摘要
目的观察真武汤联合脐灸疗法治疗慢性心力衰竭(Chronic heart failure,CHF)阳虚水泛型患者的临床疗效。方法选取2020年6月—2021年6月期间于中国医科大学附属第一医院心内科门诊就诊的60例CHF阳虚水泛型患者,根据随机数字表法分为对照组和治疗组,每组各30例。对照组给予西医常规治疗,治疗组给予真武汤配合脐灸并联合西医治疗。治疗4周后,观察比较两组患者临床疗效、不良反应情况及治疗前后中医证候积分、N末端B型利钠肽原(N-terminal pro-B type natriuretic peptide,NT-proBNP)、左心室射血分数(Left Ventricular Ejection Fractions,LVEF)、白细胞介素6(Interleukin-6,IL-6)、超敏C反应蛋白(hypersensitive-c-reactive-protein,hs-CRP)、肿瘤坏死因子α(Tumor Necrosis Factor Alpha,TNF-α)、同型半胱氨酸(Homocysteine,Hcy)、丙二醛(Malondialdehyde,MDA)、超氧化物歧化酶(Superoxide dismutase,SOD)、生长分化因子15(Growth differentiation factor-15,GDF-15)、6 min步行距离、一氧化氮(Nitric oxide,NO)、ET(Endothelin,ET)、降钙素基因相关肽(Calcitonin gene-related peptide,CGRP)水平变化。结果治疗后治疗组总有效率为90.00%(27/30)优于对照组73.33%(22/30),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前下降,差异有统计学意义(P<0.05);且治疗组优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NT-proBNP水平均较治疗前下降,而LVEF水平均较治疗前升高,差异具有统计学意义(P<0.05);且治疗组各项指标均优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-6、hs-CRP、TNF-α水平均较治疗前下降,差异有统计学意义(P<0.05);且治疗组各项指标均优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者SOD和MDA水平均较治疗前上升,而Hcy水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组各项指标均优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者GDF-15水平均较治疗前下降,6 min步行距离均较治疗前增加,差异有统计学意义(P<0.05);且治疗组各项指标均优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NO、CGRP水平均较治疗前升高,而ET水平均较治疗前降低,差异有统计学意义(P<0.05)。且治疗组各项指标均优于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者均无严重不良反应发生。结论真武汤联合脐灸疗法对CHF患者的炎症和氧化应激反应具有明显的改善作用,进而延缓CHF的发生和发展进程。
Objective To observe the clinical efficacy of Zhenwu Decoction combined with umbilical moxibustion in treating chronic heart failure(CHF)due to yang deficiency and water diffusion.Methods Sixty CHF patients due to yang deficiency and water diffusion treated in the Department of Cardiology of The First Hospital of China Medical University from June 2020 to June 2021 were included and divided into a control group and a treatment group according to the random number table,with 30 in each group.The control group was given conventional western medicine treatment,whilethe treatment group was given Zhenwu Decoction combined with umbilical moxibustion on the basis of the control group.After 4 weeks of treatment,the clinical efficacy,adverse reaction,and traditional Chinese medicine(TCM)syndrome score,levels of N-terminal pro-B type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor alpha(TNF-α),homocysteine(Hcy),malondialdehyde(MDA),superoxide dismutase(SOD),and growth differentiation factor-15(GDF-15),6-minute walk distance(6MWD),levels of nitric oxide(NO),endothelin(ET),and calcitonin gene-related peptide(CGRP)of the two groups before and after treatment were observed and compared.Results After treatment,the total effective rate of the treatment group was 90.00%(27/30),higher than 73.33%(22/30)of the control group(P<0.05).Compared with the conditions before treatment,both groups had a decrease in TCM syndrome score and levels of NT-proBNP,IL-6,hs-CRP,TNF-α,Hcy,and GDF-15,while an increase in levels of LVEF,SOD,MDA,and 6MWD after treatment(all P<0.05),and the treatment group had more decrease or increase than the control group(P<0.05).In addition,the levels of NO and CGRP in the two groups after treatment were higher while the level of ET was lower than those before treatment(P<0.05),and the treatment group was superior to the control group in the above indexes(P<0.05).No serious adverse reactions were observed in both groups during treatment.Conclusion Zhenwu Decoction combined with umbilical moxibustion can effectively improve inflammation and oxidative stress of CHF patients,and thus delay the occurrence and development of CHF.
作者
孟超
杨丹丹
MENG Chao;YANG Dan-dan(The First Hospital of China Medical University,Shenyang Liaoning 110000;The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110000)
出处
《世界中西医结合杂志》
2022年第12期2469-2474,2480,共7页
World Journal of Integrated Traditional and Western Medicine
基金
辽宁省博士科研启动基金计划项目(2020-BS-165)。
关键词
慢性心力衰竭
真武汤
脐灸
阳虚水泛证
Chronic heart failure
Zhenwu Decoction
Umbilical moxibustion
Syndrome of yang deficiency and water diffusion
