目的:观察冠脉宁通方加味治疗冠状动脉粥样硬化性心脏病(简称冠心病)心力衰竭(简称心衰)气虚痰瘀互结水停证患者的有效性和安全性.方法:120 例冠心病心衰气虚痰瘀互结水停证患者按照随机数字表法平均分为对照组和观察组.对照组给予常规药物(袢利尿剂、螺内酯、沙库巴曲缬沙坦、β受体阻滞剂、沙库巴曲缬沙坦钠片)治疗,观察组在对照组基础上给予冠脉宁通方加味治疗.两组疗程均为4 周.比较治疗后两组临床疗效、症状积分、N末端B型利钠肽前体(N-terminal B-type natriuretic peptide precursor,NT-proBNP)、左室射血分数(left ventricular ejection fraction,LVEF)、生活质量评分以及安全性.结果:(1)观察组有效率为91.66%(55/60),对照组有效率为70.00%(42/60),两组比较,差异有统计学意义(P<0.05).(2)治疗后,两组患者中医证候积分低于本组治疗前;观察组中医证候积分为(10.71±2.98)分,低于同期对照组(P<0.05).(3)治疗后,两组患者明尼苏达生活质量评分均显著降低,观察组明尼苏达生活质量评分为(20.16±5.87)分,低于同期对照组(P<0.05).(4)治疗后,两组患者LVEF均显著升高,观察组LVEF为(51.80±3.58)%,高于同期对照组(P<0.05).(5)治疗后,两组患者NT-proBNP水平均显著降低,观察组NT-proBNP水平为(796.49±281.76)ng·L-1,低于同期对照组(P<0.05).(6)两组患者治疗后均未出现明显不良反应.结论:冠脉宁通方加味治疗冠心病心衰气虚痰瘀互结水停证疗效显著,可降低患者中医症状积分、明尼苏达生活质量评分、NT-proBNP水平,提高LVEF水平.
Objective:To observe the effectiveness and safety of Guanmai Ningtong Formula in treatment of patients with coronary athero-sclerotic heart disease(CHD)and heart failure.Methods:120 patients with coronary heart failure were divided into two groups(control group and observation group)according to random number table.The control group was treated with conventional drugs(loop diuretics,spironolactone,sacubactril valsartan,β-blocker,sacubactril valsartan sodium tablets),and the observation group was treated with Guanmai Ningtong Formula on the basis of that of the control group.The treatment course of both groups was 4 weeks.The clinical effi-cacy,symptom score and N-terminal B-type natriuretic peptide precursor(NT-proBNP),left ventricular ejection fraction(LVEF),quality of life score,and safety were compared between the two groups after treatment.Results:(1)The effective rate was 91.66%(55/60)in the observation group and70%(42/60)in the control group,the difference between the two groups was statistically signif-icant(P<0.05).(2)After treatment,the scores of TCM symptoms in the two groups were lower than that before treatment;The TCM symptom score of the observation group was(10.71±2.98),which was significantly lower than that of the control group(P<0.05).(3)After treatment,the Minnesota quality of life score of both groups was significantly decreased,and the Minnesota quality of life score of the observation group was(20.16±5.87),which was significantly lower than that of the control group(P<0.05).(4)After treatment,LVEF in both groups was significantly increased,and LVEF in observation group was(51.80±3.58)%,which was signifi-cantly higher than that of the control group(P<0.05).(5)After treatment,the level of NT-proBNP in both groups was significantly decreased,and the level of NT-proBNP in the observation group was(796.49±281.76)ng·L-1,which was significantly lower than that of the control group(P<0.05).(6)There were no obvious adverse reactions after treatment in both groups.Conclusion:Modified Guanmai Ningtong Formula is effective in treating CHD and heart failure(Qi-deficiency,phlegm-stasis and water-stopping syn-drome),which can reduce TCM symptom score,Minnesota quality of life score,NT-proBNP level and increase LVEF.
张志国;焦丽华;黄兴;高帅飞;连帅杰
河南中医药大学第三附属医院,河南 郑州 450008周口市中医院,河南 周口 466000
中医学
冠状动脉粥样硬化性心脏病;心力衰竭;气虚痰瘀互结水停证;冠脉宁通方
coronary atherosclerotic heart disease;heart failure;Qi deficiency,Phlegm,stasis and Water stagnation syndrome;Guanmai Ningtong Formula
《中医学报》 2024 (006)
1323-1327 / 5
河南省中医药科学研究专项课题项目(20-21ZY2222);李庆海全国名老中医药专家传承工作室建设项目{国中医药人教函[2022]75号}
10.16368/j.issn.1674-8999.2024.06.220
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