摘要
目的观察加味升陷汤联合沙库巴曲缬沙坦钠片(诺欣妥)治疗慢性射血分数降低的心力衰竭(HFrEF)病人的临床疗效。方法选取2019年1月—2021年1月上海中医药大学附属岳阳中西医结合医院心血管内科住院的70例慢性心力衰竭(CHF)病人作为研究对象,按随机数字表法分为对照组和观察组,每组35例。对照组给予西医基础治疗加诺欣妥治疗,观察组在对照组的基础上加用加味升陷汤治疗,两组均治疗8周。观察对比两组病人治疗前后中医证候积分、明尼苏达心力衰竭生活质量量表(MLHFQ)评分、Lee氏心力衰竭评分、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、N末端B型脑钠肽原(NT-proBNP)、6 min步行距离(6MWT),并统计临床疗效,观察不良反应。结果观察组中医证候疗效和临床疗效总有效率均高于对照组(P<0.05);两组病人治疗后Lee氏心力衰竭评分、中医证候积分、MLHFQ评分、LVEDD、AngⅡ、ALD、NT-proBNP水平较治疗前均降低(P<0.05),且观察组降低更明显(P<0.05);两组病人治疗后6MWT和LVEF水平均较治疗前升高(P<0.05),且观察组升高更明显(P<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论加味升陷汤联合诺欣妥可以明显提高慢性HFrEF病人的临床疗效,有效地改善病人临床症状及心功能,抑制心室重塑,提高生活质量。
Objective To observe the clinical efficacy of Jiawei Shengxian Decoction combined with Entresto in the treatment of chronic heart failure with reduced ejection fraction(HFrEF).Methods A total of 70 patients with chronic heart failure(CHF)were selected as the subjects,and they were divided into control group and observation group according to random number table method,with 35 patients in each group.The control group was treated with basic western medicine treatment and Entresto(Sakobactri valsartan sodium tablet),and the observation group was additionally treated with Jiawei Shengtang Decoction on the basis of the control group.Both groups were treated for 8 weeks.Traditional Chinese medicine(TCM)syndrome score,Minnesota Heart Failure Quality of Life Scale(MLHFQ)score,Lee′s heart failure score,left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),angiotensinⅡ(AngⅡ),aldosterone(ALD),N-terminal B-type brain natriuretic peptide(NT-proBNP),6 minutes walking distance(6MWT),clinical efficacy,and adverse reactions were observed before and after treatment,.Results The curative effect of TCM syndrome and total effective rate in the observation group were higher than that of the control group(P<0.05).After treatment,Lee′s heart failure score,TCM syndrome score,MLHFQ score,LVEDD,and AngⅡ,ALD,NT-proBNP levels in 2 groups were decreased compared with that before treatment(P<0.05),and the reduction in observation group was more obvious(P<0.05).The levels of 6MWT and LVEF in 2 groups were increased after treatment compared with that before treatment(P<0.05),and the increase were more obvious in observation group(P<0.05).There was no statistical significance in adverse reactions between 2 groups(P>0.05).Conclusion Jiawei Shengxian Decoction combined with Entresto can significantly improve the clinical efficacy of chronic HFrEF patients,effectively improve the clinical symptoms and cardiac function,inhibit ventricular remodeling,and improve the quality of life.
作者
李建华
王明珠
姚磊
符德玉
LI Jianhua;WANG Mingzhu;YAO Lei;FU Deyu(Yueyang Hospital of Intergrated Traditional Chinese Medicine and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《中西医结合心脑血管病杂志》
2022年第11期1946-1949,1958,共5页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
国家自然科学基金项目(No.81774111)
上海市进一步加快中医药事业发展三年行动-计划项目[No.ZY(2018-2020)-ZWB-1001-CPJS29]
上海中医药大学预算内项目(No.2019LK022)
上海市进一步加快中医事业三年行动计划(2018年—2020年)中医心病专科项目。
关键词
射血分数降低的心力衰竭
加味升陷汤
诺欣妥
生活质量
Lee氏心力衰竭评分
heart failure with reduced ejection fraction
HFrEF
Jiawei Shengxian Decoction
Entresto
quality of life
Lee′s heart failure score
