摘要
目的:探讨益气健心汤联合常规治疗对慢性心力衰竭患者心室重构、血管内皮功能和血清半乳糖凝集素-3(Galectin-3)、分泌型卷曲相关蛋白2(SFRP2)水平的影响。方法:选取2022年8月~2024年5月期间于某院接受治疗的105例慢性心力衰竭患者作为研究对象,采用随机数字表法分为对照组(依从性差剔除2例,n=50)和观察组(依从性差剔除1例,治疗期间突发脑梗死剔除1例,主动退出1例,n=50)。对照组患者给予常规西药对症治疗,观察组患者在对照组治疗基础上联合益气健心汤治疗。比较两组中医证候评分、6分钟步行距离(6MWD)、Galectin-3、SFRP2、N-末端脑钠肽前体(NT-proBNP)、血管内皮功能[内皮素(ET)、一氧化氮(NO)、降钙素基因相关肽(CGRP)]、心功能指标[左心室收缩末期内径(LVESD)、左室射血分数(LVEF)、每搏量(SV)、二尖瓣血流最大流速/心房收缩期二尖瓣血流最大流速(E/A)]、临床疗效及不良反应发生情况。结果:治疗后,两组患者中医证候评分均降低(P<0.05),且观察组低于对照组(P<0.05);6MWD均升高(P<0.05),且观察组高于对照组(P<0.05);Galectin-3、NT-proBNP和ET水平均降低(P<0.05),且观察组低于对照组(P<0.05);SFRP2、NO和CGRP水平均升高(P<0.05),且观察组高于对照组(P<0.05);LVESD均降低(P<0.05),且观察组低于对照组(P<0.05);LVEF、SV、E/A均升高(P<0.05),且观察组高于对照组(P<0.05)。观察组患者治疗总有效率(94.00%)高于对照组(78.00%,P<0.05)。两组患者不良反应总发生率比较无统计学差异(χ^(2)=0.000,P=1.000)。结论:益气健心汤联合常规治疗慢性心力衰竭患者临床疗效较佳,可显著改善心室重构和血管内皮功能,调节血清Galectin-3、SFRP2水平,且不会增加不良反应的发生风险。
Objective:To investigate the effects of Yiqi Jianxin decoction combined with conventional therapy on ventricular remodeling,vascular endothelial function and serum levels of Galectin-3,secreted frizzled-related protein 2(SFRP2)in patients with chronic heart failure.Methods:A total of 105 patients with chronic heart failure visited the hospital from August 2022 to May 2024 were selected and divided into the control group(n=50,after excluding 2 cases with poor treatment compliance)and the observation group(n=50,after excluding 1 case with poor treatment compliance,1 case with sudden cerebral infarction during treatment,1 case of voluntary withdrawal),using random number table method.The control group was given conventional western medicines for symptomatic treatment,and the observation group was treated with Yiqi Jianxin decoction in addition to the control treatment.The traditional Chinese medicine(TCM)symptom scores,6-minute walking distance(6MWD),Galectin-3,SFRP2,N-terminal pro-brain natriuretic peptide(NT-proBNP),vascular endothelial function[endothelin(ET),nitric oxide(NO),calcitonin gene-related peptide(CGRP)],cardiac function index[left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),stroke volume(SV),mitral flow maximum velocity/mitral flow maximum velocity during atrial systole(E/A)],clinical efficacy and adverse reactions were compared between the two groups.Results:After treatment,the TCM symptom score was decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).6MWD was increased in both groups(P<0.05),and higher in the observation group than in the control group(P<0.05).The levels of Galectin-3,NT-proBNP and ET were decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).The levels of SFRP2,NO and CGRP were increased in both groups(P<0.05),and higher in the observation group than in the control group(P<0.05).LVESD was decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).LVEF,SV and E/A were increased in both groups(P<0.05),and higher in the observation group than in the control group(P<0.05).The total effective rate in the observation group(94.00%)was higher than that in the control group(78.00%,P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=0.000,P=1.000).Conclusion:Yiqi Jianxin decoction combined with conventional therapy has better clinical efficacy in patients with chronic heart failure,which can significantly improve ventricular remodeling and vascular endothelial function,regulate serum Galectin-3 and SFRP2 levels,without increasing the risk of adverse reactions.
作者
付占宇
李相中
张克清
FU Zhan-yu;LI Xiang-zhong;ZHANG Ke-qing(Department of Internal Medicine,the Seventh People's Hospital of Anyang,Anyang 455000,China;Department of Cardiology,Anyang Hospital of Traditional Chinese Medicine,Anyang 455000,China)
出处
《中国合理用药探索》
2025年第3期55-61,共7页
Chinese Journal of Rational Drug Use
基金
河南省医学科技攻关计划项目(LHGJ20220144)。
关键词
益气健心汤
慢性心力衰竭
心室重构
血管内皮功能
疗效
Yiqi Jianxin decoction
chronic heart failure
ventricular remodeling
vascular endothelial function
efficacy
