益气通脉汤对冠心病心力衰竭患者左心室射血分数、用力肺活量、第1秒钟用力呼气容积及N端脑钠肽前体水平的影响
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摘要
目的:研究益气通脉汤对冠心病心力衰竭患者左心室射血分数(LVEF)、用力肺活量(FVC)、第1秒钟用力呼气容积(FEV_1)及N端脑钠肽前体(Nt-pro BNP)水平的影响。方法:选取2015年2月至2017年2月接受治疗的冠心病心力衰竭患者84例进行回顾性分析。根据就诊时间前后顺序分为观察组与对照组,每组42例。对照组予以常规西药治疗,观察组则在对照组的基础上予以益气通脉汤治疗。分别比较2组临床疗效,治疗前后LVEF、FVC、FEV_1以及6 min步行距离,治疗前后血浆Nt-pro BNP水平,治疗前后IL-6、TNF-α水平变化情况。结果:观察组治疗总有效率为95.24%(40/42),明显高于对照组的80.95%(34/42),差异有统计学意义(P<0.05)。治疗后观察组LVEF、FVC、FEV_1以及6 min步行距离分别为(52.9±7.5)%、(2.6±0.5)L、(1.7±0.3)L、(413.1±67.2)m,均明显高于对照组的(45.3±9.6)%、(2.2±0.3)L、(1.4±0.1)L、(365.4±73.2)m,差异有统计学意义(P<0.05)。治疗后观察组与对照组血浆NT-pro BNP水平分别为(478.7±211.4)pg/m L、(783.5±281.5)pg/m L,均明显低于治疗前,而观察组又明显低于对照组,差异均有统计学意义(均P<0.05)。治疗后血清IL-6、TNF-α水平分别为(10.4±2.5)ng/L、(4.5±0.9)mg/L,均明显低于对照组的(17.2±3.3)ng/L、(7.5±1.2)mg/L,差异有统计学意义(P<0.05)。结论:益气通脉汤可有效改善冠心病心力衰竭患者心肺功能,同时有利于降低炎性反应。
Objective: To study the effect of Yiqi Tongmai Decoction on left ventricular ejection fraction( LVEF),forced vital capacity( FVC),forced expiratory volume in one second( FEV_1) and N terminal pro brain natriuretic peptide( Nt-pro BNP) of patients with coronary heart disease. Methods: A retrospective analysis was conducted for 84 cases of patients with coronary heart disease and heart failure from February 2015 to February 2017 in our hospital. According to the time of diagnosis,they were divided into study group and control group,with 42 cases in each group. The control group received conventional western medicine treatment,and the study group was given Yiqi Tongmai Decoction on the basis of that. The clinical curative effect of two groups was compared respectively. LVEF,FVC,FEV_1 and 6 min walking distance,plasma levels of Nt-pro BNP,IL-6,and the changes of TNF-α level of two groups before and after treatment were compared. Results: The total effective rate of study group was95. 24%( 40/42),which was significantly higher than the control group 80. 95%( 34/42). The difference was statistically significant( P < 0. 05). LVEF,FVC,FEV_1 and 6 min walking distance of the study group of after treatment respectively was( 52. 9± 7. 5) % and( 2. 6 ± 0. 5) L,( 1. 7 ± 0. 3) L,( 413. 1 ± 67. 2) m,which were significantly higher than those in control group of( 45. 3 ± 9. 6) % and( 2. 2 ± 0. 3) L,( 1. 4 ± 0. 1) L,( 365. 4 ± 73. 2) m. The differences were statistically significant( P <0. 05). After treatment,the plasma levels of NT-pro BNP of the study group and the control group were( 478. 7 ± 211. 4) pg/m L,( 783. 5 ± 281. 5) pg/m L respectively,which was significantly lower than before treatment. The study group was significantly lower than the control group. The differences were statistically significant( P < 0. 05). After treatment,the serum IL-6,TNF-α was( 10. 4 ± 2. 5) ng/L,( 4. 5 ± 0. 9) mg/L,which were significantly lower than the control group( 17. 2 ± 3. 3) ng/L,( 7. 5 ± 1. 2)mg/L. The differences were statistically significant( P < 0. 05). Conclusion: Yiqi Tongmai Decoction can effectively improve the heart and lung function in patients with coronary heart disease and heart failure,and reduce the inflammatory reaction at the same time.
Objective: To study the effect of Yiqi Tongmai Decoction on left ventricular ejection fraction( LVEF),forced vital capacity( FVC),forced expiratory volume in one second( FEV_1) and N terminal pro brain natriuretic peptide( Nt-pro BNP) of patients with coronary heart disease. Methods: A retrospective analysis was conducted for 84 cases of patients with coronary heart disease and heart failure from February 2015 to February 2017 in our hospital. According to the time of diagnosis,they were divided into study group and control group,with 42 cases in each group. The control group received conventional western medicine treatment,and the study group was given Yiqi Tongmai Decoction on the basis of that. The clinical curative effect of two groups was compared respectively. LVEF,FVC,FEV_1 and 6 min walking distance,plasma levels of Nt-pro BNP,IL-6,and the changes of TNF-α level of two groups before and after treatment were compared. Results: The total effective rate of study group was95. 24%( 40/42),which was significantly higher than the control group 80. 95%( 34/42). The difference was statistically significant( P < 0. 05). LVEF,FVC,FEV_1 and 6 min walking distance of the study group of after treatment respectively was( 52. 9± 7. 5) % and( 2. 6 ± 0. 5) L,( 1. 7 ± 0. 3) L,( 413. 1 ± 67. 2) m,which were significantly higher than those in control group of( 45. 3 ± 9. 6) % and( 2. 2 ± 0. 3) L,( 1. 4 ± 0. 1) L,( 365. 4 ± 73. 2) m. The differences were statistically significant( P <0. 05). After treatment,the plasma levels of NT-pro BNP of the study group and the control group were( 478. 7 ± 211. 4) pg/m L,( 783. 5 ± 281. 5) pg/m L respectively,which was significantly lower than before treatment. The study group was significantly lower than the control group. The differences were statistically significant( P < 0. 05). After treatment,the serum IL-6,TNF-α was( 10. 4 ± 2. 5) ng/L,( 4. 5 ± 0. 9) mg/L,which were significantly lower than the control group( 17. 2 ± 3. 3) ng/L,( 7. 5 ± 1. 2)mg/L. The differences were statistically significant( P < 0. 05). Conclusion: Yiqi Tongmai Decoction can effectively improve the heart and lung function in patients with coronary heart disease and heart failure,and reduce the inflammatory reaction at the same time.
引文
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[8]阿吉木·吾布力哈斯木,阿吉古力·巴吾东,曲曼古丽·亚逊,等.益心舒胶囊联合坎地沙坦治疗冠心病并慢性心力衰竭患者的临床疗效[J].实用心脑肺血管病杂志,2017,25(4):77-80.
[9]胡英,王伟.阿托伐他汀对冠心病合并心力衰竭患者心功能与预后的影响[J].医学综述,2017,23(10):2062-2065.
[10]褚美琴,俞学铭,许慧芬.不同剂量阿托伐他汀治疗冠状动脉粥样硬化性心脏病慢性心力衰竭疗效分析[J].中国生化药物杂志,2017,37(8):139-141.
[11]刘晓玲,张爱军,李洋,等.自拟养胃护心汤对慢性心力衰竭患者症状缓解期食欲减退的疗效观察[J].世界中医药,2017,12(8):1852-1854.
[12]石立鹏,周爱民,杜旭勤,等.真武汤合血府逐瘀汤对冠心病心力衰竭患者心功能及血浆NT-pro BNP的影响[J].中国中医急症,2017,26(1):15-18.
[13]贾宏育.益气温阳活血利水中药治疗冠心病心力衰竭的临床效果观察[J].中国现代药物应用,2017,11(7):190-191.
[14]李栋.益气通脉汤治疗冠心病心力衰竭的疗效及对N端脑钠肽前体的影响[J].实用中西医结合临床,2015,15(3):15-16.
[15]单翠平.益气通脉汤对冠心病心力衰竭患者心功能及N端脑钠肽前体的影响[J].中西医结合心血管病电子杂志,2016,4(24):1-2.
[16]郭海龙,李瑞环,金川.自拟益气通脉汤在冠心病心力衰竭治疗的效果分析[J].临床心身疾病杂志,2016,22(z2):90-91.
[17]《基层医院心力衰竭临床诊疗中B型利钠肽和N末端B型利钠肽原的应用中国专家建议》专家组.基层医院心力衰竭临床诊疗中B型利钠肽和N末端B型利钠肽原的应用中国专家建议[J].中华全科医师杂志,2017,16(3):169-173.
[18]刘鹏,高学良,原建华,等.心脉隆治疗冠心病心力衰竭的临床疗效及对血浆高敏C反应蛋白和N末端B型脑钠肽前体的影响[J].中华老年医学杂志,2017,36(5):502-505.
[19]林营,陈智,陈苗苗.益气通脉汤对冠心病心力衰竭患者心功能及N端脑钠肽前体的影响[J].实用医学杂志,2012,28(3):488-490.
[2]黄劲增.生脉注射液联合丹参多酚酸盐注射液治疗冠心病慢性心力衰竭的疗效分析[J].中医临床研究,2017,9(13):16-18.
[3]张东阳,白小涓,韩璐璐,等.老年心力衰竭早期阶段患者血小板参数与肾功能评价的相关性研究[J].中华老年心脑血管病杂志,2017,19(7):725-730.
[4]仇晓敏,胡晓晟,蒲建芬,等.冠心病心力衰竭患者QRS波时限与血浆Hcy的相关性分析[J].中华全科医学,2016,14(7):1134-1137.
[5]谢中华,方大楼,刘清文,等.美托洛尔单用和联合通心络治疗冠心病心力衰竭疗效比较[J].中国实用医刊,2014,41(7):107-108.
[6]朱小莉,周云,王晓峰,等.芪苈强心胶囊对冠心病合并心力衰竭患者血清脑钠肽及心功能的影响[J].湖南师范大学学报:医学版,2017,14(2):42-44.
[7]Simmons MA,Brueckner M.The genetics of congenital heart disease…understanding and improving long-term outcomes in congenital heart disease:a review for the general cardiologist and primary care physician[J].Curr Opin Pediatr,2017,29(5):520-528.
[8]阿吉木·吾布力哈斯木,阿吉古力·巴吾东,曲曼古丽·亚逊,等.益心舒胶囊联合坎地沙坦治疗冠心病并慢性心力衰竭患者的临床疗效[J].实用心脑肺血管病杂志,2017,25(4):77-80.
[9]胡英,王伟.阿托伐他汀对冠心病合并心力衰竭患者心功能与预后的影响[J].医学综述,2017,23(10):2062-2065.
[10]褚美琴,俞学铭,许慧芬.不同剂量阿托伐他汀治疗冠状动脉粥样硬化性心脏病慢性心力衰竭疗效分析[J].中国生化药物杂志,2017,37(8):139-141.
[11]刘晓玲,张爱军,李洋,等.自拟养胃护心汤对慢性心力衰竭患者症状缓解期食欲减退的疗效观察[J].世界中医药,2017,12(8):1852-1854.
[12]石立鹏,周爱民,杜旭勤,等.真武汤合血府逐瘀汤对冠心病心力衰竭患者心功能及血浆NT-pro BNP的影响[J].中国中医急症,2017,26(1):15-18.
[13]贾宏育.益气温阳活血利水中药治疗冠心病心力衰竭的临床效果观察[J].中国现代药物应用,2017,11(7):190-191.
[14]李栋.益气通脉汤治疗冠心病心力衰竭的疗效及对N端脑钠肽前体的影响[J].实用中西医结合临床,2015,15(3):15-16.
[15]单翠平.益气通脉汤对冠心病心力衰竭患者心功能及N端脑钠肽前体的影响[J].中西医结合心血管病电子杂志,2016,4(24):1-2.
[16]郭海龙,李瑞环,金川.自拟益气通脉汤在冠心病心力衰竭治疗的效果分析[J].临床心身疾病杂志,2016,22(z2):90-91.
[17]《基层医院心力衰竭临床诊疗中B型利钠肽和N末端B型利钠肽原的应用中国专家建议》专家组.基层医院心力衰竭临床诊疗中B型利钠肽和N末端B型利钠肽原的应用中国专家建议[J].中华全科医师杂志,2017,16(3):169-173.
[18]刘鹏,高学良,原建华,等.心脉隆治疗冠心病心力衰竭的临床疗效及对血浆高敏C反应蛋白和N末端B型脑钠肽前体的影响[J].中华老年医学杂志,2017,36(5):502-505.
[19]林营,陈智,陈苗苗.益气通脉汤对冠心病心力衰竭患者心功能及N端脑钠肽前体的影响[J].实用医学杂志,2012,28(3):488-490.