摘要
【目的】探讨扶阳针刺疗法联合复方真武冲剂治疗心肾阳虚型慢性心衰患者的临床疗效。【方法】采用回顾性分析的研究方法,选取2021年7月~2022年6月在新疆医科大学附属中医医院心内科收治的142例心肾阳虚型慢性心衰患者,根据治疗方案的不同将其分为对照A组49例,对照B组41例,观察组52例。3组均给予常规治疗处理,对照A组给予复方真武冲剂治疗,对照B组给予扶阳针刺疗法治疗,观察组给予扶阳针刺疗法联合复方真武冲剂治疗,3组均治疗2周。治疗2周后,观察3组患者治疗前后左室射血分数(LVEF)、心搏出量(CO)、心肌肌钙蛋白I(cardiac troponin,cTnI)水平、血清氨基末端脑钠肽前体(NT-proBNP)水平和可溶性生长刺激表达基因2蛋白(sST2)水平的变化情况,以及lee心衰积分、中医证候积分、6 min步行距离(6MWT)和明尼苏达心力衰竭生活质量量表(MLHFQ)评分的变化情况,并评价3组的临床疗效。【结果】(1)对照A组总有效率为75.51%(37/49),对照B组为78.05%(32/41),观察组为94.23%(49/52)。观察组疗效优于对照A组与对照B组,差异均有统计学意义(P<0.05)。(2)治疗后,3组患者的LVEF、CO水平均明显改善(P<0.05),且观察组在改善LVEF和CO水平方面明显优于对照A组与对照B组,差异有统计学意义(P<0.05)。(3)治疗后,3组患者的lee心衰积分、中医证候积分均明显改善(P<0.05),且观察组的lee心衰积分、中医证候积分均明显优于对照A组与对照B组,差异有统计学意义(P<0.05)。(4)治疗后,3组患者的NT-proBNP、sST2、c TnI水平均明显改善(P<0.05),且观察组在改善NT-proBNP、sST2、cTnI水平方面明显优于对照A组与对照B组,差异均有统计学意义(P<0.05)。(5)治疗后,3组患者6MWT和MLHFQ总分均明显改善,且观察组在改善6MWT和MLHFQ总分方面明显优于对照A组与对照B组,差异有统计学意义(P<0.05)。【结论】扶阳针刺疗法联合复方真武冲剂治疗心肾阳虚型慢性心衰可明显改善患者血清NT-proBNP、sST2蛋白及cTnI水平,提高患者心功能,缓解心衰,提高患者的运动能力和生活质量,疗效确切。
Objective To investigate the clinical efficacy of compound Fuyang acupuncture therapy combined with compound Zhenwu Granules in the treatment of patients with chronic heart failure of heart-kidney yang deficiency type.Methods A retrospective analysis was adopted to select 142 patients with heart-kidney yang deficiency type of chronic heart failure admitted to the Department of Cardiology of the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from July 2021 to June 2022,then divided into 49 cases in control group A,41 cases in control group B and 52 cases in the observation group according to the different treatment regimens.The control group A was treated with compound Zhenwu Granules,the control group B was treated with Fuyang acupuncture therapy and the observation group was treated with Fuyang acupuncture therapy combined with compound compound Zhenwu Granules,all three groups were treated for 2 weeks.After 2 weeks of treatment,changes in left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac troponin I(cTnI)levels,serum amino-terminal brain natriuretic peptide precursor(NT-proBNP)levels and soluble growth-stimulated expression gene 2 protein(s ST2)levels,and lee heart failure were observed before and after treatment in the three groups.The changes in lee heart failure score,TCM syndrome score,6-minute walking distance(6MWT)and Minnesota Living with Heart Failure Quenstionnaire(MLHFQ)score,and the clinical efficacy of the 3 groups was evaluated.Results(1)The total effective rate was 75.51%(37/49)in control group A,78.05%(32/41)in control group B and 94.23%(49/52)in the observation group.The efficacy of the observation group was superior to that of control group A and control group B.The difference was statistically significant(P<0.05).(2)After treatment,the LVEF and CO levels of all three groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group A and control group B in improving LVEF and CO levels,and the difference was statistically significant(P<0.05).(3)After treatment,the lee heart failure score and TCM syndrome score of the three groups were significantly improved(P<0.05),and the lee heart failure score and TCM syndrome score of the observation group were significantly superior to those of control group A and control group B,and the difference was statistically significant(P<0.05).(4)After treatment,the NTproBNP,s ST2 and cTnI levels in all three groups were significantly improved(P<0.05),and the observation group was significantly superior to the control A and control B groups in improving NT-proBNP,sST2 and cTnI levels,and the difference was statistically significant(P<0.05).(5)After treatment,the 6MWT and MLHFQ total scores of all three groups were significantly improved,and the observation group was significantly superior to the control group A and control group B in improving the 6MWT and MLHFQ total scores,and the difference was statistically significant(P<0.05).Conclusion The combination of Fuyang acupuncture therapy with compound Zhenwu Granules can significantly improve serum NT-proBNP,sST2 protein and cTnI levels,improve patients'cardiac function,relieve heart failure,exercise capacity and quality of life in the treatment of heart-kidney yang deficiency type of chronic heart failure.
作者
杨燕
杨新
李秀芬
YANG Yan;YANG Xin;LI Xiu-Fen(Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Xinjiang 830000 Urumqi,China;People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang 830000 Urumqi,China)
出处
《广州中医药大学学报》
CAS
2023年第10期2549-2555,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
新疆维吾尔自治区卫生健康青年医学科技人才专项科研资助项目(编号:WJWY-202228)。
关键词
扶阳针刺疗法
慢性心力衰竭
心肾阳虚型
复方真武冲剂
回顾性研究
Fuyang acupuncture therapy
chronic heart failure
heart-kidney yang deficiency type
compound Zhenwu Granules
retrospective study
