摘要
目的探究二参真武汤联合美托洛尔治疗左心室射血分数保留型心力衰竭(Heart failure with preserved ejection fraction,HFpEF)患者的疗效及对其心功能和神经内分泌因子的影响。方法选取2021年6月-2023年6月期间就诊于安徽省中西医结合医院心血管内科的HFpEF患者92例,依据简单随机数字表法分为对照组和研究组,每组各46例。两组患者均给予常规治疗,对照组在常规干预基础上口服美托洛尔,研究组在对照组基础上联合二参真武汤,两组患者均治疗4周。观察比较两组患者临床疗效、不良反应发生情况,治疗前后中医证候积分、心功能[左心室射血分数(Left ventricular ejection fractions,LVEF)、左心室收缩末内径(Left ventricular end systolic diameter,LVESD)、左心室舒张末内径(Left ventricular end diastolic diameter,LVEDD)、左心室等容舒张时间(Isovolumic relaxation time,IVRT)]、神经内分泌因子指标[醛固酮(Aldosterone,ALD)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)、去甲肾上腺素(Noradrenaline,NE)]水平、中性粒细胞明胶酶相关脂质运载蛋白(Neutrophil gelatinase-associated lipocalin,NGAL)、生长分化因子-15(Growth differentiation factor-15,GDF-15)水平。结果治疗后研究组治疗总有效率93.48%(43/46)明显高于对照组78.26%(36/46),差异有统计学意义(P<0.05)。治疗后两组患者胸胁作痛、心悸、气短喘息、浮肿与唇甲青紫、面色晦暗、畏寒肢冷分值均较治疗前降低,差异有统计学意义(P<0.05);且研究组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者LVEF水平均较治疗前升高,LVESD、LVEDD、IVRT水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组LVEF水平明显高于对照组,LVESD、LVEDD、IVRT水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清ALD、AngⅡ、NE水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组神经内
Objective To investigate the efficacy of Ershen Zhenwu decoction combined with metoprolol in treating patients with heart failure with preserved ejection fraction(HFpEF)of left ventricular and its effects on cardiac function and neuroendocrine factors.Methods Ninety-two HFpEF patients treated at the Cardiovascular Medicine Department of Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to June 2023 were selected and divided into a control group and a study group according to the simple random number table method,with 46 patients in each group.Both groups received conventional treatment;the control group was given oral metoprolol in addition to conventional intervention,while the study group received Ershen Zhenwu decoction combined with the control group′s regimen.Both groups were treated for four weeks.Clinical efficacy,the incidence of adverse reactions,traditional Chinese medicine(TCM)syndrome scores,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),isovolumic relaxation time(IVRT)],neuroendocrine factor[aldosterone(ALD),angiotensin II(AngII),norepinephrine(NE)],and levels of neutrophil gelatinase-associated lipocalin(NGAL)and growth differentiation factor-15(GDF-15)were observed and compared before and after treatment.Results After treatment,the total effective rate in the study group was 93.48%(43/46),significantly higher than the control group′s 78.26%(36/46),with a statistically significant difference(P<0.05).TCM syndrome scores for chest pain,palpitations,shortness of breath,edema,cyanosis of lips and nails,dark complexion,and aversion to cold limbs decreased significantly in both groups compared to before treatment,with a statistically significant difference(P<0.05);the study group showing significantly lower scores than the control group,with a statistically significant difference(P<0.05).LVEF levels increased,while LVESD,LVEDD,and IVRT levels decreased s
作者
盛晟
程晓昱
程丹
SHENG Sheng;CHENG Xiao-yu;CHENG Dan(Department of Cardiovascular Medicine,The Third Affiliated Hospital of Anhui University of Chinese Medicine/Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Hefei Anhui 230031;Department of Geriatric Cardiovascular Medicine,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230031)
出处
《世界中西医结合杂志》
2024年第7期1452-1457,共6页
World Journal of Integrated Traditional and Western Medicine
基金
安徽省自然科学重点研究项目(2023AH050841)
安徽省中医药学术流派传承工作室建设项目(皖中医药发展秘[2021]30号)
安徽中医药大学科研项目(2018zryb64)。
关键词
二参真武汤
美托洛尔
左心室射血分数保留型心力衰竭
心功能
神经内分泌因子
Ershen Zhenwu Decoction
Metoprolol
Heart Failure with Preserved Ejection Fraction of Left Ventricular
Cardiac Function
Neuroendocrine Factors
