参芪归芎方联合注射用重组人脑利钠肽治疗慢性心力衰竭急性加重期临床研究  

Clinical Study on the Treatment of Acute Exacerbation of Chronic Heart Failure with Ginseng and Astragalus and Chinese Angelica and Chuanxiong Decoction Combined with Recombinant Human Brain Natriuretic Peptide for Injection

作　　者：田国芳[1] 宋玉勤[1] 杨会杰 陈宁宁 陈浩 谢庆成 胡慧英[1] 侯宝松 TIAN Guofang;SONG Yuqin;YANG Huijie;CHEN Ningning;CHEN Hao;XIE Qingcheng;HU Huiying;HOU Baosong(Handan Mingren Hospital,Handan,Henan,China,056000)

机构地区：[1]邯郸明仁医院,河北邯郸056000

出　　处：《河南中医》2025年第2期283-288,共6页Henan Traditional Chinese Medicine

基　　金：河北省中医药管理局中医药类科研计划课题项目(2021476)。

摘　　要：目的:观察自拟参芪归芎方联合注射用重组人脑利钠肽治疗慢性心力衰竭急性加重期(acute exacerbation of chronic heart failure, ADHF)的临床疗效及其对炎症因子、心肌损伤指标、生活质量等方面的影响。方法:将102例ADHF患者按照随机数字表法分为西药组和联合组,每组各51例。西药组采用注射用重组人脑利钠肽治疗,联合组在西药组治疗的基础上加用自拟参芪归芎方。比较两组的临床疗效、不良反应发生率及治疗前后中医证候积分、心功能指标[左心室收缩末期内径(left ventricular end systolic diameter, LVESD)、每搏输出量(stroke volume, SV)、左心室射血分数(left ventricular ejection fraction, LVEF)]、炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C reactive protein, CPR)]、心肌损伤指标[N端脑钠肽前体(nterminal pro-brain natriuretic peptide, NT-proBNP)、心肌肌钙蛋白I(cardiac troponin I,cTnI)]、生活质量评分变化情况。结果:西药组有效率为76.47%,联合组有效率为92.16%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后主症、次症积分均低于本组治疗前,且治疗后联合组低于西药组(P<0.05)。两组患者治疗后LVEF、SV水平高于本组治疗前,LVESD低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后TNF-α、CRP、NT-proBNP、cTnI、生活质量评分低于本组治疗前,且治疗后联合组低于西药组(P<0.05)。两组患者治疗期间皮疹、低血压等不良反应率比较,差异无统计学意义(P>0.05)。结论:自拟参芪归芎方联合注射用重组人脑利钠肽治疗ADHF,可有效保护机体心功能,减轻炎症损伤,提高患者生活质量。Objective:To observe the clinical efficacy of the self-made Ginseng and Astragalus and Chinese Angelica and Chuanxiong Decoction combined with Recombinant Human Brain Natriuretic Peptide for Injection on acute exacerbation of chronic heart failure(ADHF),and its influence on inflammatory factors,myocardial injury indicators,and quality of life.Methods:A total of 102 patients with ADHF were randomly divided into the Western medicine group and the combination group,with 51 cases in each group.The Western medicine group was treated with Recombinant Human Brain Natriuretic Peptide for Injection,while the combination group was treated with self-made Ginseng and Astragalus and Chinese Angelica and Chuanxiong Decoction on the basis of the Western medicine group′s treatment.The clinical efficacy,incidence of adverse reactions,and the changes in TCM syndrome scores,cardiac function indicators[left ventricular end systolic diameter(LVESD),stroke volume(SV),and left ventricular ejection fraction(LVEF)],inflammatory factors[tumor necrosis factor-α(TNF-α),and C-reactive protein(CPR)],myocardial injury indicators[N-terminal pro brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI)],and quality of life scores before and after treatment were compared between the two groups.Results:The effective rate of the Western medicine group was 76.47%,while that of the combination group was 92.16%.The difference in effective rate between the two groups was statistically significant(P<0.05).After treatment,the scores of the main and secondary symptoms in both groups were lower than those before treatment,and the combination group′s above indicators were lower than those of the Western medicine group(P<0.05);the LVEF and SV levels of the two groups were higher than those before treatment,while LVESD was lower than that before treatment and all the differences between the groups were statistically significant(P<0.05);TNF-α,CRP,NT-proBNP,cTnI,and the quality of life score were lower than those before treatment in each group,and af

关 键 词：慢性心力衰竭 参芪归芎方 注射用重组人脑利钠肽 中西医结合疗法 

分 类 号：R259.416[医药卫生—中西医结合]