苓桂气化方治疗射血分数保留的心力衰竭早期的临床研究  

Clinical Study on Linggui Qihua Prescription in the Treatment of Early Heart Failure with Preserved Ejection Fraction

作　　者：刘春秋 李知轩 石玉姣 乔文博 杨晨光 刘思雨 刘永成 董国菊[1] LIU Chunqiu;LI Zhixuan;SHI Yujiao;QIAO Wenbo;YANG Chenguang;LIU Siyu;LIU Yongcheng;DONG Guoju(Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School of China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]中国中医科学院研究生院,北京100700

出　　处：《中国中医药信息杂志》2024年第5期151-156,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金(82074423);中国中医科学院科技创新工程项目(CI2021A00903)。

摘　　要：目的评价苓桂气化方对射血分数保留的心力衰竭(HFpEF)早期气化不利证见水饮内停患者运动耐量及心脏舒张功能的影响。方法采用随机数字表法将60例患者随机分为对照组和试验组各30例。对照组予西医常规治疗,试验组在此基础上予苓桂气化方颗粒,每次1袋,每日2次,口服。2组均治疗4周。比较2组治疗前后6min步行试验(6MWT)距离、堪萨斯城心肌病问卷(KCCQ)评分、中医症状积分、氨基末端脑钠肽前体(NT-proBNP)、运动负荷下左室舒张末期内径(LVEDD)、左心房内径(LAD)、室间隔厚度(IVST)、左室舒张早期充盈速度峰值(E)和心房收缩期左心室充盈速度峰值(A)。监测2组患者安全性指标。结果与本组治疗前比较,2组治疗后6MWT距离、KCCQ评分、中医症状积分及E、A值均明显改善(P<0.01),NT-proBNP、LVEDD、LAD、IVST差异无统计学意义(P>0.05)。2组治疗后比较,试验组6MWT距离、KCCQ评分、中医症状积分及E、A值均优于对照组(P<0.05,P<0.01),2组NT-proBNP、LVEDD、LAD、IVST差异均无统计学意义(P>0.05)。研究期间,2组均未发生不良反应及不良事件。结论苓桂气化方可改善HFpEF早期气化不利证见水饮内停患者的运动耐量和心脏舒张功能,抑制HFpEF早期心脏重构,延缓HFpEF发展进程。Objective To evaluate the effects of Linggui Qihua Prescription on exercise tolerance and cardiac diastolic function in patients of early heart failure with preserved ejection fraction(HFpEF)who have unfavorable qi circulation and fluid retention.Methods Totally 60 patients were divided into control group and experimental group using a random number table method,with 30 patients in each group.The control group was given routine Western medicine treatment,while the experimental group was given Linggui Qihua Prescription,one bag each time,orally twice a day.Both groups were treated for 4 weeks.The six-minute walk test(6MWT)distance,Kansas city cardiomyopathy questionnaire(KCCQ)score,TCM symptom score,N-terminal pro-B type natriuretic peptide(NT-proBNP)of both groups were compared before and after treatment,and left ventricular end diastolic diameter(LVEDD),left atrial internal diameter(LAD),interventricular septal thickness(IVST),left ventricular early diastolic filling peak velocity(E),and atrial systolic left ventricular filling peak velocity(A)were detected under exercise load.Patients in both groups were monitored for safety indicators.Results Compared with before treatment,patients in both groups showed significant improvements in 6MWT distance,KCCQ score,TCM symptom score,E and A values after treatment(P<0.01),while there was no statistical significance in NT-proBNP,LVEDD,LAD and IVST(P>0.05).After treatment,the 6MWT distance,KCCQ score,TCM symptom score,E and A values of the experimental group were better than those of the control group(P<0.05,P<0.01).There was no statistical significance in NT-proBNP,LVEDD,LAD and IVST between the two groups(P>0.05).During the study period,neither group experienced any adverse reactions or events.Conclusion Linggui Qihua Prescription can improve the exercise tolerance and cardiac diastolic function of patients with early HFpEF who have unfavorable qi circulation and fluid retention,inhibit early cardiac remodeling of HFpEF,and delay the development process of HFpEF.

关 键 词：射血分数保留的心力衰竭 苓桂气化方 心脏舒张功能 随机对照试验 

分 类 号：R259.416.1[医药卫生—中西医结合]