[1]崔晓雪,郭斯一,尹宝.加味猪苓汤联合新活素治疗气阴两虚兼水热互结型心力衰竭临床研究[J].陕西中医,2025,46(6):776-781.[doi:DOI:10.3969/j.issn.1000-7369.2025.06.011]
　CUI Xiaoxue,GUO Siyi,YIN Bao.The clinical efficacy of Jiawei Zhuling decoction combined with recombinant human brain natriuretic peptide in the treatment of qi-yin deficiency and water-heat interjunction heart failure[J].,2025,46(6):776-781.[doi:DOI:10.3969/j.issn.1000-7369.2025.06.011]
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加味猪苓汤联合新活素治疗气阴两虚兼水热互结型心力衰竭临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年6期
页码:
776-781
栏目:
临床研究
出版日期:
2025-06-05

文章信息/Info

Title:
The clinical efficacy of Jiawei Zhuling decoction combined with recombinant human brain natriuretic peptide in the treatment of qi-yin deficiency and water-heat interjunction heart failure
作者:
崔晓雪1; 郭斯一1; 尹宝2
（1.山东中医药大学，山东 济南 250014；2.淄博市中医医院，山东 淄博 255300)
Author(s):
CUI Xiaoxue1; GUO Siyi1; YIN Bao2
(1.Shandong University of Traditional Chinese Medicine,Jinan 250014，China;2.Zibo Hospital of Traditional Chinese Medicine,Zibo 255300，China)
关键词:
心力衰竭; 加味猪苓汤; 新活素; 气阴两虚; 水热互结; 左心室射血分数
Keywords:
Heart failure; Jiawei Zhuling decoction; rhBNP; Qi-yin deficiency; Water-heat interjunction; Left ventricular ejection fraction
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7369.2025.06.011
文献标志码:
A
摘要:
目的：探讨加味猪苓汤联合新活素治疗气阴两虚兼水热互结型心力衰竭(HF)的临床疗效。方法：选取气阴两虚兼水热互结型HF患者84例，按随机数字表法分为对照组和试验组各42例。两组均予以常规药物(沙库巴曲缬沙坦钠、琥珀酸美托洛尔、达格列净、螺内酯)治疗。对照组在常规药物基础上加用新活素。试验组在对照组基础上配合服用加味猪苓汤。两组治疗时间均为14 d。比较两组治疗前后的心功能、中医症候积分、明尼苏达州HF生存质量问卷(MLHF-Q)评分、6 min步行距离、N末端B型利钠肽前体(NT-proBNP)水平、肌钙蛋白I(cTnI)水平、左心室射血分数(LVEF)和左心室舒张末期内径(LVEDD)，并观察安全性指标及不良反应。结果：心功能疗效判定，治疗后对照组总有效率67.5%，试验组总有效率87.5%，试验组患者的心功能改善优于对照组(P＜0.05)。治疗后两组各证素的中医症候积分均较治疗前下降，且试验组下降更显著(P＜0.01)。治疗后两组的MLHF-Q评分均有所降低、6 min步行距离均有所提升，且试验组疗效更显著(P＜0.01)。治疗后两组的NT-proBNP及cTnI水平均有所下降，且试验组下降更多(P＜0.05)。治疗后，两组的LVEF及LVEDD较治疗前差异无统计学意义，试验组较对照组差异无统计学意义(P＞0.05)，但LVEF值治疗后比治疗前略有提升，LVEDD值治疗后比治疗前略有降低。两组均未发现安全性指标异常及不良反应。结论：在常规药物基础上联用加味猪苓汤与新活素治疗气阴两虚兼水热互结型HF相比单纯新活素治疗疗效更加显著，更有助于患者心功能、中医症候、临床症状、生活质量、运动耐量、NT-proBNP水平及心肌损伤的恢复。
Abstract:
Objective:To assess the effectiveness of Jiawei Zhuling decoction in combination with rhBNP,for treating heart failure (HF) patients with qi-yin deficiency and water-heat interjunction.Methods:A total of 84 patients with HF with qi-yin deficiency and water-heat interjunction were selected and divided into control group and experimental group with 42 cases in each group.Both groups were treated with conventional drugs (sacubitril-valsartan,metoprolol,spironolactone,dapagliflozin).In the control group,rhBNP was added to the conventional drug.The experimental group received Jiawei Zhuling decoction in addition to the treatment given to the control group.The treatment time of both groups was 14 days.Cardiac function,TCM syndrome score,minnesota HF quality of life questionnaire (MLHF-Q) score,6-minute walk test distance,NT-proBNP level,cTnI level,LVEF and LVEDD were compared between the two groups before and after treatment,and safety indicators and adverse reactions were observed.Results:The control group achieved a total effective rate of 67.5%,while the experimental group’s rate was significantly higher,reaching 87.5%,and the cardiac performance of the experimental group exhibited superiority compared to the control group (P<0.05).Following treatment,the TCM pattern element decreased in both groups when compared to their pretreatment levels,with a more pronounced reduction observed in the experimental group.(P<0.01).After treatment,the MLHF-Q score and 6-minute walking distance were reduced in both groups,and the experimental group demonstrated a more pronounced effectiveness (P<0.01).After treatment,both NT-proBNP and cTnI levels dropped in both groups,however,the experimental group experienced a more substantial decrease (P<0.05).Post-treatment,there was no statistically significant difference in LVEF or LVEDD when comparing both groups to their pretreatment values,nor was there a significant difference between the experimental and control groups (P>0.05),but the LVEF value was slightly higher after treatment than before treatment,and the LVEDD value was slightly lower after treatment than before treatment.No abnormal safety indicators and adverse reactions were found.Conclusion:When conventional drugs were utilized as a basis,the combined therapy of Jiawei Zhuling decoction and rhBNP for the treatment of HF characterized by qi-yin deficiency and water-heat interjunction demonstrated greater efficacy and advantages compared to rhBNP monotherapy.This combination therapy was more beneficial for improving cardiac function,TCM syndrome,clinical symptoms,quality of life,exercise tolerance,NT-proBNP levels,and myocardial injury.

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备注/Memo

备注/Memo:
山东省中医药科技项目(2020Q082)；山东省淄博市医药卫生科研项目(20231600116，20241601097)
更新日期/Last Update: 2025-06-09