摘要
目的观察益气生津散联合西医常规疗法治疗糖尿病性心脏病临床疗效,及对患者心脏自主神经功能、心功能、炎症因子的影响。方法采用随机数字表法将84例糖尿病性心脏病患者分为对照组及治疗组各42例。对照组依据患者血糖制定个体化降糖方案及心脏病治疗。治疗组在对照组基础上加服益气生津散,与西药间隔0.5 h后温开水冲服,每次2袋,每日2次,连续治疗6周,观察2组中医疗效,比较2组治疗前后中医证候评分、窦性心搏RR间期(SDNN)、相邻间期差值的均方根(RMSSD)、RR间期平均值标准差(SDANN)、高频段(HF)、低频段(LF)、心功能各指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、炎症因子[白细胞介素-6(IL-6)、转化生长因子β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)]及不良反应。结果治疗组总有效率为90.48%(38/42),对照组为73.81%(31/42),治疗组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后胸痛胸闷、心悸、心慌气短、多梦多汗、五心烦热、倦怠乏力评分均明显降低(P<0.05);2组治疗后比较,治疗组胸痛胸闷、心悸、心慌气短、多梦多汗、五心烦热、倦怠乏力评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后SDNN、SDANN、RMSSD、HF、LF均升高(P<0.05);2组治疗后比较,治疗组SDNN、SDANN、RMSSD、HF、LF均高于对照组(P<0.001)。与本组治疗前比较,2组治疗后LVEF升高,LVEDD及LVESD降低(P<0.001);2组治疗后比较,治疗组LVEF高于对照组,LVEDD、LVESD低于对照组(P<0.001)。与本组治疗前比较,2组血清TNF-α、TGF-β1、IL-6均降低(P<0.001);2组治疗后比较,治疗组血清TNF-α、TGF-β1、IL-6均低于对照组(P<0.001)。2组不良反应比较差异无统计学意义(P>0.05)。结论益气生津散联合西医常规疗法治疗糖尿病性心脏病患者效果显著,安全性高,可有效改善患者心脏自主神经功能及心功能,减轻炎症反应,无严重不良反应。
Objective To observe the clinical efficacy of Yiqi Shengjin Powder combined with conventional Western medicine in the treatment of diabetic heart disease,and the effects on cardiac autonomic nervous function,cardiac function and inflammatory factors.Methods Totolly 84 patients with diabetic heart disease were divided into control group and treatment group with random number table method,with 42 cases in each group.The control group developed personalized hypoglycemic plans and heart disease treatment drugs based on the patients’blood glucose levels.The treatment group took Yiqi Shengjin Powder in addition to the control group,and after an interval of 0.5 hours with Western medicine,they took it with warm water,2 bags each time,twice a day,for 6 consecutive weeks of treatment.TCM therapeutic effects of two groups,TCM symptoms score,sinus rhythm RR interval(SDNN),root mean square of adjacent interval difference(RMSSD),standard deviation of RR interval mean(SDANN),high frequency(HF),low frequency(LF),various indicators of cardiac function[left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)],inflammatory factors[interleukin-6(IL-6),transforming growth factor beta 1(TGF-β1),tumor necrosis factor alpha(TNF-α)]and adverse reactions before and after treatment were observed.Results The total effective rate of the treatment group was 90.48%(38/42),while that of the control group was 73.81%(31/42).The therapeutic effect of the treatment group was better than that of the control group(P<0.05).Compared with before treatment,both group showed a significant decrease in chest pain,tightness,palpitations,palpitations and shortness of breath,excessive dreaming and sweating,five heart restlessness and fatigue scores after treatment(P<0.05);after treatment,the treatment group showed a decrease in chest pain,tightness,palpitations,palpitations and shortness of breath,excessive dreaming and sweating,five heart restlessness and fatigue scores compared to the control group(P<0.05).Compared with before treatment,both group showed a significant increase in SDNN,SDANN,RMSSD,HF and LF after treatment(P<0.05);after treatment,the SDNN,SDANN,RMSSD,HF and LF levels in the treatment group were significantly higher than those in the control group(P<0.001).Compared with before treatment,LVEF increased,LVEDD and LVESD decreased in both group after treatment(P<0.001);after treatment,the LVEF of the treatment group increased compared to the control group,while LVEDD and LVESD decreased compared to the control group(P<0.001).Compared with before treatment,the serum levels of TNF-α,TGF-β1 and IL-6 in both groups decreased(P<0.001);after treatment,the serum levels of TNF-α,TGF-β1 and IL-6 in the treatment group were lower than those in the control group(P<0.001).There was no statistical significance in adverse reactions between the two groups(P>0.05).Conclusion Yiqi Shengjin Powder combined with conventional Western medicine therapy for patients with diabetes heart disease has significant effect and high safety.It can effectively improve patients’cardiac autonomic nervous function and cardiac function,reduce inflammatory reaction,and has no serious adverse reactions.
作者
翟军鹏
李江敏子
尚菊菊
张竹华
ZHAI Junpeng;LI Jiangminzi;SHANG Juju;ZHANG Zhuhua(Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China)
出处
《中国中医药信息杂志》
2025年第6期147-152,共6页
Chinese Journal of Information on Traditional Chinese Medicine
基金
北京市属医院科研培育计划项目(PZ2022023)。
关键词
糖尿病性心脏病
益气生津散
心脏自主神经功能
心功能
炎症反应
diabetic heart disease
Yiqi Shengjin Powder
cardiac autonomic nervous function
heart function
inflammatory response
