CHF)of deficiency of Qi and blood.Methods A total of 100 CHF patients(deficiency of Qi and blood)admitted to our hospital from December 2018 to June 2022 were selected as the research objects,and they were randomly assigned to the control group(sacubitril/valsartan,n=50)or observation group(ZengmianFuzhengFormula plus sacubitril/valsartan,n=50).After 8 weeks of treatment,the traditional Chinese medicine(TCM)symptoms scores(including palpitation,shortness of breath,fatigue,chest tightness,chest pain,pale complexion,spontaneous sweating,vertigo,tinnitus and edema),left ventricular remodeling indexes(LVRI)(including left ventricular end-diastolic diameter[LVEDD],left ventricular end-systolic diameter[LVESD]and left ventricular ejection fraction[LVEF])and laboratory indexes(including platelet-to-lymphocyte ratio[PLR],neutrophil-to-lymphocyte ratio[NLR],N-terminal B-type natriuretic peptide[NT-proBNP]and prealbumin[PA])were included as comparators between groups before and after treatment.Theadverse reactions during treatment was observed between groups.Results The total effective rate in observation group was significantly higher than that of control group(90.00%[45/50]vs 72.00%[36/50],P<0.05).After treatment,the dimension score and total score of TCM symptoms scores in the two groups were significantly lower than those before treatment(P<0.05),especially in the observation group(P<0.05).After treatment,LVEDD and LVESD were significantly reduced(P<0.05),while LVEF were significantly increased(P<0.05),and the improvement was more significant in the observation group(P<0.05).After treatment,the levels of PLR,NLR and serum NT-proBNP in the peripheral blood of the two groups were significantly lower than those before treatment(P<0.05),but the level of serum PA was significantly higher(P<0.05),and the improvements were more significant in the observation group(P<0.05).The incidence of adverse

关 键 词：慢性心力衰竭 气血两虚证 中西医结合疗法 

分 类 号：R541.61[医药卫生—心血管疾病]