补土汤对冠心病慢性心衰患者心功能和能量代谢指标的影响  

Clinical effect of Butu Tang and its influence on energy metabolism in patients with coronary heart disease and chronic heart failure

作　　者：李艳君 刘呈祥 张久亮[3] 柳翼[3] LI Yan-jun;LIU Cheng-xiang;ZHANG Jiu-liang(Cardiology Department,Rizhao Hospital of Traditional Chinese Medicine,Shandong Rizhao 276800,China)

机构地区：[1]日照市中医医院心血管科,山东276800 [2]日照市中医医院脑病科,山东276800 [3]中日友好医院中西医结合心内科,北京100029

出　　处：《中日友好医院学报》2024年第4期204-208,共5页Journal of China-Japan Friendship Hospital

基　　金：山东省中医药科技项目(2021Q020)。

摘　　要：目的:观察补土汤对冠心病慢性心衰患者的临床疗效及对能量代谢的影响。方法:选取2022年7月—2023年4月在日照市中医医院治疗的84例冠心病慢性心衰患者为研究对象,随机分为治疗组和对照组各42例。对照组予抗心衰西医标准治疗,治疗组在抗心衰西医标准治疗基础上加用补土汤,两组均治疗30天。观察比较治疗前后患者血常规、肝肾功、BNP、左室射血分数(LVEF)、左室短轴缩短率(LVFS)、心功能评价(NYHA)、Lee氏积分、左心室收缩末圆周室壁应力(cESS)、心肌能量消耗(MEE)、游离脂肪酸(FFA)的差异。结果:治疗后与治疗前比较,补土汤组血常规、肝肾功的差异无统计学意义(P>0.05)。治疗后,补土汤组与对照组比较,BNP、LVEF、改善心功能NYHA分级的总有效率、cESS、MEE的差异均有统计学意义(P<0.05),FFA的差异有统计学意义(P<0.01)。结论:补土汤可提高冠心病慢性心衰患者心功能,可能与调节能量代谢指标有关。Objective:To observe the clinical efficacy and impact on energy metabolism of Butu Tang based on disease differentiation and treatment in patients with chronic heart failure(CHF)and coronary heart disease(CHD).Methods:Eighty-four patients with CHD and CHF of spleen deficiency and water diffusion pattern admitted to Rizhao Traditional Chinese Medicine Hospital from July 2022 to April 2023 were selected as the research subjects,and randomly divided into a treatment group and a control group with 42 cases each.The control group received standard Western medicine treatment for anti-heart failure,while the treatment group received Butu Tang in addition to conventional anti-heart failure treatment.Both groups were treated for 30days.Observe and compare the differences of data in blood routine,liver and kidney functions,brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),New York heart association(NYHA)heart function grade,Lee's score,circumferential wall stress(cESS),myocardial energy expenditure(MEE),and free fatty acid(FFA)before and after treatment.Results:There was no significant difference in blood routine and liver and kidney functions of Butu Tang group before and after treatment(P>0.05).After treatment,there were statistically significant differences in BNP,LVEF,total effective rate of improving NYHA heart function grade,cESS and MEE between the Butu Tang group and the control group(P<0.05),and statistically significant differences in FFA between the Butu Tang group and the control group(P<0.01).Conclusion:Butu Tang based on disease differentiation and treatment can improve cardiac function in patients with CHD and CHF,which may be related to regulating energy metabolism indexes.

关 键 词：冠心病 心衰 补土汤 心功能 能量代谢 

分 类 号：R256[医药卫生—中医内科学]