破格救心汤治疗心肌梗死后急性心力衰竭临床研究  

Clinical Study on Poge Jiuxin Decoction(破格救心汤)in Treatment of Acute Heart Failure After Myocardial Infarction

作　　者：陈景利[1] 袁康 曾奕云[1] 陈广美 CHEN Jingli;YUAN Kang;ZENG Yiyun;CHEN Guangmei(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China;The Eighth Clinical College ofMedicine,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]佛山市中医院,广东佛山528000 [2]广州中医药大学第八临床医学院,广东广州510006

出　　处：《山东中医杂志》2025年第3期308-314,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：佛山市科技局项目(编号:2220001004579);佛山市高水平医院建设“登峰计划”实施方案项目(批文号:佛卫函〔2021〕73号);佛山市中医院高水平医院建设“登峰计划”项目-柔性引进国医大师及团队(编号:202100355)。

摘　　要：目的:探讨破格救心汤治疗心肌梗死后急性心力衰竭的临床疗效。方法:选取心肌梗死后并发急性心力衰竭的患者91例,按照随机数字表法分为观察组42例、对照组49例。对照组予常规西医治疗,观察组在对照组基础上加用破格救心汤口服。观察两组患者治疗前后的静息心率、收缩压变化;比较治疗前后的N末端B型利钠肽原(NT-proBNP)、左室射血分数(LVEF)、左室舒张末期内径(LVESD)、6分钟步行试验(6MWT)和明尼苏达心功能不全生命质量量表(MLHFQ)评分;统计两组患者研究期间心血管不良事件发生情况及半年内因心血管不良事件住院次数。结果:两组治疗前后的静息心率、收缩压、LVEF和LVESD比较,差异均无统计学意义(P>0.05)。治疗前,两组NT-proBNP、6MWT和MLHFQ评分比较,差异无统计学意义(P>0.05)。治疗后,两组NT-proBNP和MLHFQ评分均较治疗前降低,6MWT较治疗前升高,差异均有统计学意义(P<0.05);且观察组治疗后NT-proBNP低于对照组,差异有统计学意义(P<0.05)。两组心血管不良事件发生情况与半年内因心血管不良事件住院次数比较,差异无统计学意义(P>0.05)。结论:破格救心汤可以改善心肌梗死后急性心力衰竭患者的短期心功能,但未能改善患者的长期心功能状况。Objective:To explore the clinical efficacy of Poge Jiuxin Decoction(破格救心汤)in the treatment of acute heart failure after myocardial infarction.Method:Ninety-one patients with acute heart failure after myocardial infarction were selected and divided by using random number table method,including 42 patients in the observation group and 49 patients in the control group.The control group was treated with conventional western medicine,and the observa⁃tion group was treated with Poge Jiuxin Decoction orally on the basis of the treatment of the control group.The changes of resting heart rate and systolic blood pressure before and after treatment were observed.N-terminal B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic inner diameter(LVESD),6 min walking test(6MWT)and Minnesota Living with Heart Failure Questionnaire(MLHFQ)score were compared before and after treatment.The number of hospitalizations due to cardiovascular adverse events within half a year and the occurrence of cardiovascular adverse events during the study period in the two groups were analyzed.Results:There were no significant differences in resting heart rate,systolic blood pressure,LVEF and LVESD between the two groups before and after treatment(P>0.05).Before treatment,there was no significant difference in NT-proBNP,6MWT and MLHFQ score between the two groups(P>0.05).After treatment,NT-proBNP and MLHFQ score in both groups were lower than those before treatment,and 6MWT was higher than that before treatment,the difference was statistically significant(P<0.05).After treatment,NT-proBNP in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse cardiovascular events between the two groups and the number of hospitalizations due to cardio vascular adverse events within half a year(P>0.05).Conclusion:Poge Jiuxin Decoction can improve short-term cardiac functi

关 键 词：破格救心汤 心肌梗死 急性心力衰竭 心功能 疗效评价 

分 类 号：R256.2[医药卫生—中医内科学]