生脉强心颗粒治疗老年慢性心力衰竭的疗效观察  

Effect of Shengmai Qiangxin Granules(生脉强心颗粒)on Chronic Heart Failure in Senile Patients

作　　者：徐倩[1,2] 万冬梅[1,2] 邓立梅[1,2] 高媛 田淇元 XU Qian;WAN Dongmei;DENG Limei;GAO Yuan;TIAN Qiyuan(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,Heilongjiang,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001 [3]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中华中医药学刊》2024年第10期209-213,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：黑龙江省中医药科研项目(ZHY2022-166)

摘　　要：目的探讨生脉强心颗粒治疗老年慢性心力衰竭(简称心衰)的疗效观察及对心脏重构、心肌损伤标志物的影响。方法选取2021年6月—2022年12月期间,于医院心病科就诊的慢性心衰老年患者86例纳入研究,采用随机数字表法分为观察组与对照组各43例。对照组患者接受常规抗心衰西药治疗,观察组在此基础上加用生脉强心颗粒口服,1袋/次,2次/d,连续用药30 d后,观察比较两组患者的主要指标,包括中医证候积分、临床疗效和西药减停率;次要指标,包括左室舒张/收缩功能[舒张早期血流峰值速度(E)/舒张晚期血流峰值速度(A)、左室短轴缩短率(FS)、射血分数(EF)]、心脏重构指标[左房内径(Left atrial diameter,LAD)、左室收缩末内径(Left ventricular end-systolic diameter,LVESD)、左室舒张末内径(Left ventricular end-diastolic diameter,LVEDD)、室间隔厚度(Interventricular septal thickness,IVST)、左室后壁厚度(Left ventricular posterior wall thickness,LVPWT)]、血清心肌损伤标志物[肌酸激酶同工酶(Creatine kinase isoenzymes-MB,CK-MB)、肌钙蛋白T(Cardiac troponin T,cTnT)]、炎症因子[超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)]、生活质量(明尼苏达心力衰竭生活质量调查表评分)和运动耐量(6 min内最远步行距离)。结果治疗后观察组的总有效率(90.70%,39/43)、利尿剂减停率(88.37%,38/43)和地高辛减停率(90.70%,39/43)均显著高于对照组[69.77%(30/43)、69.77%(30/43)和72.09%(31/43)],组间差异有显著统计学意义(P<0.05)。治疗后观察组的各中医证候评分、明尼苏达心力衰竭生活质量调查表评分与对照组比较,均显著降低(P<0.05),6 min最远步行距离则显著增加(P<0.05)。治疗后观察组的E/A、FS、EF值与对照组比较,均显著升高(P<0.05),LAD、LVESD、LVEDD、IVST、LVPWT值和CK-MB、cTnT、hs-CRP、TNF-α水平与对照组比较,则显著降低(PObjective To investigate the curative effect of Shengmai Qiangxin Granules(生脉强心颗粒)in the treatment of chronic heart failure in the elderly and its influence on cardiac remodeling and myocardial injury markers.Methods A total of 86 elderly patients with chronic heart failure admitted to Heart disease Department of the hospital from June 2021 to December 2022 were included in the study and divided into observation group and control group with 43 cases in each group by random number table method.The control group received conventional anti-heart failure western drug and the observation group was additionally given Shengmai Qiangxin Granules orally,1 bag for each time,twice a day.After 30 days of continuous medication,the main indexes of the two groups were observed and compared,including TCM syndrome scores,clinical efficacy and reduction and withdrawal rate of western medicine.And the secondary indicators were observed and compared,including left ventricular diastolic/systolic function[early peak diastolic blood flow velocity(E)/late peak diastolic blood flow velocity(A),left ventricular short axis shortening rate(FS),ejection fraction(EF)],cardiac remodeling index[left atrial diameter(LAD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),ventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT)],serum markers of myocardial injury[creatine kinase isoenzyme-MB(CK-MB),cardiac troponin T(cTnT)],inflammatory factors[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],quality of life(Minnesota Heart Failure Quality of Life Questionnaire score)and exercise tolerance(farthest walking distance in 6 minutes).Results After treatment,the total effective rate(90.70%,39/43),diuretic reduction and discontinuing rate(88.37%,38/43)and digoxin reduction and discontinuing rate(90.70%,39/43)in the observation group were significantly higher than those in the control group[69.77%(30/43),69.77%(30/43)and 72.09%(31/43)],and there we

关 键 词：生脉强心颗粒 慢性心衰 心脏重构 心肌损伤标志物 疗效 

分 类 号：R259.416[医药卫生—中西医结合]