破格救心汤加减对心力衰竭合并室性心律失常患者生物标志物和近期不良心血管事件的影响  

Effect of Modified Poge Jiuxin Decoction on Biomarkers of Ventricular Arrhythmia and Recent Adverse Cardiovascular Events in Patients with Heart Failure

作　　者：刘红臻[1] 朱粮[1] 周波[1] Liu Hongzhen;Zhu Liang;Zhou Bo(Qingdao Eighth People′s Hospital,Shandong Qingdao 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7期1208-1212,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：山东省中医药科技项目(2020Z66)。

摘　　要：目的评价破格救心汤加减对心力衰竭合并室性心律失常患者生物标志物和近期不良心血管事件的影响。方法将88例心力衰竭合并室性心律失常患者随机分为对照组与观察组各44例。对照组进行抗心衰治疗,并口服美托洛尔缓释片和盐酸胺碘酮胶囊。观察组在对照组治疗的基础上口服破格救心汤加减治疗。比较治疗前后左室射血分数(LVEF)、每搏心输出量(SV)、左心室收缩末期内径(LVESD)、正常窦性心搏间期标准差(SDNN)、校正TP-Te间期(TP-Tec)每5分钟窦性心搏间期平均值的标准差(SDANN)、校正QT间期(QTc)和正常相邻R-R间期差值>50ms的百分比(Pnn50%);检测N末端B型利钠肽原(NT-proBNP)、生长分化因子15(GDF-15)可溶性肿瘤生成抑制因子-2(sST-2)和半乳糖凝集素-3(GAL-3)水平;记录近期不良心血管事件;进行治疗前后阳气亏虚血瘀证评分;比较心功能疗效和室性心律失常疗效。结果治疗后,观察组心功能疗效和室性心律失常疗效的总有效率均高于对照组(P<0.05);两组患者LVEF、SV升高,LVESD降低(P<0.05),均以观察组更明显(P<0.05);两组患者NT-proBNP、GAL-3、GDF-15和sST2水平下降(P<0.05),且观察组低于对照组(P<0.05);两组患者主要症状评分及阳气亏虚血瘀证总积分降低(P<0.05),且观察组低于对照组(P<0.05);两组患者QTc、TP-Tec减少,SDNN、SDANN和Pnn50%增加(P<0.05),且观察组改善明显(P<0.05)。观察组近期不良心血管事件累积发生率低于对照组(P<0.05)。结论破格救心汤加减方联合西医常规疗法治疗心力衰竭合并室性心律失常,能够抑制心室重构,提高心功能,减少不良心血管事件发生,临床疗效优于单纯的西医治疗。Objective:To evaluate the effect of Modified Poge Jiuxin Decoction on biomarkers of ventricular ar⁃rhythmia and short-term adverse cardiovascular events in patients with heart failure.Methods:88 patients with heart failure complicated with ventricular arrhythmia were randomly divided into the control group and observation group,44 cases for each group.In the control group,anti-heart failure treatment was performed,and metoprolol sustained-release tablets and amiodarone hydrochloride capsules were orally administered.In the observation group,on the basis of the treatment in the control group,Poge Jiuxin Decoction was orally administered.The LVEF,SV,LVESD,QTc,TP-Tec,SDNN,SDANN and Pnn50%were compared before and after treatment;NTproBNP,GDF-15,sST-2 and GAL-3 levels were measured;short-term adverse cardiovascular events were record⁃ed;Yang Qi deficiency and blood stasis syndrome scores were performed before and after treatment;and cardiac function efficacy and ventricular arrhythmia efficacy were compared.Results:After treatment,the total effective rates of cardiac function and ventricular arrhythmia in the observation group were higher than those in the control group(P<0.05).After treatment,LVEF and SV increased and LVESD decreased in both groups(P<0.05),espe⁃cially in the observation group(P<0.05).After treatment,NT-proBNP,GAL-3,GDF-15 and sST2 levels de⁃creased in both groups(P<0.05),and were lower in the observation group than in the control group(P<0.05).Af⁃ter treatment,the main symptom score and the total score of Yang Qi deficiency and blood stasis syndrome de⁃creased in the two groups(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,QTc and TP-Tec decreased,SDNN,SDANN and Pnn50% increased in both groups(P < 0.05),and weresignificant in the observation group(P < 0.05). The cumulative incidence of recent adverse cardiovascular eventsin the observation group was lower than that in the control group(P < 0.05). Conclusion:Modified Poge Jiuxin De⁃coction com

关 键 词：心力衰竭 室性心律失常 阳气亏虚血瘀证 破格救心汤 心室重构 不良心血管事件 

分 类 号：R541.7[医药卫生—心血管疾病]