补肺养心汤联合步行训练对慢性心力衰竭心肺气虚证心功能、心室重构的影响  

Effects of Bufei Yangxin Decoction(补肺养心汤)Combined with Walking Training on Cardiac Function and Ventricular Remodeling in Patients with Heart-Lung Qi Deficiency Syndrome of Chronic Heart Failure

作　　者：李莉英 祁珩 杨见青 严寒 郭仙 LI Liying;QI Heng;YANG Jianqing;YAN Han;GUO Xian(The First Hospital of Changsha,Changsha 410005,Hunan,China)

机构地区：[1]长沙市第一医院,湖南长沙410005

出　　处：《中华中医药学刊》2024年第7期206-210,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：湖南省卫生健康委员会计划项目(202109021008)。

摘　　要：目的探讨补肺养心汤联合步行训练对慢性心力衰竭心肺气虚证患者心功能、心室重构的影响。方法选取100例慢性心力衰竭心肺气虚证患者,采用数字表格法随机分为对照组与观察组各50例,两组常规西药规范治疗,对照组同时开展步行训练治疗,观察组同时给予补肺养心汤口服联合步行训练治疗,疗程12周,观察治疗前后中医证候积分、心功能及心室重构指标变化。结果两组患者治疗前主症及次症积分比较差异无统计学意义(P>0.05),治疗后积分下降,且观察组下降程度大于对照组,差异均有统计学意义(P<0.05);两组患者治疗前左心室舒张末期内径(Left ventricular end diastolic diameter, LVEDD)、左心室收缩末期内径(Left ventricular end systolic diameter, LVESD)、左室射血分数(Left ventricular ejection fraction, LVEF)、左室后壁厚度(Left ventricle posterior wall, LVPW)及室间隔厚度(Interventricular septal thickness, IVS)、 6 min步行试验(6 minute walking test, 6MWT)比较差异无统计学意义(P>0.05),治疗后LVEDD、LVESD、LVPW、IVS下降,且观察组下降程度大于对照组,LVEF、6MWT升高,且观察组升高幅度大于对照组,差异均有统计学意义(P<0.05);两组患者治疗前N末端B型利钠肽原(N-terminal pro-brain natriuretic peptide, NT-proBNP)、一氧化氮(Nitric oxide, NO)、内皮素1(Endothelin-1,ET-1)、白细胞介素6(Interleukin-6,IL-6)水平比较差异无统计学意义(P>0.05),治疗后NT-proBNP、ET-1、IL-6下降,且观察组下降程度大于对照组,NO升高,且观察组升高幅度大于对照组,差异均有统计学意义;观察组治疗疗效优于对照组(P<0.05)。结论补肺养心汤联合步行训练治疗慢性心力衰竭心肺气虚证可有助于改善患者症状及心功能,抑制心室重构,其机制可能与降低炎性因子水平及调节血管内皮功能有关。Objective To discuss the effects of Bufei Yangxin Decoction(补肺养心汤)combined with walking training on cardiac function and ventricular remodeling in patients with heart-lung Qi deficiency syndrome of chronic heart failure.Methods A hundred patients with heart-lung Qi deficiency syndrome of chronic heart failure were selected and divided into control group and observation group with 50 cases in each group.The two groups were treated with conventional western medicine.The control group was treated with walking training at the same time,and the observation group was treated with Bufei Yangxin Decoction orally combined with walking training for 12 weeks.The changes of TCM syndrome scores,heart function and ventricular remodeling index were observed before and after treatment.Results There was no statistically significant difference in the scores of primary or secondary diseases between the two groups before treatment(P>0.05),and the scores of the two groups decreased after treatment,and the decline degree of the observation group was greater than that of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPW),ventricular septal thickness(IVS)or 6 min walking test(6MWT)between two groups before treatment(P>0.05).After treatment,the values of LVEDD,LVESD,LVPW and IVS decreased,and the decrease degree of LVEF and 6MWT increased in the observation group than that in the control group,and the increase degree of the observation group was greater than that of the control group with statistical significance(P<0.05).There was no significant difference in the levels of N terminal pro B type natriuretic peptide(NT-proBNP),nitric oxide(NO),endothelin-1(ET-1)and interleukin-6(IL-6)before treatment between the two groups(P>0.05).After treatment,the levels of NT-proBNP,ET-1 and IL-6 d

关 键 词：补肺养心汤 步行训练 慢性心力衰竭 心肺气虚证 心功能 心室重构 

分 类 号：R259.416[医药卫生—中西医结合]