益气养阴化瘀法治疗气阴两虚兼血瘀证中高危心房颤动的临床研究  

Benefiting Qi,Nourishing Yin and Dissolving Stasis for the Treatment of Medium-to-high Risk Atrial Fibrillation in Patients with Deficiency of Qi and Yin Concurrent Blood Stasis

作　　者：蔡欣玲 张书玉 赵廷尧 沈琳[2] 徐燕[1] CAI Xinling;ZHANG Shuyu;ZHAO Tingyao;SHEN Lin;XU Yan(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院,上海200021 [2]上海中医药大学附属龙华医院

出　　处：《中西医结合心脑血管病杂志》2024年第15期2735-2739,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：上海市卫生健康委员会上海市中医药管理局项目(No.SHGZS-202245);上海市科学技术委员会科研计划项目(No.19401971000);上海中医药大学附属曙光医院“四明青年基金”项目(No.SGKJ-202017)。

摘　　要：目的:观察益气养阴化瘀法治疗气阴两虚兼血瘀证中高危心房颤动的临床疗效及安全性,并探究其作用机制。方法:选取2019年7月—2020年1月6所医院心血管科收治的90例心房颤动病人,脱落6例,采用随机数字表按1∶2分为对照组(28例)和观察组(56例)。对照组给予西药基础治疗,观察组给予西药基础治疗联合益气养阴化瘀法的复脉安心方治疗,两组均治疗24周。比较两组治疗前、治疗第12周、治疗第24周的中医证候积分、血清脑卒中指标[促甲状腺激素(TSH)、胰岛素样生长因子1(IGF-1)]、炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)]和血栓形成因子[血管性血友病因子(vWF)、D-二聚体(D-D)、P-选择素(GMP-140)]以及相关安全性指标。结果:治疗第12周、第24周,观察组中医证候积分低于对照组(P<0.05),且观察组中医证候积分低于治疗前(P<0.05)。治疗第12周,观察组胸闷、盗汗评分低于对照组(P<0.05);治疗第24周,观察组胸闷、疲倦乏力、气短、盗汗评分低于治疗前(P<0.05)。治疗第24周,观察组TSH、IGF-1水平低于对照组(P<0.05),且观察组TSH、IGF-1水平低于对照组(P<0.05);治疗第24周,观察组血清hs-CRP、IL-6、vWF、D-D、GMP-140水平改善程度优于对照组(P<0.05)。两组治疗前后安全性指标比较,差异均无统计学意义(P>0.05)。结论:益气养阴化瘀法治疗气阴两虚兼血瘀证中高危心房颤动病人,可改善中医证候积分,改善心房颤动症状,其机制可能通过减少血栓形成和炎性因子水平而预防脑卒中事件的发生。Objective:To observe the clinical efficacy and safety of benefiting Qi,nourishing Yin and dissolving Stasis for the treatment of medium-to-high risk atrial fibrillation in patients with deficiency of Qi and Yin concurrent blood stasis.Methods:Ninety patients with atrial fibrillation were divided into the control group(28 cases)and the observation group(56 cases)by random number table according to 1∶2.The patients of control group were treated with basic western medicine treatment for 24 weeks,and the patients of observation group were treated with basic western medicine treatment combined with Fumai Anxin formula for 24 weeks.Traditional Chinese medicine syndrome scores,serum stroke indicators[thyrotropin(TSH),insulin-like growth factor 1(IGF-1)],inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)]thrombosis factors[von Willebrand factor(vWF)],D-dimer(D-D),P-selectin(GMP-140),and related safety indicators were compared between the two groups.Results:At the 12th week and 24th week of treatment,the traditional Chinese medicine syndrome score of the observation group was less than that before treatment(P<0.05),and the traditional Chinese medicine syndrome score of the observation group was less than that of the control group(P<0.05).At the 12th week of treatment,the scores of chest tightness and night sweat in the observation group were less than those in the control group(P<0.05).At the 24th week of treatment,the scores of chest tightness,fatigue,shortness of breath and night sweat in the observation group were less than those in the control group(P<0.05).At the 24th week of treatment,the levels of TSH and IGF-1 in the observation group were less than those in the control group(P<0.05).At the 24th week of treatment,the levels of hs-CRP,IL-6,vWF,D-D,and GMP-140 in the observation group were better than those in the control group(P<0.05).There was no significant difference in safety indexes between the two groups before and after treatment(P>0.05).Conclusion:Benefiting Qi,nourishing Y

关 键 词：心房颤动 气阴两虚血瘀证 益气养阴化瘀法 复脉安心方 炎性因子 脑卒中风险 

分 类 号：R259[医药卫生—中西医结合]