摘要
目的探讨自拟心通方辅助西医治疗急性心肌梗死后心力衰竭疗效及对心功能、炎症标志物水平的影响。方法纳入2020年1月至2021年7月河南中医药大学第一附属医院收治急性心肌梗死后心力衰竭病人196例,采用随机数字表法分为观察组和对照组,对照组98例采用常规西医治疗,观察组98例则在对照组基础上加用自拟心通方治疗,均治疗4周。比较两组治疗前后主要证候积分、超声心动图指标、6 min步行距离、明尼苏达生活质量量表(MLHFQ)评分、心肌损伤相关实验室指标、炎症标志物水平及随访6个月主要心血管不良事件(MACE)发生情况。结果观察组治疗后主要证候积分和MLHFQ评分(21.06±3.26)分均显著少于对照组(30.83±5.50)分、治疗前(54.80±7.91)分(P<0.05);观察组治疗后左心射血分数(LVEF)[(68.84±8.62)%比(60.17±6.83)%、(49.37±5.72)%]、心输出量(CO)[(5.85±0.82)L/min比(5.12±0.70)L/min、(4.33±0.58)L/min]、每搏输出量(SV)[(69.44±8.97)mL比(64.93±7.70)mL、(59.41±6.34)mL]及6 min步行距离[(486.72±49.17)m比(401.16±37.23)m、(331.26±26.30)m]均显著多于对照组、治疗前(P<0.05);观察组治疗后心肌肌钙蛋白(cTn)I、cTnT、心脏型脂肪酸结合蛋白(H-FABP)、脂蛋白磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)及肿瘤坏死因子α(TNF-α)水平均显著少于对照组、治疗前(P<0.05);同时观察组随访6个月MACE发生率显著低于对照组(P<0.05)。结论自拟心通方辅助西医治疗急性心肌梗死后心力衰竭可有效控制临床症状,改善心功能,抑制炎症反应水平,有助于降低远期MACE发生风险。
Objective To investigate the clinical effects of self-made Xintong formula assisting western medicine in the treatment of heart failure after acute myocardial infarction and its influence on cardiac function and inflammatory markers.Methods A total of 196 patients with heart failure after acute myocardial infarction in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from February 2020 to July 2021 were enrolled and randomly divided into control group and experiment group.The 98 patients in the control group were treated with western medicine and the 98 patients in the experiment group were treated with self-made Xintong formula on the basis of control group.The main syndrome scores,echocardiographic indexes,6-min walking distance,MLHFQ score,laboratory indexes related to myocardial injury and inflammatory marker before and after treatment and MACE incidence after 6 months with follow-up of the 2 groups were compared.Results The main syndrome scores and MLHFQ[(21.06±3.26)vs.(30.83±5.50),(54.80±7.91)]score after treatment of the experiment group were significantly lower than those of the control group and before treatment(P<0.05).The LVEF[(68.84±8.62)%vs.(60.17±6.83)%,(49.37±5.72)%],CO[(5.85±0.82)L/min vs.(5.12±0.70)L/min,(4.33±0.58)L/min],SV[(69.44±8.97)mL vs.(64.93±7.70)mL,(59.41±6.34)mL]and 6-min walking distance[(486.72±49.17)m vs.(401.16±37.23)m,(331.26±26.30)m]after treatment of experiment group were significantly higher than those of the control group and before treatment(P<0.05).The cTnI,cTnT,H-FABP,Lp-PLA2,hs-CRP,IL-6 and TNF-α after treatment of the experiment group were significantly lower than those of the control group and before treatment(P<0.05).The MACE incidence after 6 months with follow-up of the experiment group was significantly lower than that of group(P<0.05).Conclusion Self-made Xintong formula assisting western medicine in the treatment of heart failure after acute myocardial infarction can efficiently control clinical symptoms,improve cardi
作者
王国强
伦令祝
李鹏宇
WANG Guoqiang;LUN Lingzhu;LI Pengyu(Emergency Department,The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan 450000,China)
出处
《安徽医药》
CAS
2023年第2期392-396,共5页
Anhui Medical and Pharmaceutical Journal
基金
广东省中医药局中医药科研项目(20191256)。
关键词
心肌梗死
中医药
心力衰竭
心脏功能
炎症标志物
Myocardial infarction
Traditional Chinese medicine
Heart failure
Cardiac function
Inflammatory markers
