摘要
目的探讨加味补阳还五汤治疗心肌梗死后慢性心力衰竭患者的疗效。方法将78例心肌梗死后慢性心力衰竭患者随机分为对照组(n=38)和治疗组(n=40)。对照组给予常规抗心衰治疗,包括利尿剂、硝酸异山梨脂类药物、酌情使用洋地黄制剂、血管紧张素转化酶抑制剂(ACEI)或血管紧张素II受体阻滞剂(ARB)、β-受体阻滞剂等;治疗组在对照组基础上加用加味补阳还五汤治疗,4周为1个疗程。分别观察治疗组与对照组治疗前后NYHA心功能分级、中医证候积分的改善情况,测定2组6 min试验距离及脂蛋白磷脂酶(Lp-PLA2)、超敏C反应蛋白(hs-CRP)及B型氨基端利钠肽原(NT-pro BNP)水平等。结果治疗组NYHA分级评定临床疗效明显高于常规治疗组(P<0.05);治疗组中医证候疗效明显高于对照组(P<0.05);治疗组治疗后6 min试验距离明显高于对照组,差异有统计学意义(P<0.05);治疗组治疗后Lp-PLA2、hs-CRP、NT-pro BNP分别为(228.82±58.92)mg/L、(3.11±1.85)mg/L、(468.18±182.37)ng/L,对照组分别为(252.47±69.49)mg/L、(4.36±2.26)mg/L、(722.63±263.16)ng/L,显著高于治疗组(P<0.05)。结论加味补阳还五汤可明显改善心肌梗死后心力衰竭患者的临床症状,改善心功能,其作用机制可能与减轻机体炎症反应,防止和延缓心肌重构相关。
Objective To investigate the effect of Buyang Huanwu Decoction on chronic heart failure after myocardial infarction. Methods 78 patients with chronic heart failure after myocardial infarction were randomly divided into control group（ n = 38） and treatment group（ n = 40）. The control group was treated with conventional anti-heart failure therapy,including diuretics,isosorbide mononitrate,ACEI,ARB,beta blockers,and so on. The treatment group was treated with the addition of Buyang Huanwu Decoction on the basis of the control group,and the treatment lasted 4 weeks. The improvement of NYHA classification of cardiac function,TCM syndrome score in both groups before and after treatment were observed,respectively. The distance of 6 min test,the levels of Lp-PLA2,hs-CRP and NT-pro BNP were recorded. Results The effect of the treatment group was significantly higher than that of the control group（ P〈0. 05）. The curative effect of TCM syndrome in treatment group was significantly higher than that of control group（ P〈0. 05）. After treatment,the distance of 6 min test was significantly higher than control group,and the difference was statistically significant（ P〈0. 05）. The Lp-PLA2,hs-CRP,NT-proBNP in the treatment group were（ 228. 82 ± 58. 92） mg/L,（ 3. 11 ± 1. 85） mg/L,（ 468. 18 ± 182. 37） ng/L; in the control group were（ 252. 47 ± 69. 49） mg/L,（ 4. 36 ± 2. 26） mg/L,（ 722. 63 ± 263. 16） ng/L,which were significantly higher than treatment group（ P〈0. 05）. Conclusion Buyang Huanwu Decoction could significantly improve the clinical symptoms and cardiac function of patients with heart failure after myocardial infarction. The mechanism may be related to the reduction of the inflammatory response in patients with myocardial infarction and the prevention of myocardial remodeling.
出处
《现代中医临床》
2017年第3期16-19,共4页
Modern Chinese Clinical Medicine
基金
广东省中医药管理局科研课题(No.20151106)
韶关市卫生计生科研计划项目(No.Y15060)
