益气活血温心汤联合西药对慢性心力衰竭患者心功能、血浆脑钠肽及超敏C反应蛋白的影响
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摘要
目的探讨益气活血温心汤联合西药对慢性心力衰竭(chronic heart failure, CHF)患者心功能、血浆脑钠肽(brain natriuretic peptide, BNP)、超敏C-反应蛋白(hypersensitive c-reactive protein, hs-CRP)等的影响。方法将2017年10月至2018年10月本院门诊部收治的92例CHF患者随机分为观察组和对照组,每组46例。对照组采用西药常规治疗,观察组在对照组的基础上采用益气活血温心汤治疗。观察治疗后两组CHF患者的临床疗效,对比治疗前后两组CHF患者心功能[左心室射血分数(left ventricular ejection fractions, LVEF)及左心室舒张末期内径(left ventricular end diastolic diameter, LVEDD)]、血浆BNP浓度、hs-CRP水平及6 min步行距离。结果 (1)治疗后观察组患者的总有效率高于对照组,差异有统计学意义(P<0.05);(2)治疗后,两组患者的6 min步行距离较治疗前升高,血浆BNP浓度、hs-CRP水平较治疗前比较有所下降,差异均有统计学意义(P<0.05),且观察组的6 min步行距离高于对照组(P<0.05),血浆BNP浓度、hs-CRP水平低于对照组(P<0.05);(3)治疗后,两组患者的LVEF较治疗前升高,LVEDD较治疗前下降,差异均有统计学意义(P<0.05),且观察组的LVEF高于对照组,LVEDD低于对照组(P<0.05)。结论益气活血温心汤联合西药治疗CHF患者疗效明显,可通过提高6 min步行距离、LVEF并且降低血浆BNP浓度、hs-CRP水平、LVEDD来实现,且优于单纯西药治疗。
Objective To explore the effects of Yiqi Huoxue Wenxin Decoction combined with Western medicine on cardiac function, plasma brain natriuretic peptide(BNP), and hypersensitive C-reactive protein(hs-CRP) in patients with chronic heart failure(CHF). Methods A total of 92 CHF patients admitted to our hospital from October 2017 to October2018 were randomly and equally divided into observation group and control group. The control group was treated with conventional Western medicine, while the observation group was treated with Yiqi Huoxue Wenxin Decoction in addition to conventional Western medicine. The clinical outcomes were compared between the two groups after treatment. The cardiac function [left ventricular ejection fraction(LVEF) and left ventricular end-diastolic diameter(LVEDD)], plasma BNP concentration, hs-CRP level, and 6-minute walking distance were compared between the two groups before and after treatment. Results(1) After treatment, the observation group had a significantly higher overall response rate than the control group(P<0.05);(2) After treatment, both groups had a significantly longer 6-minute walking distance and significantly reduced plasma BNP concentrations and hs-CRP levels(P <0.05). Moreover, the observation group had a significantly longer6-minute walking distance and significantly lower plasma BNP concentration and hs-CRP level than the control group(P <0.05);(3) After treatment, both groups had significantly increased LVEF and significantly reduced LVEDD(P<0.05). Moreover,the observation group had a significantly higher LVEF and a significantly lower LVEDD than the control group(P <0.05).Conclusion Yiqi Huoxue Wenxin Decoction combined with Western medicine is substantially effective in the treatment of CHF patients by increasing 6-minute walking distance and LVEF as well as reducing plasma BNP concentration, hs-CRP level,and LVEDD. The combination therapy is superior to Western medicine alone.
Objective To explore the effects of Yiqi Huoxue Wenxin Decoction combined with Western medicine on cardiac function, plasma brain natriuretic peptide(BNP), and hypersensitive C-reactive protein(hs-CRP) in patients with chronic heart failure(CHF). Methods A total of 92 CHF patients admitted to our hospital from October 2017 to October2018 were randomly and equally divided into observation group and control group. The control group was treated with conventional Western medicine, while the observation group was treated with Yiqi Huoxue Wenxin Decoction in addition to conventional Western medicine. The clinical outcomes were compared between the two groups after treatment. The cardiac function [left ventricular ejection fraction(LVEF) and left ventricular end-diastolic diameter(LVEDD)], plasma BNP concentration, hs-CRP level, and 6-minute walking distance were compared between the two groups before and after treatment. Results(1) After treatment, the observation group had a significantly higher overall response rate than the control group(P<0.05);(2) After treatment, both groups had a significantly longer 6-minute walking distance and significantly reduced plasma BNP concentrations and hs-CRP levels(P <0.05). Moreover, the observation group had a significantly longer6-minute walking distance and significantly lower plasma BNP concentration and hs-CRP level than the control group(P <0.05);(3) After treatment, both groups had significantly increased LVEF and significantly reduced LVEDD(P<0.05). Moreover,the observation group had a significantly higher LVEF and a significantly lower LVEDD than the control group(P <0.05).Conclusion Yiqi Huoxue Wenxin Decoction combined with Western medicine is substantially effective in the treatment of CHF patients by increasing 6-minute walking distance and LVEF as well as reducing plasma BNP concentration, hs-CRP level,and LVEDD. The combination therapy is superior to Western medicine alone.
引文
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[6]成蓓,张秀娥,彭雯,等.6分钟步行试验评价心衰患者的心功能[J].中华慢性病杂志,2004,3(3):1-4.
[7]杨波,张道亮,周琍珍,等.保心合剂对慢性心力衰竭患者血浆脑钠肽及心功能的影响[J].中国中西医结合急救杂志,2008,15(1):34-36.
[8]李玉子,金恩泽,关立克,等.曲美他嗪对慢性心力衰竭患者血浆脑钠肽水平及心功能的影响[J].临床心血管病杂志,2007,23(11):879-880.
[9]李建明,张杰,史忠良,等.慢性心力衰竭患者血尿酸、脑钠肽水平联合检测的临床价值和意义[J].中国实用医刊,2015,42(12):82-84.
[10]舒华,张世鹰,王笑莹,等.“动而生阳”理论对慢性心力衰竭患者运动康复影响分析[J].湖南中医药大学学报,2015,35(11),27-29.
[11]杨晓琨.论活血化瘀法治疗慢性充血性心力衰竭[J].中国中医急症,2007,16(7):834-835.
[12]邵静.益心汤对慢性心衰患者肿瘤坏死因子及血管内皮素的影响[J].社区中医药,2009,11(22):149-150.
[2] LEDWIDGE M, GALLAGHER J, CONLON C, et al. Natriuretic peptide-based screening and collaborative care for heart failure:the STOP-HF randomized trial[J]. The Journal of the American Medical Association, 2013,310(1):66-74.
[3]陈国伟.心功能的判定和分级[J].中国社区医师,2002,18(20):15-16.
[4]中华医学会心血管病学分会.2007年中国慢性心力衰竭诊断标准指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[5]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,2002:72-77.
[6]成蓓,张秀娥,彭雯,等.6分钟步行试验评价心衰患者的心功能[J].中华慢性病杂志,2004,3(3):1-4.
[7]杨波,张道亮,周琍珍,等.保心合剂对慢性心力衰竭患者血浆脑钠肽及心功能的影响[J].中国中西医结合急救杂志,2008,15(1):34-36.
[8]李玉子,金恩泽,关立克,等.曲美他嗪对慢性心力衰竭患者血浆脑钠肽水平及心功能的影响[J].临床心血管病杂志,2007,23(11):879-880.
[9]李建明,张杰,史忠良,等.慢性心力衰竭患者血尿酸、脑钠肽水平联合检测的临床价值和意义[J].中国实用医刊,2015,42(12):82-84.
[10]舒华,张世鹰,王笑莹,等.“动而生阳”理论对慢性心力衰竭患者运动康复影响分析[J].湖南中医药大学学报,2015,35(11),27-29.
[11]杨晓琨.论活血化瘀法治疗慢性充血性心力衰竭[J].中国中医急症,2007,16(7):834-835.
[12]邵静.益心汤对慢性心衰患者肿瘤坏死因子及血管内皮素的影响[J].社区中医药,2009,11(22):149-150.