基于补肾活血法探讨中药自拟方在急性心肌梗死后慢性心力衰竭治疗中对心功能改善的效果  

The improvement effect of traditional Chinese medicine in treating chronic heart failure after acute myocardial infarction based on self-formulated Bushen Huoxue formula

作　　者：李洁 董显峰 解晓青 朱栋栋 李焱 LI Jie;DONG Xianfeng;XIE Xiaoqing;ZHU Dongdong;LI Yan(Qingdao Hospital of Traditional Chinese Medicine,Qingdao 266000,Shandong,China;The Sixth People's Hospital of Qingdao,Qingdao 266000,Shandong,China)

机构地区：[1]青岛市中医医院,山东青岛266000 [2]青岛市第六人民医院,山东青岛266000

出　　处：《西部医学》2024年第8期1196-1201,共6页Medical Journal of West China

基　　金：国家自然科学基金项目(81804045);青岛市卫生健康委员会科研基金项目(20211715)。

摘　　要：目的分析补肾活血自拟方在急性心肌梗死(AMI)后慢性心力衰竭(CHF)治疗中对心功能的改善效果。方法选定青岛市中医医院2022年2月—2023年2月就诊的90例AMI后CHF患者进行回顾性研究,根据治疗方案的不同将其分为对照组和观察组,每组45例。对照组给予常规西药治疗,观察组在对照组基础上给予补肾活血自拟方治疗。比较两组临床疗效、中医证候积分、Lee氏心衰积分、6 min步行距离(6WMD)、心功能超声指标[每搏输出量(SV)、心输出量(CO)、左室射血分数(LVEF)]、心功能生化指标[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、不良反应总发生率。结果观察组临床总有效率高于对照组(P<0.05)。观察组治疗后胸闷胸痛、心悸气短、腰膝酸软、面浮肢肿积分均低于对照组(P<0.05)。观察组治疗后Lee氏心衰积分低于对照组(P<0.05),观察组治疗后6WMD高于对照组(P<0.05)。观察组治疗后SV、CO、LVEF均高于对照组(P<0.05)。观察组治疗后血清cTnI、sST2、NT-proBNP水平均低于对照组(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论补肾活血自拟方可有效缓解AMI后CHF患者胸闷、呼吸困难等症状,提高运动耐力及临床疗效,改善心功能,且治疗期间患者未出现严重不良反应,安全有效。Objective To analyze the improvement effect of Bushen Huoxue self-formulated formula on cardiac function in the treatment of chronic heart failure(CHF)after acute myocardial infarction(AMI).Methods A retrospective study was conducted on 90 patients with post-AMI CHF treated in Qingdao Hospital of Traditional Chinese Medicine from February 2022 to February 2023,and they were divided into 2 groups according to different treatment regiments,45 cases in each group.The control group was given conventional western medicine treatment,and the observation group was given self-designed prescription therapy to Bushen Huoxue self-formulated formula on the basis of the control group.The clinical efficacy,TCM syndrome score,Lee's heart failure score,6 were compared between the two groups min walking distance(6WMD),ultrasonic indexes of cardiac function[stroke output(SV),cardiac output(CO),left ventricular ejection fraction(LVEF)],biochemical indexes of cardiac function[cardiac troponin I(cTnI),soluble human stromal lysin 2(sST2),N-terminal B-type natriuretic peptide(NT-proBNP)],adverse reactions Total incidence.Results The total effective rate of observation group(95.56%)was higher than that of control group(68.89%)(P<0.05).The scores of chest tightness,chest pain,palpitation,shortness of breath,waist and knee soreness,floating face and swollen limbs in the observation group were lower than those in the control group after treatment(P<0.05).Lee's heart failure score in the observation group was lower than that in the control group(P<0.05),and 6WMD in the observation group was higher than that in the control group(P<0.05).SV,CO and LVEF in observation group were higher than those in control group after treatment(P<0.05).After treatment,the levels of cTnI,sST2 and NT-proBNP in the observation group were lower than those in the control group(P<0.05).The total incidence of adverse reactions in observation group(4.44%)was higher than that in control group(8.89%)(P>0.05).Conclusion Bushen Huoxue self-formulated formula can effective

关 键 词：补肾活血方 急性心肌梗死 慢性心力衰竭 临床疗效 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]