基于Gal-3和sST2水平的气虚血瘀型心力衰竭患者改良心脏康复与血府逐瘀汤治疗效果研究  

Study on the effectiveness of modified cardiac rehabilitation and Xuefu Zhuyu decoction in treating Qi deficiency and blood stasis type heart failure based on Gal-3 and sST2 levels

作　　者：吴费凯[1] 肖美霞 施胜铭[1] 刘海兵[2] 张莎莎[3] WU Feikai;XIAO Meixia;SHI Shengming;LIU Haibing;ZHANG Shasha(General Practice,Huzhou First People’s Hospital,Huzhou 313000,Zhejiang,China;Department of Rehabilitation Medicine,Huzhou First People’s Hospital,Huzhou 313000,Zhejiang,China;Department of Traditional Chinese Medicine,Huzhou First People’s Hospital,Huzhou 313000,Zhejiang,China)

机构地区：[1]湖州市第一人民医院全科医学科,浙江湖州313000 [2]湖州市第一人民医院康复医学科,浙江湖州313000 [3]湖州市第一人民医院中医科,浙江湖州3130001

出　　处：《中国现代医生》2025年第6期19-23,共5页China Modern Doctor

基　　金：浙江省湖州市科学技术局公益性应用研究项目(2021GYB44)。

摘　　要：目的 评估改良心脏康复结合血府逐瘀汤对气虚血瘀型心力衰竭患者的疗效,分析半乳糖凝集素-3(galectin-3,Gal-3)、可溶性致癌抑制因子2(soluble suppression of tumorigenicity 2,sST2)水平、心脏功能、中医证候及运动耐量的改善效果。方法 选取2021年10月至2023年3月于湖州市第一人民医院康复医学科就诊的180例气虚血瘀型心力衰竭患者,随机分为治疗组(改良心脏康复+血府逐瘀汤)和对照组(常规治疗),疗程为12周。比较两组患者治疗前和治疗12周后的Gal-3、sST2、左心室射血分数(left ventricular ejection fraction,LVEF)、纽约心功能分级(New York heart association functional classification,NYHA)、N末端脑利尿钠肽前体(N-terminal B-type natriuretic peptide,NT-proBNP)、中医证候积分及6min步行试验(6-minute walk test,6MWT)的变化,并评估其安全性。结果 治疗12周后,治疗组患者的Gal-3和sST2水平均显著低于对照组;LVEF水平显著高于对照组,NYHA改善程度显著优于对照组;NT-proBNP显著低于对照组;6MWT显著高于对照组;中医证候积分低于对照组;比较差异有统计学意义(P<0.05)。治疗12周后,治疗组的有效率显著高于对照组(P<0.05);两组患者的不良反应及严重不良事件比较差异无统计学意义(P>0.05)。结论改良心脏康复联合血府逐瘀汤可显著改善气虚血瘀型心力衰竭患者的心脏功能、中医证候及运动耐量,降低Gal-3和sST2水平,具有较高的临床应用价值。Objective To evaluate the efficacy of modified cardiac rehabilitation combined with Xuefu Zhuyu decoction on patients with heart failure of Qi deficiency and blood stasis type,with a focus on analyzing the improvement of galectin-3(Gal-3),soluble suppression of tumorigenicity 2(sST2)levels,cardiac function,traditional Chinese medicine syndromes,and exercise tolerance.Methods 180 patients with heart failure of Qi deficiency and blood stasis type who attended the Department of Rehabilitation Medicine,Huzhou First People’s Hospital from October 2021 to March 2023 were selected and randomly divided into treatment group(modified cardiac rehabilitation+Xuefu Zhuyu decoction)and control group(conventional treatment),with a treatment course of 12 weeks.The changes of Gal-3,sST2,left ventricular ejection fraction(LVEF),New York heart association functional classification(NYHA),N-terminal B-type natriuretic peptide(NT-proBNP),traditional Chinese medicine syndrome score and 6-minute walk test(6MWT)were compared between two groups before and after 12 weeks of treatment,and the safety was evaluated.Results After 12 weeks of treatment,Gal-3 and sST2 levels of patients in treatment group were significantly lower than those in control group;LVEF levels of patients in treatment group were significantly higher than those in control group,and the degree of improvement of cardiac function grading in treatment group was significantly better than that in control group;NT-proBNP in treatment group was significantly lower than that in control group;The 6MWT in treatment group was significantly higher than that in control group;The score of traditional Chinese medicine syndrome in treatment group was lower than that in control group;The difference is statistically significant(P<0.05).After 12 weeks of treatment,the effective rate of treatment group was significantly higher than that of control group(P<0.05);There was no statistically significant difference in adverse reactions and serious adverse events between two groups of patients(P

关 键 词：心力衰竭 气虚血瘀型 半乳糖凝集素-3 可溶性致癌抑制因子2 左心室射血分数 6分钟步行试验 

分 类 号：R541.6[医药卫生—心血管疾病] R256.22[医药卫生—内科学]