加味来复汤对慢性心力衰竭急性加重期血清H-FABP、cTnI及NT-proBNP表达的影响  

Effects of Modified Laifu Decoction on Serum H-FABP,cTn I,and NT-proBNP Expression in Patients with Acute Exacerbation of Chronic Heart Failure

作　　者：李想 李妍 岳宝霞 Li Xiang;Li Yan;Yue Baoxia(Qingdao Eighth People's Hospital,Qingdao,Shandong 266000,China)

机构地区：[1]山东省青岛市第八人民医院,山东青岛266000

出　　处：《中国中医急症》2024年第6期1034-1038,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：山东省中医药科技项目(M-2023191T)。

摘　　要：目的观察加味来复汤联合常规疗法治疗慢性心力衰竭(CHF)急性加重期的临床疗效。方法将100例患者随机分为两组各50例。对照组采用西医综合治疗措施,观察组在对照组的基础上采用加味来复汤辨证内服,每天1剂,连续治疗4周。比较治疗前后超声心动图参数;检测治疗前后心肌损伤生物标志物水平;进行治疗前后6分钟步行距离(6MWT)、阳虚血瘀证积分、NYHA心功能分级和静息心率评估;进行治疗前后Memorial心力衰竭症状评估量表(MSAS-HF)和明尼苏达心衰生活质量量表(MLHFQ)评估;比较治疗后疾病总有效率。结果治疗后,两组患者超声心动图参数[左室射血分数(LVEF)、每搏心搏量(SV)、每分钟心排血量(CO)和心脏指数(CI)]均升高(P<0.05),且观察组高于对照组(P<0.05);治疗后,两组患者N末端B型利钠肽原(NT-proBNP),采用酶联免疫吸附剂测定心脏肌钙蛋白I(c TnI)、心型脂肪酸结合蛋白(H-FABP)和半乳糖凝集素-3(GAL-3)水平下降(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组患者MSAS-HF量表各个维度评分和总分降低(P<0.05),两组患者MLHFQ量表各个维度评分和总分降低(P<0.05),两组患者阳虚血瘀证各主要症状和总积分降低,且观察组以上各指标均低于对照组(P<0.05)。治疗后两组6MWT增加(P<0.05),静息心率减少(P<0.05),且均以观察组为显著(P<0.05)。观察组总有效率明显高于对照组(P<0.05)。结论加味来复汤联合常规疗法治疗CHF急性加重期患者,可保护心肌损伤,减轻心衰相关临床症状、体征及中医证候,改善心功能,提高患者的生活质量和运动耐力,临床疗效优于西医常规治疗效果。Objective:To evaluate the clinical efficacy of modified Laifu Decoction combined with conventional therapy in the treatment of acute exacerbation of chronic heart failure(CHF).Methods:Totally 100 patients were randomly divided into the control group and observation group,with 50 cases in each group.The control group received comprehensive treatment with western medicine,while the observation group was given modified Laifu Decoction on the basis of the control group,one dose/day,and continuously for four weeks.Echocardiographic parameters(LVEF,SV,CO and CI)were compared before and after treatment;myocardial injury biomarkers(NT-proBNP,cTnl,H-FABP and GAL-3)levels were measured before and after treatment;6-minute walk test distance(6 MWT),yang deficiency and blood stasis syndrome,NYHA functional classification and resting heart rate were assessed before and after treatment;MSAS-HF and MLHFQ were assessed before and after treatment;and the overall response rate was compared after treatment.Results:After treatment,echocardiographic parameters(LVEF,SV,CO and CI)increased in both groups(P<0.05),and the observation group was higher than the control group(P<0.05);after treatment,NT-proBNP,cTnl,H-FABP and GAL-3 levels decreased in both groups(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the scores of all dimensions and total score of MSAS-HF scale decreased in the two groups(P<0.05),the scores of all dimensions and total score of MLHFQ scale decreased in the two groups(P<0.05),the main symptoms and total scores of yang deficiency and blood stasis syndrome decreased in the two groups,and the above indicators in the observation group were lower than those in the control group(P<0.05).After treatment,6 MWT increased(P<0.05)and resting heart rate decreased in both groups(P<0.05),and were observed to be significant(P<0.05).The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:The combination of modified Laifu De

关 键 词：慢性心力衰竭 急性加重期 加味来复汤 阳虚血瘀证 生活质量 心肌损伤生物标志物 

分 类 号：R541.61[医药卫生—心血管疾病]