摘要
目的探讨大补元煎加味联合针刺治疗对心肾气虚型心律失常老年患者中医证候积分及NF-κB信号通路的影响。方法选取2016年6月至2019年12月西安市中医医院收治的116例心肾气虚型心律失常老年患者,按简单随机化方法分为观察组和对照组各58例。对照组给予常规西医治疗,观察组在常规西医治疗基础上给予大补元煎加味联合针刺治疗,两组均连续治疗4周。比较两组患者的临床疗效、不良反应发生率及治疗前后中医证候积分、心功能[心搏量(SV)、心输出量(CO)、射血分数(EF)]、血液流变学、核转录因子κB (NF-κB)信号通路[NF-κB p65、磷酸化NF-κB抑制蛋白α(p-IκBα)]。结果观察组患者的治疗总有效率为89.66%,明显高于对照组的74.14%,差异有统计学意义(P<0.05);治疗后,观察组患者的中医证候积分(8.14±2.25)分,明显低于对照组的(11.84±3.16)分,SV、CO、EF分别为(89.43±8.31) m L/s、(6.94±1.25) L/min、(52.47±6.24)%,明显高于对照组的(83.12±7.98) mL/s、(6.10±1.03) L/min、(48.37±5.94)%,差异均有统计学意义(P<0.05);治疗后,观察组患者的全血高切黏度、全血中切黏度、全血低切黏度、血浆黏度分别为(4.24±0.63) m Pa·s、(6.23±1.30) mPa·s、(9.12±2.45) mPa·s、(1.51±0.62) mPa·s,明显低于对照组的(5.76±0.65) m Pa·s、(7.34±1.85) m Pa·s、(11.36±3.14) mPa·s、(1.94±0.73) mPa·s,差异均有统计学意义(P<0.05);治疗后,观察组患者的NF-κB p65、p-IκBα分别为(0.43±0.15) ng/mL、(0.47±0.03) ng/mL,明显低于对照组的(0.56±0.23) ng/mL、(0.58±0.04) ng/mL,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为15.52%,与对照组的12.07%比较差异无统计学意义(P>0.05)。结论大补元煎加味联合针刺治疗老年心肾气虚型心律失常能有效减轻患者的临床症状,调节血液流变学,抑制NF-κB信号通路激活,改善心功能,临床疗效确切且安全性较高。
Objective To investigate the effect of modified Dabuyuanjian combined with acupuncture on TCM syndrome scores and NF-κB signal pathway in elderly patients with cardio-kidney Qi deficiency arrhythmia.Methods From June 2016 to December 2019,116 elderly patients with arrhythmia of cardio-kidney Qi deficiency type admitted to Xi'an Traditional Chinese Medicine Hospital were selected.According to simple randomization method,they were divided into the observation group and control group,with 58 patients in each group.The control group was treated with conventional western medicine,and the observation group was treated with Dabuyuanjian modified combined with acupuncture on the basis of conventional western medicine.Both groups were treated for 4 consecutive weeks.The clinical efficacy,incidence of adverse reactions,TCM syndrome scores,cardiac function(heart stroke volume[SV],cardiac output[CO],ejection fraction[EF]),hemorheology,nuclear transcription factorκB(NF-κB)signaling pathway(NF-κB p65,phosphorylated NF-κB inhibitor proteinα[p-IκBα])before and after treatment were compared between the two groups.Results The total effective rate of treatment in the observation group was 89.66%,which was significantly higher than 74.14%in the control group(P<0.05).After treatment,the scores of TCM syndromes of the observation group were 8.14±2.25,which was significantly lower than 11.84±3.16 of the control group,SV,CO and EF were(89.43±8.31)mL/s,(6.94±1.25)L/min,(52.47±6.24)%,respectively,which were significantly higher than corresponding(83.12±7.98)mL/s,(6.10±1.03)L/min,(48.37±5.94)%of the control group(all P<0.05);the whole blood high shear viscosity,whole blood midcut viscosity,whole blood low shear viscosity,and plasma viscosity of the observation group were(4.24±0.63)mPa·s,(6.23±1.30)mPa·s,(9.12±2.45)mPa·s,(1.51±0.62)mPa·s,respectively,which were significantly lower than corresponding(5.76±0.65)mPa·s,(7.34±1.85)mPa·s,(11.36±3.14)mPa·s,(1.94±0.73)mPa·s of the control group(all P<0.05);NF-κB p65 and p-IκBαof the observation group were(0.43±0.15)ng/mL and(0.47±0.03)ng/mL,respectively,which were significantly lower than corresponding(0.56±0.23)ng/mL and(0.58±0.04)ng/mL of the control group(P<0.05).The incidence of adverse reactions in the observation group was 15.52%versus 12.07%in the control group(P>0.05).Conclusion Dabuyuanjian modified combined with acupuncture for elderly patients with cardio-kidney Qi deficiency arrhythmia can effectively reduce clinical symptoms,regulate hemorheology,inhibit the activation of NF-κB signal pathway,improve cardiac function.The clinical efficacy is definite and the safety is high.
作者
张茜
毛艳
ZHANG Qian;MAO Yan(Department of Geriatrics,Xi'an Traditional Chinese Medicine Hospital,Xi'an 710021,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第4期433-437,共5页
Hainan Medical Journal
关键词
大补元煎加味
针刺
心肾气虚型
心律失常
中医证候积分
NF-ΚB信号通路
Modified Dabuyuanjian
Acupuncture
Cardio-kidney Qi deficiency type
Arrhythmia
TCM syndrome integral
NF-κB signaling pathway
