参附龙牡汤治疗缺血性心肌病伴急性心力衰竭的临床研究  

Clinical Study of Shenfu Longmu Decoction for Treating Ischemic Cardiomyopathy with Acute Heart Failure

作　　者：赵起 高琦 车启富 ZHAO Qi;GAO Qi;CHE Qifu(Jiamusi Hospital of Traditional Chinese Medicine,Jiamusi 154000,Heilongjiang,China;Heilongjiang Academy of Chinese Medicine)

机构地区：[1]佳木斯市中医医院,黑龙江佳木斯154000 [2]黑龙江省中医药科学院

出　　处：《中西医结合心脑血管病杂志》2025年第7期1050-1054,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：黑龙江省中医药科研项目(No.ZHY22-W0418)。

摘　　要：目的:观察参附龙牡汤对缺血性心肌病伴急性心力衰竭病人心脏血流灌注、室壁运动及血清生长分化因子-15(GDF-15)、可溶性基质裂解素2(s ST2)、血管紧张素1-7[Ang-(1-7)]的影响。方法:选取2021年10月—2023年10月佳木斯市中医医院收治的缺血性心肌病伴急性心力衰竭病人92例,采用随机数字表法分为西医组与中西医结合组,每组46例。西医组采用常规西医治疗,中西医结合组在西医组基础上加用参附龙牡汤治疗。比较两组临床疗效,观察两组治疗前后中医证候评分、左心室室壁运动评分指数、心脏血流灌注(平均血流量、血管周围阻力)变化;检测两组治疗前后左室质量指数、左心室射血分数、每搏输出量、E峰减速时间以及Ang-(1-7)、s ST2、GDF-15、白细胞介素33(IL-33)水平。结果:中西医结合组临床疗效总有效率为97.83%,高于西医组的82.61%,差异有统计学意义(P<0.05)。中西医结合组治疗后心悸、身寒肢冷、动则气喘、短气乏力、面色灰青、腹胀便溏、尿少浮肿评分以及左心室室壁运动评分较西医组降低(P<0.05),血管周围阻力较西医组降低(P<0.05),平均血流量、每搏输出量、左心室射血分数较西医组升高(P<0.05),中西医结合组E峰减速时间、左室质量指数以及血清Ang-(1-7)、s ST2、GDF-15、IL-33水平较西医组降低(P<0.05)。结论:参附龙牡汤治疗缺血性心肌病伴急性心力衰竭病人,可抑制炎症损伤,改善心脏血流灌注,减少心室重构,提升室壁运动功能、心功能及临床疗效。ObjectiveObjective:To observe the effects of Shenfu Longmao Decoction on cardiac blood perfusion,ventricular wall motion,serum growth differentiation factor-15(GDF-15),soluble stromal lysin 2(sST2),and angiotensin 1-7[Ang-(1-7)]in patients with ischemic cardiomyopathy with acute heart failure.MethodsMethods:A total of 92 patients with ischemic cardiomyopathy combined with acute heart failure were divided into western medicine group and integrated Chinese and western medicine group by random number table method,with 46 cases in each group.The western medicine group was treated with conventional western medicine,and the integrated Chinese and Western medicine group was treated with Shenfu Longmu Decoction on the basis of Western medicine group.The clinical effects of the two groups were compared,and the changes of traditional Chinese medicine(TCM)syndrome score,left ventricular wall motion score index,cardiac blood perfusion(mean blood flow,perivascular resistance)before and after treatment were observed.Left ventricular mass index,left ventricular ejection fraction,stroke output,E peak deceleration time and Ang-(1-7),sST2,GDF-15,and interleukin33(IL-33)levels were detected before and after treatment in both groups.ResultsResults:The total effective rate of integrated Chinese and western medicine group was 97.83%,which was higher than that of the western medicine group(82.61%),the difference was statistically significant(P<0.05).After treatment,the scores of palpitation,cold body and cold limbs,asthma,shortness of breath,pale complexion,abdominal distension and loose stool,oliguria and edema,and left ventricular wall movement score of the integrated Chinese and western medicine group were lower than those of the western medicine group(P<0.05),and the perivascular resistance was lower than that of the western medicine group(P<0.05),the mean blood flow,stroke output and left ventricular ejection fraction were higher than those in the western medicine group(P<0.05),and the peak deceleration time of E,left ventricular

关 键 词：缺血性心肌病 急性心力衰竭 参附龙牡汤 心脏血流灌注 室壁运动 心室重构 

分 类 号：R259[医药卫生—中西医结合]