芪红汤联合心可舒片治疗冠心病合并慢性心力衰竭的临床研究
|
摘要
目的:研究芪红汤联合心可舒片治疗冠心病合并慢性心力衰竭(CHF)气虚血瘀证的疗效。方法:将94例CHF气虚血瘀证患者按随机数字表分成两组(每组47例),对照组患者采用心可舒片治疗,治疗组患者采用芪红汤联合心可舒片治疗。观察比较两组患者的临床疗效、心功能、食欲和血清线粒体偶联因子(CF-6)、脂联素(APN)、细胞间黏附分子-1(ICAM-1)表达水平及不良反应情况。结果:治疗组总有效率为89.36%,对照组总有效率为61.70%,治疗组优于对照组(P<0.05);两组患者治疗后左心室射血分数(LVEF)水平升高,左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)水平均降低,差异均有统计学意义(P<0.05);治疗后两组比较,治疗组患者LVEF水平高于对照组,LVEDD、LVESD水平均低于对照组,差异均有统计学意义(P<0.05);两组患者治疗后胃动素、胃泌素水平均上升(P<0.05),且治疗组患者治疗后胃动素、胃泌素水平均高于对照组(P<0.05);两组患者治疗后血清CF-6、APN及ICAM-1水平均降低,且治疗组患者治疗后血清CF-6、APN及ICAM-1水平均低于对照组(P<0.05);治疗组不良反应总发生率(14.89%)低于对照组(31.91%),但差异无统计学意义(P>0.05)。结论:芪红汤联合心可舒片治疗CHF气虚血瘀证有较好临床疗效,可改善患者心功能,促进胃动素、胃泌素分泌,提高食欲,降低血清CF-6、APN及ICAM-1水平。
Objective: To study the efficacy of Qihong decoction combined with Xinkeshu tablet in the treatment of coronary heart disease complicated with chronic heart failure(CHF) with Qi deficiency and blood stasis syndrome. Methods: A total of 94 CHF patients with Qi deficiency and blood stasis syndrome were randomly divided into two groups, with 47 cases in each group. The control group was treated with Xinkeshu tablet( 心可舒片), while the treatment group was treated with Qihong decoction( 芪红汤) combined with Xinkeshu tablet. The clinical efficacy, cardiac function, appetite, serum levels of mitochondrial coupling factor(CF-6),adiponectin(APN), intercellular adhesion molecule-1(ICAM-1) and adverse reactions were observed and compared between the two groups. Results: The total effective rate was 89.36% in the treatment group and 61.70%in the control group. The treatment group was superior to the control group(P<0.05). The left ventricular ejection fraction(LVEF) level was increased, left ventricular end-diastolic diameter(LVEDD) and left ventricular endsystolic diameter(LVESD) levels were decreased in both groups after treatment, and the difference was statistically significant(P<0.05). After treatment, the levels of LVEF in the treatment group were higher than those inthe control group, and the levels of LVEDD and LVESD in the treatment group were lower than those in the control group, the difference was statistically significant(P<0.05). After treatment, the levels of motilin and gastrin were increased in both groups(P<0.05), and the levels of motilin and gastrin in the treatment group were higher than those in the control group(P<0.05). The serum levels of CF-6, APN and ICAM-1 were decreased in both groups after treatment, and the levels of serum CF-6, APN and ICAM-1 in the treatment group were lower than those in the control group(P <0.05). The total incidence of adverse reactions in the treatment group(14.89%) was lower than that in the control group(31.91%), but there was no significant difference(P>0.05).Conclusion: Qihong decoction combined with Xinkeshu tablet has better clinical efficacy in treating CHF with Qi deficiency and blood stasis syndrome. It can improve the heart function, promote the secretion of motilin and gastrin, increase appetite, and reduce the levels of serum CF-6, APN and ICAM-1.
Objective: To study the efficacy of Qihong decoction combined with Xinkeshu tablet in the treatment of coronary heart disease complicated with chronic heart failure(CHF) with Qi deficiency and blood stasis syndrome. Methods: A total of 94 CHF patients with Qi deficiency and blood stasis syndrome were randomly divided into two groups, with 47 cases in each group. The control group was treated with Xinkeshu tablet( 心可舒片), while the treatment group was treated with Qihong decoction( 芪红汤) combined with Xinkeshu tablet. The clinical efficacy, cardiac function, appetite, serum levels of mitochondrial coupling factor(CF-6),adiponectin(APN), intercellular adhesion molecule-1(ICAM-1) and adverse reactions were observed and compared between the two groups. Results: The total effective rate was 89.36% in the treatment group and 61.70%in the control group. The treatment group was superior to the control group(P<0.05). The left ventricular ejection fraction(LVEF) level was increased, left ventricular end-diastolic diameter(LVEDD) and left ventricular endsystolic diameter(LVESD) levels were decreased in both groups after treatment, and the difference was statistically significant(P<0.05). After treatment, the levels of LVEF in the treatment group were higher than those inthe control group, and the levels of LVEDD and LVESD in the treatment group were lower than those in the control group, the difference was statistically significant(P<0.05). After treatment, the levels of motilin and gastrin were increased in both groups(P<0.05), and the levels of motilin and gastrin in the treatment group were higher than those in the control group(P<0.05). The serum levels of CF-6, APN and ICAM-1 were decreased in both groups after treatment, and the levels of serum CF-6, APN and ICAM-1 in the treatment group were lower than those in the control group(P <0.05). The total incidence of adverse reactions in the treatment group(14.89%) was lower than that in the control group(31.91%), but there was no significant difference(P>0.05).Conclusion: Qihong decoction combined with Xinkeshu tablet has better clinical efficacy in treating CHF with Qi deficiency and blood stasis syndrome. It can improve the heart function, promote the secretion of motilin and gastrin, increase appetite, and reduce the levels of serum CF-6, APN and ICAM-1.
引文
[1]汪奕忱,庄燕,顾阳,等.黄芪注射液联合复方丹参注射液治疗心力衰竭临床疗效Meta分析[J].中医药导报,2016,23(24):62-68.
[2]唐胜,沈建锋,谢玉华,等.自拟益气活血方治疗冠心病慢性心力衰竭临床效果及对炎症因子水平的影响[J].河北中医药学报,2018,33(1):857-859.
[3] SANDRI M, VVEHMANN M, ADAMS V, et al.Chronic heart failure and aging-effects of exercise training on endothelial function and mechanisms of endothelial regeneration:Results from the Leipzig Exercise Intervention in Chronic heart failure and Aging(LEICA)study[J]. European Journal of Preventive Cardiology,2016,23(4):349.
[4]赵汉清,贾评,蒋欢欢,等.利水活血温阳方结合穴位敷贴治疗慢性心力衰竭的疗效观察[J].中医药导报,2017,22(16):93-96.
[5]徐雪峰.自拟黄芪桃红汤辅助化疗对乳腺癌术后患者免疫功能的影响研究[J].现代中西医结合杂志,2016,25(23):2547-2549.
[6]中华医学会心血管病学分会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[7] YORK S N. NEW York Heart Association ClassificationThe Stages of Heart Failure[M]. New York:Springer,2010:4269-4269.
[8]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:77-79.
[9]卢永昕.慢性心力衰竭的临床评估和治疗原则:2005 ACC/AHA慢性心力衰竭治疗指南简介[J].临床心血管病杂志,2005,21(11):691-695.
[10]鲁延红,王东艳,屈莫,等.循证干预对冠心病介入手术后患者QOL评分及情绪的影响[J].西部医学,2016,28(3):424-426.
[11]李清.养心氏片联合曲美他嗪治疗冠心病合并慢性心力衰竭对血管内皮功能的影响[J].河北医药,2017,39(8):1222-1224.
[12]王素青,林英会.冠心病合并慢性心力衰竭患者血清HCY、CF-6、UMA水平及意义[J].解放军预防医学杂志,2017,35(2):142-143.
[13]田龙.补气畅络方对冠心病伴心衰患者BNP、APN、MMP-9的影响及临床疗效分析[J].四川中医,2017,36(6):62-65.
[14] NG R C, CHENG O Y, JIAN M, et al. Chronic adiponectin deficiency leads to Alzheimer’s disease-like cognitive impairments and pathologies through AMPK inactivation and cerebral insulin resistance in aged mice[J].Molecular Neurodegeneration,2016,11(1):71.
[15]郝明芬,范颖,李新,等.黄芪葛根配伍对糖尿病大鼠胰腺组织脂联素及其受体的影响和交互效应[J].中医药导报,2016,23(5):7-9.
[16]姜敏华,敬波,宁保红.血塞通软胶囊治疗冠心病合并慢性心力衰竭疗效及对血清D-二聚体、NT-proBNP、ICAM-1的影响[J].现代中西医结合杂志,2016,25(29):3221-3224.
[17]王强,施洪飞.红芪复方预处理对大鼠心肌缺血再灌注损伤的保护作用[J].中国新药与临床杂志,2016,35(9):659-664.
[18]王转转.长期口服芪红汤对慢性心力衰竭患者左心室重构、MMP-9及NP-proBNP的影响[J].陕西中医,2017,38(2):165-166.
[19]韩轶,陈继红,高玉,等.芪红汤联合美托洛尔治疗冠心病合并慢性心力衰竭的疗效及对心功能、hs-CRP、NTproBNP的影响[J].陕西中医,2015,36(7):800-801.
[20]王健,曾庆宁,周晓露,等.益气温阳活血利水方对慢性心力衰竭患者ICAM-1水平的影响[J].四川中医,2017,36(2):76-78.
[2]唐胜,沈建锋,谢玉华,等.自拟益气活血方治疗冠心病慢性心力衰竭临床效果及对炎症因子水平的影响[J].河北中医药学报,2018,33(1):857-859.
[3] SANDRI M, VVEHMANN M, ADAMS V, et al.Chronic heart failure and aging-effects of exercise training on endothelial function and mechanisms of endothelial regeneration:Results from the Leipzig Exercise Intervention in Chronic heart failure and Aging(LEICA)study[J]. European Journal of Preventive Cardiology,2016,23(4):349.
[4]赵汉清,贾评,蒋欢欢,等.利水活血温阳方结合穴位敷贴治疗慢性心力衰竭的疗效观察[J].中医药导报,2017,22(16):93-96.
[5]徐雪峰.自拟黄芪桃红汤辅助化疗对乳腺癌术后患者免疫功能的影响研究[J].现代中西医结合杂志,2016,25(23):2547-2549.
[6]中华医学会心血管病学分会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[7] YORK S N. NEW York Heart Association ClassificationThe Stages of Heart Failure[M]. New York:Springer,2010:4269-4269.
[8]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:77-79.
[9]卢永昕.慢性心力衰竭的临床评估和治疗原则:2005 ACC/AHA慢性心力衰竭治疗指南简介[J].临床心血管病杂志,2005,21(11):691-695.
[10]鲁延红,王东艳,屈莫,等.循证干预对冠心病介入手术后患者QOL评分及情绪的影响[J].西部医学,2016,28(3):424-426.
[11]李清.养心氏片联合曲美他嗪治疗冠心病合并慢性心力衰竭对血管内皮功能的影响[J].河北医药,2017,39(8):1222-1224.
[12]王素青,林英会.冠心病合并慢性心力衰竭患者血清HCY、CF-6、UMA水平及意义[J].解放军预防医学杂志,2017,35(2):142-143.
[13]田龙.补气畅络方对冠心病伴心衰患者BNP、APN、MMP-9的影响及临床疗效分析[J].四川中医,2017,36(6):62-65.
[14] NG R C, CHENG O Y, JIAN M, et al. Chronic adiponectin deficiency leads to Alzheimer’s disease-like cognitive impairments and pathologies through AMPK inactivation and cerebral insulin resistance in aged mice[J].Molecular Neurodegeneration,2016,11(1):71.
[15]郝明芬,范颖,李新,等.黄芪葛根配伍对糖尿病大鼠胰腺组织脂联素及其受体的影响和交互效应[J].中医药导报,2016,23(5):7-9.
[16]姜敏华,敬波,宁保红.血塞通软胶囊治疗冠心病合并慢性心力衰竭疗效及对血清D-二聚体、NT-proBNP、ICAM-1的影响[J].现代中西医结合杂志,2016,25(29):3221-3224.
[17]王强,施洪飞.红芪复方预处理对大鼠心肌缺血再灌注损伤的保护作用[J].中国新药与临床杂志,2016,35(9):659-664.
[18]王转转.长期口服芪红汤对慢性心力衰竭患者左心室重构、MMP-9及NP-proBNP的影响[J].陕西中医,2017,38(2):165-166.
[19]韩轶,陈继红,高玉,等.芪红汤联合美托洛尔治疗冠心病合并慢性心力衰竭的疗效及对心功能、hs-CRP、NTproBNP的影响[J].陕西中医,2015,36(7):800-801.
[20]王健,曾庆宁,周晓露,等.益气温阳活血利水方对慢性心力衰竭患者ICAM-1水平的影响[J].四川中医,2017,36(2):76-78.