耳穴贴压联合新四联疗法治疗心衰加重的疗效观察  

Observation on therapeutic effect of auricular acupoint therapy combined with new quadruple therapy on aggravated heart failure

作　　者：雷巧灵 李擎虎[2] LEI Qiaoling;LI Qinghu(Department of Cardiology,the Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410000,China;Department of Astroenterology,the Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410000,China)

机构地区：[1]湖南中医药大学第二附属医院心血管内科,长沙410000 [2]湖南中医药大学第二附属医院消化内科,长沙410000

出　　处：《新疆医科大学学报》2024年第6期895-900,共6页Journal of Xinjiang Medical University

基　　金：2022年度湖南省中医药科研计划项目(C2022031);2022年度湖南省自然科学基金项目(2022JJ30448)。

摘　　要：目的探讨耳穴贴压联合新四联疗法治疗心衰加重的疗效。方法采用随机数字表法将心衰加重患者120例分成对照组和试验组,各60例。对照组实施新四联疗法,试验组在对照组治疗基础上加用耳穴贴压,均治疗2周。比较两组六分钟步行试验(6 minutes walk test,6MWT)结果、运动峰摄氧量(Peak oxygen uptake,PVO2)、每搏耗氧量(Oxygen consumption/heart rate,VO2/HR)、正常窦性心搏RR间期标准差(Standard deviation of NN intervals,SDNN)、全程相邻窦性心搏RR间期差值均方根(Root mean square successive differences be-tween successive R-R intervals,RMSSD)、低频功率(Low frequencies,LF)、高频功率(High fre-quencies,HF)、氨基末端脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、肾素(Plasma renin activity,PRA)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)、醛固酮(Aldosterone,ALD)水平。结果试验组治疗总有效率为93.33%,高于对照组的80.00%(P<0.05)。与治疗前比较,治疗后2周,两组PVO2、VO2/HR、6MWT、SDNN、RMSSD、LF及HF均升高,且试验组高于对照组(P<0.05)。与治疗前比较,治疗后2周,两组NT-proBNP、PRA、AngⅡ及ALD均下降,且试验组低于对照组(P<0.05)。结论耳穴贴压联合新四联疗法可有效改善心衰加重患者运动耐量、心率变异性,调节神经激素,降低NT-proBNP水平,临床疗效优于单一新四联疗法。Objective To explore the effect of auricular point therapy combined with new quadruple therapy in the treatment of aggravated heart failure.Methods Using a random number table,120 patients with worsening heart failure were divided into control group and experimental group,with 60 patients in each group.The control group was administered a new quadruple therapy,while the experimental group re-ceived additional auricular acupoint plaster therapy.Both groups underwent treatment for 2 weeks.To compare the results of the 6-minute walk test(6MWT),peak oxygen uptake(PVO2),oxygen consump-tion per heart rate(VO2/HR),standard deviation of normal sinus RR intervals(SDNN),root mean square of successive differences of normal sinus RR intervals(RMSSD),low frequencies(LF),high fre-quencies(HF),levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),plasma renin activity(PRA),angiotensin II(Ang II)and aldosterone(ALD)between the 2 groups.Results The total effec-tive rate of treatment in the experimental group was 93.33%,which was higher than the 80.00%in the control group(P<0.05).Compared with before the treatment,after 2 weeks of the treatment,both groups showed an increase in PVO2,VO2/HR,6MWT,SDNN,RMSSD,LF and HF.Furthermore,the experimental group had higher values than control group(P<0.05).Compared with before the treat-ment,after 2 weeks of the treatment,both groups showed a decrease in NT-proBNP,PRA,Ang II and ALD levels,and the experimental group had lower levels than the control group(P<0.05).Conclusion Auricular acupoint plaster therapy combined with the new quadruple therapy can effectively improve exercise toler-ance,heart rate variability,regulate neurohormones and lower NT-proBNP levels in patients with worse-ning heart failure.Its clinical efficacy is superior to that of the new quadruple therapy alone.

关 键 词：耳穴贴压 新四联疗法 心衰加重 心率变异性 运动耐量 神经激素 

分 类 号：R24[医药卫生—中医临床基础]