保元汤合补肺汤辅助沙库巴曲缬沙坦治疗HFmrEF的临床疗效  

Clinical efficacy of Baoyuan Decoction combined with Bufei Decoction to assist sacubitril-valsartan in treatment of heart failure with mid-range ejection fraction(HFmrEF)

作　　者：王丹丹 李巍巍 WANG Dandan;LI Weiwei(National Medical Center of Maternity and Child Healthcare Hospital of Cangzhou City,Cangzhou Hebei 062350,China;Department of Cardiovascular Diseases,Seventh People's Hospital of Hebei Province/Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Baoding Hebei 073000,China)

机构地区：[1]沧州市妇幼保健院国医馆,河北沧州061000 [2]河北省第七人民医院/河北中医学院第二附属医院心血管病科,河北保定073000

出　　处：《新疆医科大学学报》2025年第3期362-367,共6页Journal of Xinjiang Medical University

基　　金：河北省中医药管理局2024年度中医药类科学研究课题计划项目(2024304)。

摘　　要：目的探讨保元汤合补肺汤辅助沙库巴曲缬沙坦治疗射血分数中间值心力衰竭(HFmrEF)的疗效。方法选取2022年1月-2023年1月沧州市妇幼保健院国医馆120例HFmrEF患者,采用随机数字表法分为研究组和对照组,每组60例。两组入院后均给予常规治疗,在此基础上,对照组采用沙库巴曲缬沙坦治疗,研究组采用保元汤合补肺汤加减辅助沙库巴曲缬沙坦治疗。比较两组治疗效果及治疗前后中医证候积分、心功能指标[左室射血分数(LVEF)、左室舒张末径(LVEDd)、左室收缩末期内径(LVESd)]、心肌损伤标志物[N末端B型钠尿肽前体(NT-proBNP)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白Ⅰ(cTnⅠ)]。比较两组不良反应、主要心血管不良事件(MACE)发生率。结果研究组总有效率高于对照组,中医证候积分低于对照组,差异有统计学意义(P<0.05);研究组治疗后LVEF高于对照组,LVEDd、LVESd及血清N末端B型钠尿肽前体(NT-proBNP)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平低于对照组,MACE发生率低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论保元汤合补肺汤加减辅助沙库巴曲缬沙坦治疗HFmrEF的疗效优于单独使用沙库巴曲缬沙坦治疗,可改善临床症状和心功能,减少MACE发生。Objective To explore the efficacy of Baoyuan Decoction combined with Bufei Decoction as an adjuvant to the treatment of heart failure with mid-range ejection fraction(HFmrEF)using sacubitril-valsartan.Methods A total of 120 patients with HFmrEF in the hospital from January 2022 to January 2023 were selected and randomly divided into a study group and a control group using a random number table method,with 60 patients in each group.Both groups were given conventional treatment after the admission.On this basis,the control group was treated with Sacubatril Valasartan,while the study group was treated with Baoyuan Decoction combined with Bufei Decoction as an adjuvant to Sacubatril Valasartan.The therapeutic effects of the 2 groups were compared,as well as the scores of traditional Chinese medicine(TCM)syndromes,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd)],and myocardial injury markers[N-terminal B-type natriuretic peptide precursor(NT-proBNP),cardiac troponin T(cTnT)and cardiac troponin I(cTnI)]before and after the treatment.The incidence of adverse reactions and major adverse cardiovascular events(MACE)were compared between the 2 groups.Results The total effective rate of the study group was higher than that of the control group,and the TCM syndrome score was lower than that of the control group,with statistically significant differences(P<0.05).After the treatment,the LVEF in the study group was higher than that in the control group,while the LVEDd,LVESd,and serum NT-proBNP,cTnT and cTnI levels were lower than those in the control group,and the incidence of MACE was lower than that in the control group,with statistically significant differences(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion The efficacy of Baoyuan Decoction combined with Bufei Decoction,as an adjunct to treatment with Sacubatril Val

关 键 词：射血分数中间值心力衰竭 保元汤 补肺汤 沙库巴曲缬沙坦 

分 类 号：R541.61[医药卫生—心血管疾病]