自拟参芪养心汤联合沙库巴曲缬沙坦钠治疗心脾阳虚证冠心病伴心力衰竭的效果观察OA
Clinical Effect Observation of Self-Designed Shenqi Yangxin Decoction Combined with Sacubitril/Valsartan Sodium in the Treatment of Coronary Heart Disease Complicated with Heart Failure with Heart-Spleen Yang Deficiency Syndrome
目的:探究自拟参芪养心汤联合沙库巴曲缬沙坦钠治疗心脾阳虚证冠心病伴心力衰竭(CHD-HF)患者的临床效果.方法:选取 2022 年1月～2023 年6 月于本院确诊的108例心脾阳虚证 CHD-HF 患者作为研究对象,采用随机数字表法分为对照组和联合组,每组 54例.两组患者均接受常规治疗,对照组给予沙库巴曲缬沙坦钠片治疗,联合组在对照组基础上加用自拟参芪养心汤.比较两组临床疗效、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、炎症指标[C反应蛋白(CRP)、脂联素(ADPN)、基质金属蛋白酶-9(MMP-9)]、心肌损伤指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、N末端脑钠肽前体(NT-proBNP)]、血管内皮生长因子[内皮素(ET)、降钙素基因相关肽(CGRP)、一氧化氮(NO)]、运动耐力[6 分钟步行距离(6MWD)]、生活质量评分[躯体健康(PCS)评分、心理健康(MCS)评分]及不良反应发生情况.结果:治疗后,联合组临床治疗总有效率(87.04%)高于对照组(70.37%,P＜0.05).两组患者 LVEF、ADPN、CGRP、NO、6MWD、PCS评分和MCS评分均升高,且联合组高于对照组(P＜0.05);LVEDD、LVESD、CRP、MMP-9、CK、CK-MB、cTnI、NT-proBNP 和 ET 均降低,且联合组低于对照组(P＜0.05).两组患者不良反应总发生率比较无统计学差异(P＞0.05).结论:自拟参芪养心汤联合沙库巴曲缬沙坦钠可有效提高心脾阳虚证CHD-HF患者临床疗效及心功能,减轻心肌损伤程度及炎症反应,改善血管内皮生长因子水平,提高运动耐力和生活质量.
Objective:To explore the clinical effect of self-designed Shenqi Yangxin Decoction combined with sacubitril/valsartan sodium in patients with coronary heart disease with heart failure(CHD-HF)of heart-spleen yang deficiency syndrome.Methods:A total of 108 patients with CHD-HF of heart-spleen yang deficiency syndrome diagnosed in our hospital from January 2022 to June 2023 were selected as study subjects.They were divided into the control group and the combined group by random number table method,with 54 patients in each group.Both groups received conventional treatment.The control group was treated with sacubitril/valsartan sodium tablets,while the combined group was additionally given self-designed Shenqi Yangxin Decoction on the basis of the control group's treatment.Clinical efficacy,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],inflammatory indicators[C reactive protein(CRP),adiponectin(ADPN),matrix metalloproteinase-9(MMP-9)],myocardial injury indicators[creatine kinase(CK),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP)],vascular endothelial factors[endothelin(ET),calcitonin gene-related peptide(CGRP),nitric oxide(NO)],exercise endurance[6-minute walking distance(6MWD)],quality of life scores[Physical Component Summary(PCS)score,Mental Component Summary(MCS)score],and incidence of adverse reactions were compared between the two groups.Results:After treatment,the total clinical effective rate of the combined group(87.04%)was higher than that of the control group(70.37%,P<0.05).LVEF,ADPN,CGRP,NO,6MWD,PCS score and MCS score increased in both groups,and the combined group had significantly higher values than the control group(P<0.05);LVEDD,LVESD,CRP,MMP-9,CK,CK-MB,cTnI,NT-proBNP and ET decreased in both groups,and the combined group had significantly lower values than the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Self-designed Shenqi Yangxin Decoction combined with sacubitril/valsartan sodium can effectively improve clinical efficacy and cardiac function,reduce the degree of myocardial injury and inflammatory response,optimize the level of vascular endothelial factors,and enhance exercise endurance and quality of life in patients with CHD-HF of heart-spleen yang deficiency syndrome.
杨琼琼;仲豪杰;陈鑫
许昌市中心医院鹿鸣湖院区,许昌 461000许昌市中心医院鹿鸣湖院区,许昌 461000许昌市中心医院鹿鸣湖院区,许昌 461000
医药卫生
自拟参芪养心汤沙库巴曲缬沙坦钠冠心病伴心力衰竭心脾阳虚证临床效果心功能
self-designed Shenqi Yangxin Decoctionsacubitril/valsartan sodiumcoronary heart disease complicated with heart failureheart-spleen yang deficiency syndromeclinical efficacycardiac function
《中国合理用药探索》 2026 (3)
127-134,8
河南省医学科技攻关计划联合共建项目(LHGJ20200979)
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