摘要
目的 探讨二参真武汤治疗心肾阳虚型慢性心力衰竭(chronic heart failure,CHF)的疗效。方法 选取2022年1月-2024年3月在安徽中医药大学附属太和中医院接受治疗的心肾阳虚型老年CHF患者112例,采用随机数字表法分为观察组和对照组,各56例,对照组采用沙库巴曲缬沙坦钠片治疗,观察组联合二参真武汤治疗。治疗4周后,比较2组的中医证候、LVEF、LVESD/LVEDD、NT-proBNP、HCY、AngII、ALD,心脏每搏输出量、排血量及外周阻力,评价疗效及不良反应。结果 治疗后,观察组和对照组的LVEF分别为(54.16±6.08)%、(51.18±7.43)%,LVESD分别为(47.68±5.15)mm、(50.16±6.34)mm,LVEDD分别为(58.32±5.81)mm、(61.27±5.43)mm,心脏每搏输出量分别为(67.43±6.15)mL、(63.51±5.84)mL,排血量分别为(4.23±0.95)L/min、(3.61±0.72)L/min,外周阻力分别为(1 702.31±251.69)kPa·s/L、(1 858.37±263.41)kPa·s/L,治疗有效率分别为92.86%、78.57%,差异有统计学意义(P<0.05)。治疗后,2组主证、次证、舌脉评分降低,NT-proBNP、HCY降低,ALD、AngII降低,观察组低于对照组(P<0.05)。治疗期间,2组未出现严重不良反应。结论 二参真武汤联合沙库巴曲缬沙坦钠片治疗心肾阳虚型老年CHF,有助调节NT-proBNP、HCY、AngII等表达,改善心脏功能。
Objective To explore the therapeutic effect of Ershen Zhenwu Tang in the treatment of chronic heart failure(CHF)with the syndrome of yang deficiency of both the heart and the kidney.Methods A total of 112 elderly CHF patients with the syndrome of yang deficiency of the heart and kidney,who received a treatment at the Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine from January 2022 to March 2024,were randomly divided into an observation group and a control group using a random number table method,with 56 cases in each group.The control group was treated with Sacubitril Valsartan Sodium Tablets,while the observation group was treated with Ershen Zhenwu Tang on the basis of that.After 4 weeks of treatment,the traditional Chinese medicine syndrome scores,the levels of left ventricular ejection fraction(LVEF),left ventricular end-systolic/diastolic diameter(LVESD/LVEDD),N-terminal proBNP precursor(NT proBNP),homocysteine(HCY),angiotensin II(AngII),aldosterone(ALD),cardiac output per stroke,blood output,and peripheral resistance were compared between the two groups to evaluate their therapeutic effects and adverse reactions.Results After treatment,the main syndrome scores of the observation group and the control group were respectively(6.72±1.13)and(7.21±1.06)points,while their secondary syndrome scores were(2.47±0.65)and(3.02±0.59)points,and the tongue and pulse scores were(1.97±0.46)and(2.23±0.51)points,the LVEF was(54.16±6.08)versus(51.18±7.43)%,the LVESD was(47.68±5.15)versus(50.16±6.34)mm,and the LVEDD was(58.32±5.81)versus(61.27±5.43)mm,NT proBNP was(759.63±154.32)versus(841.35±169.71)pg/mL,HCY values were(13.24±2.56)versus(15.87±3.01)μmol/L,AngII was(65.13±21.46)versus(89.96±26.71)pg/mL,ALD was(72.37±25.18)versus(90.14±23.57)pg/mL,the cardiac output per stroke was(67.43±6.15)vs(63.51±5.84)mL,the blood output was(4.23±0.95)vs(3.61±0.72)L/min,the peripheral resistance was(1702.31±251.69)vs(1858.37±263.41)kPa·s/L,and the treatment efficacy was 92.86%vs 78.57%,with statistically significant differences(P<0.05).After treatment,the scores of the main and secondary syndromes,tongue and pulse,NT proBNP and HCY,ALD and AngII were decreased in both groups,and the observation group was lower than the control group(P<0.05).During the treatment period,no serious adverse reactions occurred in both groups.Conclusion In the treatment of elderly CHF patients with the syndrome of yang deficiency of both the heart and the kidney,the combination of Ershen Zhenwu Tang and Sacubitril Valsartan Sodium Tablets can help regulate the expression of NT proBNP,HCY,AngII,and improve heart function.
作者
张明明
倪代梅
付小奎
孙玉
葛岚
ZHANG Mingming;NI Daimei;FU Xiaokui;SUN Yu;GE Lan(Department of General Practice and Geriatrics,Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine,Fuyang 236600,China;Department of Cardiology,Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine,Fuyang 236600,China;Department of Geriatric Cardiology,First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)
出处
《吉林中医药》
2025年第6期689-694,共6页
Jilin Journal of Chinese Medicine
基金
安徽省卫生健康科研项目(AHWJ2023A10087)。
关键词
慢性心力衰竭
老年
心肾阳虚型
二参真武汤
沙库巴曲缬沙坦钠片
心功能
chronic heart failure
elderly
syndrome of yang deficiency of heart and kidney
Ershen Zhenwu Tang
Sacubitril Valsartan Sodium Tablets
cardiac function
