[1]黄 磊,王凌燕,熊 专,等.温阳健脾方治疗心力衰竭疗效观察[J].陕西中医,2024,(10):1374-1376,1381.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.017]
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温阳健脾方治疗心力衰竭疗效观察
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1374-1376,1381
栏目:
临床研究
出版日期:
2024-10-05

文章信息/Info

作者:
黄 磊1王凌燕1熊 专1廖 林2
(1.武汉中西医结合骨科医院 武汉体育学院附属医院,湖北 武汉 430070; 2.武汉市中医医院,湖北 武汉 430070)
关键词:
心力衰竭 温阳健脾方 心功能 生活质量 生物标志物 肌钙蛋白I
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7369.2024.10.017
文献标志码:
A
摘要:
目的:观察温阳健脾方改善心力衰竭患者心功能的临床疗效。方法:120例心力衰竭患者按照随机数字表法分为对照组和观察组。对照组给予地高辛、曲美他嗪等西药内服治疗; 而观察组则给予西药内服联合温阳健脾方中药口服治疗。两组均连续治疗8周。采用NYHA心功能分级,评估患者治疗后心功能分级,计算两组患者治疗后临床有效率; 记录并对比两组中医症候积分。检测患者肌钙蛋白I(TnI)、肌酸激酶同工酶(CK-MB)、半乳糖凝集素-3(Galectin-3)和氨基末端B型钠尿肽前体(NT-proBNP)指标变化。采用6 min步行试验(6MWT)和明尼苏达州心功能不全生命质量量表(MLHFQ)评价患者生活质量。此外,观察患者治疗不良反应。结果:NYHA心功能分级疗效比较发现两组总有效率分别为53.33%和71.67%,观察组明显高于对照组(P<0.05)。中医症候积分比较结果提示观察组明显高于对照组(P<0.05)。与治疗前相比,治疗后两组TnI、CK-MB、Galectin-3和NT-proBNP水平明显降低; 6MWT步行距离明显增加,MLHFQ评分明显降低; 且观察组的改善趋势优于对照组(均P<0.05)。治疗后两组均未见严重不良事件。结论:温阳健脾方可增强心力衰竭患者临床疗效,改善心功能并提高生活质量,可能与降低患者TnI、CK-MB、Galectin-3和NT-proBNP水平有关。

参考文献/References:

[1] 毕月,史娜.血清核苷酸结合寡聚化结构域样受体蛋白3水平与心力衰竭患者心电图QRS波时限关系[J].陕西医学杂志,2022,51(1):48-50.
[2] TOMASONI D,ADAMO M,LOMBARDI C M,et al.Highlights in heart failure[J].ESC Heart Fail,2019,6(6):1105-1127.
[3] 边树伟,周志安.频发室性早搏致心肌病诱发心力衰竭一例并文献复习[J].中华老年多器官疾病杂志,2022,20(12):959-960.
[4] 朱杰,林兆奋,胡聃,等.中西医结合治疗慢性心力衰竭研究进展[J].陕西中医,2020,41(9):1342-1344.
[5] 廖晓倩,范星宇,黄淑敏,等.基于证素辨证的心力衰竭精准辨证模式探析[J].中国中医基础医学杂志,2023,29(7):1119-1123.
[6] 陈铭钦,雷瑗琳,师瑞瑞,等.益心附葶饮对慢性心力衰竭心肾阳虚证大鼠HIF-1/VEGF信号通路的影响[J].陕西中医,2023,44(11):1527-1531.
[7] LI X Q,HE J C,HUANG P X,et al.Chinese medicine syndromes in congestive heart failure:A literature study and retrospective analysis of clinical cases[J].Chin J Inter Med,2016,22(10):738-744.
[8] WANG S M,YE L F,WANG L H.Traditional Chinese medicine enhances myocardial metabolism during heart failure[J].Biomed Pharmacother,2022,146:112538.
[9] 林清志,陈广,谢夏南,等.温阳健脾化瘀法治疗慢性肺源性心脏病心力衰竭临床观察[J].内蒙古中医药,2019,38(10):47-49.
[10] 张茂,刘四荣.温阳健脾法对老年慢性心力衰竭病人血清BNP、MMP-2及肝细胞生长因子水平的影响[J].中西医结合心脑血管病杂志,2016,21(16):1848-1851.
[11] SKRZYPEK A,MOSTOWIK M,SZELIGA M,et al.Chronic heart failure in the elderly:Still a current medical problem[J].Folia Med Cracov,2018,58(4):47-56.
[12] BASIC C,ROSENGREN A,DAHLSTROM U,et al.Sex-related differences among young adults with heart failure in Sweden[J].Int J Cardiol,2022,362:97-103.
[13] TRIPOSKIADIS F,XANTHOPOULOS A,PARISSIS J,et al.Pathogenesis of chronic heart failure:Cardiovascular aging,risk factors,comorbidities,and disease modifiers[J].Heart Fail Rev,2022,27(1):337-344.
[14] WU Y,CHEN L,ZHONG F,et al.Cognitive impairment in patients with heart failure:Molecular mechanism and therapy[J].Heart Fail Rev,2023,28(4):807-820.
[15] 高颖,孟蕾.双水平无创正压通气对老年中晚期肺癌并心力衰竭患者心肺功能及心肌损伤标志物的影响[J].陕西医学杂志,2023,52(4):428-432.
[16] WAN J,ZHANG Z,WU C,et al.Astragaloside Ⅳ derivative HHQ16 ameliorates infarction-induced hypertrophy and heart failure through degradation of lncRNA4012/9456[J].Signal Transduct Target Ther,2023,8(1):414-429.
[17] 郭言午,方才敬,施俊峰,等.基于网络药理学和临床观察探讨参芪健心方干预气虚血瘀型慢性心力衰竭的临床疗效和机制[J].中西医结合心脑血管病杂志,2023,21(7):1180-1185.
[18] 涂雅丹,何德英,任毅.五苓散合桂枝茯苓丸治疗舒张性心力衰竭(阳虚血瘀水停型)患者的临床观察[J].湖北中医杂志,2023,45(5):3-7.
[19] 刘挺,曹守沛.冠状动脉粥样硬化性心脏病气虚血瘀证中医证治研究[J].中医临床研究,2022,14(4):130-133.
[20] 夏梅华,刘金良,魏艳伟,等.督脉灸联合益气温阳活血利水方治疗阳气亏虚,血瘀水停型慢性心力衰竭临床研究[J].河北中医,2023,45(10):1703-1706.
[21] YU Y,JIN Z X,LUO F K,et al.Research ideas of core formulas-syndromes based on disease-syndrome-treatment combination[J].Zhongguo Zhong Yao Za Zhi,2023,48(10):2625-2629.
[22] KWAK M J,WANG Q,ONYEBEKE C,et al.How do we define high and low dose intensity of heart failure medications:A scoping review[J].BMC Cardiovasc Disord,2023,23(1):478-487.
[23] 陈宏丽,林谦.益气活血利水法应用于慢性心力衰竭利尿剂治疗致不良反应1则分析[J].北京中医药,2022,41(10):1193-1194.
[24] WANG Y,WANG Q,LI C,et al.A review of Chinese herbal medicine for the treatment of chronic heart failure[J].Curr Pharm Des,2017,23(34):5115-5124.
[25] QIANG Z,WANG B,GARRETT B C,et al.Coronavirus disease 2019:A comprehensive review and meta-analysis on cardiovascular biomarkers[J].Curr Opin Cardiol,2021,36(3):367-373.

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备注/Memo

备注/Memo:
基金项目:湖北省科技厅自然科学基金资助项目(2020FB970); 武汉市卫生与健康委员会医学科研项目(WZ20C14); 武汉六七二中西医结合骨科医院院级科研项目(HGY202004)
更新日期/Last Update: 2024-10-08