热敏灸联合芪苈强心胶囊治疗慢性心力衰竭急性失代偿期临床观察  

Clinical Study of Thermosensitive Moxibustion Combined with Qiliqiangxin Capsules for Treating Acute Decompensated Chronic Heart Failure

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作  者:王进[1] 左莉莉 杨宝 梁晓东[3] Wang Jin;Zuo Lili;Yang Bao;Liang Xiaodong(Zibo Hospital of Traditional Chinese Medicine,Shandong,Zibo 255300,China)

机构地区:[1]山东省淄博市中医医院,山东淄博255300 [2]山东省淄博市第三人民医院,山东淄博255300 [3]山东中医药大学,山东济南250355

出  处:《中国中医急症》2025年第3期455-459,共5页Journal of Emergency in Traditional Chinese Medicine

基  金:山东省中医药科技项目(2021M110);淄博市医药卫生科研项目(20231502099)。

摘  要:目的观察热敏灸联合芪苈强心胶囊治疗慢性心力衰竭急性失代偿期(ADHF)的疗效及对神经内分泌因子的影响。方法100例ADHF患者随机分为对照组与观察组各50例。两组均采用西医综合治疗措施,对照组给予芪苈强心胶囊口服;观察组在对照组的基础上加用热敏灸,连续治疗2周。检测治疗前后N末端B型利钠肽原(NT-proBNP)、心肌肌钙蛋白(cTn)、可溶性生长刺激表达基因2蛋白(sST2)水平。治疗前后进行超声心动图检查,比较左室射血分数(LVEF)、每搏心搏量(SV)、每分钟心输出量(CO)和左室舒张末径(LVEDD)等参数;进行治疗前后NYHA心功能分级和6分钟步行试验距离(6MWT);检测治疗前后抗利尿激素(ADH)、肾素活性(PRA)和血管紧张素Ⅱ(AngⅡ)水平;治疗前后进行阳气虚乏、络瘀水停证评分;比较治疗后总有效率。结果观察组临床总有效率高于对照组(P<0.05)。治疗后,两组NT-proBNP、cTn、sST2、ADH、PRA、AngⅡ、LVEDD下降(P<0.05),且观察组低于对照组(P<0.05),LVEF、CO、SV升高(P<0.05),24 h尿量和6MWT增加(P<0.05),且观察组多于对照组(P<0.05)。治疗后,两组中医证候主症、次症和总分降低(P<0.05),且观察组低于对照组(P<0.05)。结论热敏灸联合芪苈强心胶囊治疗ADHF患者,能降低神经内分泌因子,减轻心衰严重程度,改善心功能,减轻临床症状,提高临床治疗效果。Objective:To observe the therapeutic effect of thermosensitive moxibustion combined with Qiliqiangxin Capsules in treating acute decompensated chronic heart failure(ADHF)and its impact on neuroendocrine factors.Methods:A total of 100 ADHF patients were randomly divided into a control group and an observation group,with 50 cases in each group.Both groups received comprehensive western medicine treatments.The control group was given oral administration of Qiliqiangxin Capsules,while the observation group additionally received thermosensitive moxibustion on the basis of the control group.The treatment lasted for 2 weeks.Levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),cardiac troponin(cTn),soluble suppression of tumorigenicity 2 protein(sST2),antidiuretic hormone(ADH),plasma renin activity(PRA),and angiotensin II(Ang I)were measured before and after treatment.Echocardiography was performed to compare parameters such as left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output per minute(CO),and left ventricular end-diastolic diameter(LVEDD).The New York Heart Association(NYHA)functional classification and 6-minute walk test distance(6MWT)were evaluated before and after treatment.Scores for yang qi deficiency and blood stasis with water retention syndrome were also assessed.The total effective rate after treatment was compared between the two groups.Results:The overall clinical efficacy of the observation group was significantly higher than that of the control group(P<0.05).After treatment,NT-proBNP,cTn,sST2,ADH,PRA,Ang II,and LVEDD levels decreased in both groups(P<0.05),and the observation group showed significantly lower levels compared with the control group(P<0.05).LVEF,CO,and SV increased(P<0.05),and 24 hour urine volume and 6MWT distance increased(P<0.05),with greater improvements observed in the observation group than the control group(P<0.05).The scores after for main symptoms,secondary symptoms,and total scores decreased in both groups treatment(P<0.05),and the observation grou

关 键 词:慢性心力衰竭 急性失代偿性 热敏灸 芪苈强心胶囊 神经内分泌因子 

分 类 号:R541.61[医药卫生—心血管疾病]

 

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