真武汤联合补心气方加味治疗心肾阳虚型慢性心力衰竭患者的疗效及对其氧化应激反应、血管内皮功能的影响  

Efficacy of Zhenwu Decoction Combined with Modified Buxinqi Prescription in Treatment of Patients with Chronic Heart Failure of Heart and Kidney Yang Deficiency and Its Effects on Oxidative Stress and Vascular Endothelial Functions

作　　者：刘薇 李凤娥 苏萍 徐雪梅 LIU Wei;LI Feng-e;SU Ping;XU Xue-mei(Cardiovascular Department II,Tangshan Hospital of Traditional Chinese Medicine,Tangshan Hebei 063000)

机构地区：[1]唐山市中医医院心血管二科,河北唐山063000

出　　处：《世界中西医结合杂志》2024年第6期1238-1242,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2022286)。

摘　　要：目的观察真武汤联合补心气方加味治疗心肾阳虚型慢性心力衰竭(Chronic heart failure,CHF)患者的临床疗效及对其氧化应激反应、血管内皮功能的影响。方法选取2020年5月—2022年5月期间唐山市中医医院心血管二科收治的CHF患者110例作为研究对象,按随机数字表法分为对照组和观察组,每组各55例。对照组予以常规对症治疗,观察组在对照组基础上予以真武汤合补心气方加味治疗。两组患者均以4周为1个疗程,治疗3个疗程。观察比较两组患者临床疗效,治疗前后中医证候积分、心功能[左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末期内径(Left ventricular end-diastolic diameter,LVEDD)及每搏输出量(Stroke volume,SV)]、氧化应激反应[血清超氧化物歧化酶(Superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-Px)、丙二醛(Malondialdehyde,MDA)]、血管内皮功能[血清内皮素-1(Eendothelin-1,ET-1)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)、一氧化氮(Nitric oxide,NO)]水平。结果治疗后观察组总有效率92.73%(51/55)明显高于对照组77.36%(41/53),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者心功能LVEF、SV水平均较治疗前升高,LVEDD水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组LVEF、SV水平明显高于对照组,LVEDD水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清SOD、GSH-Px水平均较治疗前升高,血清MDA水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组血清SOD、GSH-Px水平明显高于对照组,血清MDA水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清ET-1、NO水平均较治疗前降低,血清VEGF水平均较治疗前Objective To investigate the clinical effects of Zhenwu Decoction combined with modified Buxinqi Prescription on patients with chronic heart failure(CHF)of heart and kidney Yang deficiency and its effects on oxidative stress and vascular endothelial functions.Methods A total of 110 patients with CHF admitted to Cardiovascular Department Ⅱ,Tangshan Hospital of Traditional Chinese Medicine from May 2020 to May 2022 were studied and divided into a control group and an observation group by random number table method,with 55 patients in each group.The control group was treated with conventional symptomatic treatment,and the observation group was treated with Zhenwu Decoction combined with modified Buxinqi Prescription on the basis of the control group.Patients in both groups were treated with three courses,with four weeks as a course.The clinical effects of the two groups were observed and compared,as well as the traditional Chinese medicine(TCM)syndrome score before and after treatment,cardiac functions[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and stroke volume(SV)],oxidative stress reactions(serum superoxide dismutase(SOD)),glutathione peroxidase(GSH-Px),and malondialdehyde(MDA),and vascular endothelial functions[serum endothelin-1(ET-1),vascular endothelial growth factor(VEGF),and nitric oxide(NO)].Results After treatment,the total effective rate of the observation group was 92.73%(51/55),significantly higher than that of the control group of 77.36%(41/53),and the difference was statistically significant(P<0.05).The TCM syndrome score of the two groups decreased(P<0.05),and the TCM syndrome score of the observation group was lower than that of the control group(P<0.05).After treatment,LVEF and SV levels in both groups were higher,and LVEDD levels were lower(P<0.05).LVEF and SV levels in the observation group were significantly higher than those in the control group,and LVEDD levels were significantly lower than those in the control group(P<0.05).After treatment,the l

关 键 词：慢性心力衰竭 心肾阳虚证 真武汤合补心气方加味 心功能 血管内皮功能 氧化应激反应 

分 类 号：R541.6[医药卫生—心血管疾病]