摘要
目的:观察真武汤联合常规西药治疗重度心力衰竭的临床疗效。方法:将100例冠心病重度心力衰竭患者分为对照组和治疗组,各50例。治疗组的对照组治疗的基础上给予真武汤加味,对照组给予常规西药治疗。比较两组患者的临床疗效及治疗前后临床症状积分、左心功能与心室重塑指标[E峰/A峰(E peak/A peak,E/A)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、左心室射血分数(left ventricular ejection fraction,LVEF)、每搏输出量(stroke output,SV)、每分钟排血量(blood output per minute,CO)、心率(heart rate,HR)]、生化指标[高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)及B型脑利钠肽(B-type brain natriuretic peptide,BNP)]、血管内皮功能[一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)、肱动脉非内皮依赖性血管舒张功能(brachial artery endothelium-independent vasodilation,NMD)、肱动脉内皮依赖性血管舒张功能(brachial artery endothelium-dependent vasodilation,FMD)、肱动脉峰值流速变化率]、6分钟步行试验(6-minute walk test,6MWT)变化情况。结果:治疗后治疗组临床症状积分低于对照组(P<0.05)。治疗组LVEDD、LVESD、HR低于对照组,E/A、LVEF、SV、CO高于对照组(P<0.05)。两组患者治疗后hs-CRP、BNP低于本组治疗前,且治疗后治疗组低于对照组(P<0.05)。两组患者治疗后ET-1水平均低于治疗前,NO、NMD、FMD、肱动脉峰值流速变化率高于治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后6MWT均高于治疗前,且治疗后治疗组高于对照组(P<0.05)。治疗组有效率为92.00%,对照组有效率为76.00%,两组患者有效率比较,差异具有统计学意义(P<0.05)。结论:真武汤联合常规西药治疗重度心力衰竭,可改善患者的临床症状及左心功能,减轻心室重塑程度。
Objective:To observe the clinical efficacy of True Warrior Decoction combined with conventional Western medicine on severe heart failure.Methods:A total of 100 patients with severe heart failure caused by coronary heart disease were divided into the control group and the treatment group,with 50 cases in each group.The control group was given conventional Western medicine treatment,while the treatment group was additionally treated with Supplemented True Warrior Decoction on the basis of the control group.The clinical efficacy,the changes of clinical symptom scores,left ventricular function and ventricular remodeling indexes[including E peak/A peak(E/A),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),stroke volume(SV),blood output per minute(CO),heart rate(HR)],biochemical indexes[including B-type brain natriuretic peptide(BNP),high sensitivity C-reactive protein(hs-CRP)],vascular endothelial function[including nitric oxide(NO),endothelin 1(ET-1),brachial artery endothelium independent vasodilation(NMD),brachial artery endothelium dependent vasodilation(FMD),brachial artery peak velocity change rate],and 6-minute walk test(6MWT)of the two groups before and after treatment were observed.Results:After treatment,the clinical symptom score of the treatment group was lower than that of the control group(P<0.05).The LVEDD,LVESD,and HR in the treatment group were lower than those in the control group,while E/A,LVEF,SV,and CO were higher than those in the control group(P<0.05);the hs-CRP and BNP of the two groups were lower than those of the same group before treatment,and the treatment group's were lower than those of the control group(P<0.05);the level of ET-1 in both groups was lower than that of the same group before treatment,and the change rates of NO,NMD,FMD,brachial artery peak flow rate were higher than those of the same group before treatment,and all the differences between the two groups were statistically significant(P<0.05);
作者
范倩
吴彦
FAN Qian;WU Yan(Meijiang Street Community Health Service Center of Hexi District of Tianjin,Tianjin,China,300221)
出处
《河南中医》
2023年第5期670-674,共5页
Henan Traditional Chinese Medicine
基金
天津市科技计划项目(SHGY-2020024)。
关键词
冠状动脉粥样硬化心脏病
重度心力衰竭
真武汤
左心功能
心室重塑
《伤寒论》
张仲景
coronary atherosclerotic heart disease
severe heart failure
True Warrior Decoction
left heart function
ventricular remodeling
Treatise on Cold Damage Diseases
Zhang Zhong-jing
