扶阳通络法联合常规西医疗法治疗冠状动脉粥样硬化性心脏病心力衰竭老年患者的疗效  

Efficacy of Fuyang Tongluo therapy combined with conventional western medicine in elderly patients with coronary heart disease and heart failure

作　　者：柴松波 杜亚康 张淑娟[2] 兀江波 王晓飞 CHAI Songbo;DU Yakang;ZHANG Shujuan;WU Jiangbo;WANG Xiaofei(Department of Cardiology,Sanmenxia Traditional Chinese Medicine Hospital,Sanmenxia 472000,China;Department of Cardiology,Henan Provincial Hospital of TCM,Zhengzhou 450002,China;Pharmacy Department,Sanmenxia Traditional Chinese Medicine Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中医院心病科,河南三门峡472000 [2]河南省中医院心病科,郑州450002 [3]三门峡市中医院药剂科,河南三门峡472000

出　　处：《中国医科大学学报》2024年第6期531-535,共5页Journal of China Medical University

基　　金：河南省中医药拔尖人才培养项目专项课题(2022ZYBJ29);河南省自然科学基金(212300410169)。

摘　　要：目的探讨扶阳通络法联合常规西医疗法治疗冠状动脉粥样硬化性心脏病(简称冠心病)心力衰竭(简称心衰)老年患者的疗效。方法本研究为单盲随机对照研究,将96例老年冠心病心衰患者分为3组,每组32例。对照A组予以常规西医治疗(阿托伐他汀联合美托洛尔),对照B组予以扶阳通络法治疗,观察组予以扶阳通络法联合常规西医治疗。比较3组的疗效、中医证候积分以及治疗前后血白细胞介素(IL)-23、IL-17、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)。结果观察组临床总有效率为93.75%,高于对照A组(68.75%)和对照B组(65.63%)(P<0.05)。治疗4和8周后,观察组中医证候主症积分、次症积分、总积分以及LVESD、LVEDD、IL-23、IL-17均低于对照A组和对照B组(P<0.05)。结论扶阳通络法与常规西医疗法联合治疗老年冠心病心衰患者疗效良好,可抑制IL-23/IL-17炎症轴因子过量表达,促进心脏功能恢复。Objective To explore the therapeutic efficacy of the Fuyang Tongluo therapy combined with conventional western medicine in elderly patients with heart failure due to coronary heart disease.Methods In this single-blind randomized controlled trial,96 elderly patients with coronary heart disease and heart failure were randomly divided into three groups,each consisting of 32 individuals.Control group A was treated with conventional western medicine(atorvastatin combined with metoprolol),control group B with Fuyang Tongluo therapy,and the observation group with Fuyang Tongluo therapy and conventional western medicine.The three groups were compared in terms of therapeutic efficacy and traditional Chinese medicine symptom points as well as blood interleukin(IL)-23 and IL-17 levels,left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)values before and after treatment.Results The total clinical efficacy rate in the observation group was 93.75%,which was significantly higher than those in control groups A(68.75%)and B(65.63%)(P<0.05).After 4 and 8 weeks of treatment,the primary and minor symptom scores,total symptom scores,LVESD,LVEDD,and IL-23 and IL-17 levels in the observation group were significantly lower than those in control groups A and B(P<0.05).Conclusion The combination of the Fuyang Tongluo therapy with conventional western medicine exhibited good therapeutic efficacy in elderly patients with coronary heart disease and heart failure.These effects were achieved by inhibiting excessive expression of the inflammatory axis factors IL-23 and IL-17 and promoting the recovery of cardiac function.

关 键 词：扶阳通络法 冠状动脉粥样硬化性心脏病 老年患者 心力衰竭 炎症轴 

分 类 号：R541.4[医药卫生—心血管疾病]