摘要
目的:探讨疏凿饮子加减对慢性心力衰竭(CHF)患者心功能、心肌重构及血清炎性因子的影响。方法:纳入CHF患者86例,采用随机数字表将患者分为观察组与对照组,每组各43例。观察组患者给予疏凿饮子加减结合西医常规疗法治疗,对照组患者给予西医常规疗法治疗,治疗周期为4周。评价并比较两组患者的临床疗效;治疗前后,检测患者的左室射血分数(LVEF)、三尖瓣血流舒张早期最大流速与三尖瓣血流心房收缩期最大流速比值(E/A比值)、心输出量(CO),测试患者的6 min步行距离(6MWD),以评价患者的心功能;治疗前后,检测患者的血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、脑钠肽(BNP)及超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、同型半胱氨酸(Hcy)水平,以评价患者的心肌重构及炎症状态。结果:(1)治疗后,观察组患者的心功能改善总有效率为93.02%,对照组为81.40%,观察组的疗效优于对照组(P<0.05)。(2)治疗后,两组患者的LVEF、CO、E/A比值及6MWD较治疗前均明显升高(P<0.05,P<0.01),且观察组患者的LVEF、CO、E/A比值及6MWD均明显高于对照组(P<0.05,P<0.01)。(3)治疗后,两组患者的AngⅡ、ALD、BNP水平较治疗前均明显降低(P<0.01),且观察组患者的AngⅡ、ALD、BNP水平均明显低于对照组(P<0.01)。(4)治疗后,两组患者的hs-CRP、TNF-α、Hcy水平较治疗前均明显降低(P<0.05,P<0.01),且观察组患者的hs-CRP、TNF-α、Hcy水平均明显低于对照组(P<0.05,P<0.01)。(5)随机行走模型评价结果显示,观察组患者的心功能指标、心肌重构指标及血清炎性因子的改善较对照组更显著。结论:疏凿饮子加减结合西医常规疗法可更好地改善CHF患者的心功能,降低心肌重构指标及血清炎性因子水平,值得在临床中推广。
Objective: To explore the effects of modified Shuzao Yinzi Recipe on cardiac function, myocardial remodeling and serum inflammatory factors in patients with chronic heart failure(CHF). Methods: A total of 86 patients with CHF were included and randomly divided into the observation group and control group according to random number table, 43 cases in each group. The patients in the observation group were treated with modified Shuzao Yinzi Recipe combined with conventional western medicine, and the patients in the control group were treated with conventional western medicine. The treatment course was 4 weeks. The clinical efficacy of the two groups was evaluated and compared. Before and after treatment, the left ventricular ejection fraction(LVEF), ratio of maximum early diastolic flow velocity of tricuspid valve to maximum atrial systolic flow velocity of tricuspid valve(E/A ratio) and cardiac output(CO) were detected and 6-minute walking distance(6 MWD) was measured to evaluate the cardiac function. Before and after treatment, the levels of angiotensin Ⅱ(Ang Ⅱ), aldosterone(ALD), brain natriuretic peptide(BNP), hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor α( TNF-α) and homocysteine( Hcy) were detected to evaluate the myocardial remodeling and inflammation status. Results:(1)After treatment,the total effective rate on cardiac function improvement was 93.02% in the observation group and 81.40% in the control group. The efficacy of the observation group was better than that of the control group( P<0.05).(2)After treatment,the LVEF,CO,E/A ratio and 6 MWD in the two groups were significantly increased compared with those before treatment( P<0.05,P<0.01),and the LVEF,CO,E/A ratio and 6 MWD in the observation group were significantly higher than those in the control group( P<0.05,P<0.01).(3)After treatment,the levels of Ang Ⅱ,ALD and BNP in the two groups were significantly decreased compared with those before treatment( P<0.01),and the levels of Ang Ⅱ,ALD and BNP in the observation group were significantly lower than those in the control group( P<0.01).(4)After treatment,the levels of hs-CRP,TNF-α and Hcy in the two groups were significantly decreased compared with those before treatment( P<0.05,P<0.01),and the levels of hs-CRP,TNF-α and Hcy in the observation group were significantly lower than those in the control group( P<0.05,P<0.01).(5)The evaluation results of random walking model showed that the improvements of cardiac function,myocardial remodeling and serum inflammatory factors in the observation group were more significant than those in the control group. Conclusion: Modified Shuzao Yinzi Recipe combined with conventional western medicine therapy can better improve the cardiac function and reduce the myocardial remodeling indexes and serum inflammatory factors levels in patients with CHF,which is worth popularizing in clinical practice.
作者
郭丽芬
胡晓军
孙玉真
GUO Lifen;HU Xiaojun;SUN Yuzhen(Department of Cardiology,Hubei Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430015,Hubei,China)
出处
《上海中医药大学学报》
CAS
2021年第4期18-24,共7页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
湖北省卫计委科研项目(WJ2017F005)。
关键词
慢性心力衰竭
疏凿饮子
心功能
心肌重构
血清炎性因子
中西医结合
chronic heart failure
Shuzao Yinzi Recipe
cardiac function
myocardial remodeling
serum inflammatory factor
integrated traditional Chinese and western medicine
作者简介
郭丽芬,女,硕士,副主任医师,主要从事中西医结合治疗心血管疾病临床研究;通信作者:胡晓军,主任医师,E-mail:hxjsuper@163.com。
