摘要
目的:观察益气强心汤联合美托洛尔治疗慢性心力衰竭(CHF)气虚血瘀证的临床疗效。方法:选取84例CHF气虚血瘀证患者,按随机数字表法分为对照组与治疗组各42例。对照组给予美托洛尔治疗,治疗组在对照组基础上联合益气强心汤治疗,2组均连续治疗3个月。比较2组治疗前后中医证候积分、心功能指标、心肌损伤标志物水平及临床疗效。结果:治疗后,2组胸闷、喘促、水肿及气短积分均较治疗前降低(P<0.05),治疗组上述4项中医证候积分均低于对照组(P<0.05)。治疗后,2组射血前期/左心室射血时间比值(PEP/LVET)、总外周阻力(TPR)均较治疗前降低(P<0.05),治疗组PEP/LVET、TPR均低于对照组(P<0.05);2组每搏出量(SV)、心输出量(CO)、心脏指数(CI)、左室射血分数(LVEF)均较治疗前升高(P<0.05),治疗组SV、CO、CI及LVEF均高于对照组(P<0.05)。治疗后,2组N-末端脑钠肽前体(NT-proBNP)、心型脂肪酸结合蛋白(H-FABP)水平均较治疗前降低(P<0.05),治疗组NT-proBNP、H-FABP水平均低于对照组(P<0.05)。治疗组总有效率为80.95%,高于对照组的57.14%(P<0.05)。结论:益气强心汤联合美托洛尔治疗CHF气虚血瘀证,可有效改善患者的临床症状,逆转心肌受损情况,保护心功能,临床疗效优于单纯使用美托洛尔治疗。
Objective:To observe the clinical effect of Yiqi Qiangxin tang combined with metoprolol for chronic heart failure(CHF)with qi deficiency and blood stasis syndrome.Methods:A total of 84 cases of CHF patients with qi deficiency and blood stasis syndrome were selected and divided into the control group and the treatment group according to the random number table method,42 cases in each group.The control group was treated with metoprolol,and the treatment group was additionally treated with Yiqi Qiangxin tang based on the treatment of the control group.Both groups were continuously treated for three months.The Chinese medicine syndrome scores,heart function indexes,levels of myocardial injury markers,and clinical effect were compared between the two groups.Results:After treatment,the scores of oppression in the chest,panting,edema,and shortness of breath in the two groups were decreased when compared with those before treatment(P<0.05),and the four Chinese medicine syndrome scores above in the treatment group were lower than those in the control group(P<0.05).After treatment,the ratio of preejection phrase to left ventricular ejection time(PEP/LVET)and total peripheral resistance(TPR)in the two groups were decreased when compared with those before treatment(P<0.05),and the two indexes above in the treatment group were lower than those in the control group(P<0.05).After treatment,cardiac stroke volume(SV),cardiac output(CO),cardiac index(CI),and left ventricular ejection fraction(LVEF)in the two groups were increased when compared with those before treatment(P<0.05),and the four indexes above in the treatment group were higher than those in the control group(P<0.05).After treatment,levels of N terminal pro B type natriuretic peptide(NT-proBNP)and heart-type fatty acid-binding protein(H-FABP)in the two groups were decreased when compared with those before treatment(P<0.05),and the two levels in the treatment group were lower than those in the control group(P<0.05).The total effective rate was 80.95%in the treatment group,higher than that of 57.14%in the control group(P<0.05).Conclusion:In the treatment of CHF with qi deficiency and blood stasis syndrome,the therapy of Yiqi Qiangxin tang combined with metoprolol can effectively improve clinical symptoms,reverse myocardial damage and protect the heart function.The clinical effect is better than that of simple application of metoprolol.
作者
孙虎豪
王军伟
詹君华
SUN Huhao;WANG Junwei;ZHAN Junhua
出处
《新中医》
CAS
2021年第8期51-54,共4页
New Chinese Medicine
关键词
慢性心力衰竭
气虚血瘀证
益气强心汤
美托洛尔
中医证候
心功能
心肌损伤标志物
Chronic heart failure
Qi deficiency and blood stasis syndrome
Yiqi Qiangxin tang
Metoprolol
Chinese medicine syndrome
Heart function
Myocardial injury markers
