摘要
目的:观察温阳补心汤治疗心肾阳虚型慢性心功能不全的临床疗效及对血浆N末端B型利钠肽原(NT-proBNP)、左心室射血分数(LVEF)、运动耐力及机制的影响。方法:采用随机数字表法将80例心肾阳虚型慢性心功能不全患者分为对照组与观察组各40例,对照组予常规西药治疗,观察组在此基础上加服温阳补心汤。比较2组临床疗效,比较2组治疗前后心肺功能[无氧阈(AT)、最大摄氧量(VO_(2)max)、氧脉搏(O_(2)pulse)、最大运动时间、左心室射血分数(LVEF)]、6 min步行距离、明尼苏达心衰生活质量问卷表(MLWHFQ)、血浆NT-proBNP及炎症因子[超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α (TNF-α)、白细胞介素-18 (IL-18)]水平。结果:观察组心功能疗效总有效率80.0%,高于对照组67.5%(P<0.05);观察组中医证候疗效总有效率82.5%,高于对照组62.5%(P<0.05)。治疗前,2组AT、VO_(2)max、O_(2)pulse、最大运动时间、LVEF比较,差异无统计学意义(P>0.05);治疗后,观察组AT、VO_(2)max、O_(2)pulse、最大运动时间、LVEF均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗前,2组6 min步行试验、NT-proBNP水平及MLWHFQ评分比较,差异无统计学意义(P>0.05);治疗后,2组6 min步行试验距离延长(P<0.05),NT-proBNP水平、MLWHFQ评分降低(P<0.05),且观察组6 min步行试验距离长于对照组(P<0.05),NT-proBNP水平、MLWHFQ评分低于对照组(P<0.05)。治疗前,2组hs-CRP、TNF-α、IL-18水平比较,差异无统计学意义(P>0.05);治疗后,2组hs-CRP、TNF-α、IL-18水平均降低(P<0.05),且观察组低于对照组(P<0.05)。结论:温阳补心汤可有效提高心肾阳虚型慢性心功能不全患者的临床疗效、运动耐力及生活质量,降低NT-proBNP水平,改善心肺功能,这可能与其能降低炎症因子hs-CRP、TNF-α、IL-18表达水平有关。
Objective:To observe the clinical effect of Wenyang Buxin Tang for chronic cardiac insufficiency of heart-kidney yang deficiency type and its effect on N-terminal pro B-type natriuretic peptide(NT-proBNP) in plasma,left ventricular ejection fraction(LVEF),exercise endurance and mechanism.Methods:A total of 80 cases of patients with chronic cardiac insufficiency of heart-kidney yang deficiency type were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Wenyang Buxin Tang based on the treatment of the control group.The clinical effects in the two groups were compared.Before and after treatment,the cardiopulmonary function including anaerobic threshold(AT),maximal oxygen consumption(VO_(2)max),oxygen pulse(O_(2)pulse),maximal exercise time and LVEF,the distance in six-minute walk test,Minnesota Living With Heart Failure Questionnaire(MLWHFQ),NT-proBNP in plasma,and the levels of inflammatory factors including high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α) and interleukin-18(IL-18) in the two groups were compared.Results:The total effective rate of cardiac function was 80.0% in the observation group,higher than that of 67.5% in the control group(P0.05).After treatment,the AT,VO_(2)max,O_(2)pulse,maximal exercise time and LVEF in the observation group were increased(P0.05).After treatment,the distance in six-minute walk test in the two groups was prolonged(P0.05).After treatment,the levels of hs-CRP,TNF-α and IL-18 in the two groups were decreased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Wenyang Buxin Tang can effectively improve the clinical effects,exercise endurance and quality of life of patients with chronic cardiac insufficiency of heart-kidney yang deficiency type,reduce NT-proBNP levels,and enhance cardiopulmonary function,which may be related to its ability to reduce the expression levels of inflammatory factors including hs-CRP,TNF-α and IL-18.
作者
印美
薛晓波
YIN Mei;XUE Xiaobo
出处
《新中医》
CAS
2022年第23期56-60,共5页
New Chinese Medicine
关键词
慢性心功能不全
温阳补心汤
心肾阳虚
运动耐力
心肺功能
生活质量
炎症因子
Chronic cardiac insufficiency
Wenyang Buxin Tang
Heart-kidney yang deficiency
Exercise endurance
Cardiopulmonary function
Quality of life
Inflammatory factors
