复脉益心方辅助治疗风湿性心脏瓣膜病患者的临床疗效及对其心功能、基质金属蛋白酶-9、N末端前体脑利钠肽水平的影响  

Therapeutic Effect of Fumai Yixin Formula on Rheumatic Heart Valve Disease and Its Impact on Heart Function,Matrix Metalloproteinase-9,and N-terminal Pro-brain Natriuretic Peptide Levels in Patients with Rheumatic Heart Valve Disease

作　　者：王静[1] 唐云[1] WANG Jing;TANG Yun(Hunan University of Traditional Chinese Medicine First Affiliated Hospital/National Center for Clinical Research of Traditional Chinese Medicine Cardiovascular Disease Branch Cardiology Department,Changsha Hunan 410000)

机构地区：[1]湖南中医药大学第一附属医院/国家中医心血管病临床医学研究中心分中心心内科,湖南长沙410000

出　　处：《世界中西医结合杂志》2024年第5期941-945,951,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：湖南省中医药科研计划项目(2021064)。

摘　　要：目的 探讨复脉益心方辅助治疗风湿性心脏瓣膜病患者的疗效及对其心功能、血清基质金属蛋白酶-9(Matrix metalloprotein-9,MMP-9)水平、N末端前体脑利钠肽(N-terminal precursor brain natriuretic peptide,NT-pro BNP)水平的影响。方法 选取2021年2月—2022年2月期间湖南中医药大学第一附属医院收治的风湿性心脏瓣膜病患者88例作为研究对象。采用随机数字表法将患者分为对照组和观察组,每组各44例。两组患者均接受二尖瓣置换术治疗,术后根据病情给予西医常规治疗,观察组术后在常规西医治疗基础上联合复脉益心方治疗。治疗4周后,观察比较两组患者临床疗效、安全性,治疗前后中医证候积分,MMP-9、NT-pro BNP水平、心功能指标(每分钟心输出量、每搏输出量、心脏指数、左心室射血分数)、生活质量评分(社会限制、体力限制、症状、情绪)变化情况。结果 治疗后两组患者心悸、疲乏、气短、盗汗或自汗、心烦、失眠多梦评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组心悸、疲乏、气短、盗汗或自汗、心烦、失眠多梦评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清MMP-9和NT-pro BNP水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组血清MMP-9和NT-pro BNP水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者每分钟心输出量、每搏输出量、心脏指数及左心室射血分数指标均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组每分钟心输出量、每搏输出量、心脏指数及左心室射血分数指标均高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者社会限制、体力限制、症状及情绪评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组社会限制、体力限制、症状及情绪评分均低于对照组,差异有统计学意义(P<0.05)。治疗后Objective To explore the therapeutic effect of Fumai Yixin Formula in the adjuvant treatment of rheumatic heart valve disease and its effects on patient heart function,serum matrix metalloproteinase-9(MMP-9)levels,and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels.Methods A total of 88 patients with rheumatic heart valve disease admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from February2021 to February 2022 were selected as the research subjects.The patients were divided into a control group and an observation group using a random number table method,with 44 cases in each group.Both groups of patients underwent mitral valve replacement surgery,receiving routine Western medicine treatment based on their condition after surgery.The observation group received a combination of Fumai Yixin Formula and conventional Western medicine treatment for 4 weeks after surgery.Changes in the traditional Chinese medicine syndrome scores,MMP-9,NT-proBNP levels,the cardiac function indicators(minute cardiac output,stroke output,heart index,left ventricular ejection fraction),and the quality of life scores(social and physical limitations,symptoms,emotions)between two groups of patients after 4 weeks of treatment were observed and compared.Clinical efficacy after 4 weeks of treatment and the safety of the treatment plans for both groups of patients was evaluated.Results After treatment,the scores of palpitations,fatigue,shortness of breath,night or spontaneous sweating,restlessness,insomnia,and multiple dreams in both groups of patients were decreased compared to before treatment,and the difference was statistically significant(P<0.05);the scores of the observation group was lower than those of the control group,with a statistically significant difference(P<0.05).The serum levels of MMP-9 and NT-proBNP in both groups of patients were reduced compared to before treatment,and the difference was statistically significant(P<0.05);the observation group was significantly lower tha

关 键 词：风湿性心脏瓣膜病 复脉益心方 二尖瓣置换术 基质金属蛋白酶-9 N末端前体脑利钠肽 心功能 生活质量 

分 类 号：R541.2[医药卫生—心血管疾病]