参芪益心汤治疗心力衰竭合并利尿剂抵抗患者的临床疗效及对其心功能、NT-proBNP水平的影响  

Effects of Shenqi Yixin Decoction on Cardiac Function and NT-proBNP Level in Patients with Heart Failure Combined with Diuretic Resistance

作　　者：王琪[1] 吴限[1] 刘丰[1] 苗永悦 孙少谦 刘莉[1] WANG Qi;WU Xian;LIU Feng;MIAO Yong-yue;SUN Shao-qian;LIU Li(Department of Cardiovascular Medicine,The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin Heilongjiang 150040)

机构地区：[1]黑龙江中医药大学附属第一医院心血管内科,黑龙江哈尔滨150040

出　　处：《世界中西医结合杂志》2024年第5期971-974,981,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号);黑龙江省中医药管理局课题(ZHY2023-183)。

摘　　要：目的 探讨参芪益心汤加减治疗心力衰竭合并利尿剂抵抗患者的疗效。方法 选取2021年12月—2022年12月期间黑龙江中医药大学附属第一医院收治的心力衰竭合并利尿剂抵抗患者100例作为研究对象,按照随机数字表法分为对照组和试验组,每组各50例。对照组予常规治疗,试验组在对照组基础上加用参芪益心汤,两周为1个疗程,两组患者均治疗4周。观察比较两组患者治疗前后心功能指标[左心室舒张末期内径(Left ventricular end-diastolic diameter,LVDD)、左房内径(Left atrial diameter,LAD),计算左室射血分数(Left ventricular ejection fraction,LVEF)]、血清指标[N端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、肌钙蛋白T(Cardiac troponin T,CTnT)、肌酸磷化脢同功脢(Creatine kinase isoenzyme,Ck-MB)]、中医证候积分,比较两组患者临床疗效及不良反应。结果 治疗后两组患者心功能LVDD、LAD水平均较治疗前降低,LVEF水平均较治疗前升高,差异有统计学意义(P<0.05);且试验组LVDD、LAD水平均明显低于对照组,LVEF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NT-proBNP、CTnT、Ck-MB水平均较治疗前降低,差异有统计学意义(P<0.05);且试验组NT-proBNP、CTnT、Ck-MB水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者心悸、气短、气喘、胸闷评分均较治疗前降低,差异有统计学意义(P>0.05);且试验组心悸、气短、气喘、胸闷评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后试验组总有效率96.00%(48/50)高于对照组72.00%(36/50),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 应用参芪益心汤能够显著改善心功能,缓解临床症状,疗效显著,值得临床应用。Objective To investigate the therapeutic effect of modified Shenqi Yixin Decoction in patients with heart failure combined with diuretic resistance.Methods A total of 100 patients with heart failure combined with diuretic resistance admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2021 to December 2022 were selected as the study objects and were divided into control group and experimental group according to random number table method,with 50 cases in each group.The control group was given conventional treatment,and the experimental group was given Shenqi Yixin Decoction based on the control group.Both groups were treated for 4 weeks with two weeks as a course of treatment.Compare two groups before and after treatment in patients with cardiac function index,left ventricular end-diastolic diameter(LVDD),and left atrial diameter(LAD).Left ventricular ejection fraction(LVEF),serum indicators[N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin T(CTnT),creatine phosphate(creatine)kinase isoenzyme(Ck-MB)],and TCM syndrome score were calculated.In addition,the clinical efficacy and adverse reactions of the two groups were compared.Results After treatment,LVDD and LAD levels of cardiac function in both groups were lower than before treatment,and LVEF levels were higher than before treatment,with statistical significance(P<0.05).LVDD and LAD levels in experimental groups were lower than those in the control group,and the LVEF level was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of NT-proBNP,CTnT,and Ck-MB in both groups were lower than before treatment,the difference was statistically significant(P<0.05).The experimental group was lower than the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of palpitation,shortness of breath,asthma,and chest tightness in both groups were lower than before treatment,with statistical significanc

关 键 词：心力衰竭 利尿剂抵抗 参芪益心汤 中医证候积分 

分 类 号：R541[医药卫生—心血管疾病]