灵宝护心丹联合针灸治疗老年冠心病慢性心力衰竭的临床效应OA
Clinical efficacy of Lingbao Huxin Dan combined with acupuncture in treating patients with chronic heart failure due to coronary heart disease of Qi deficiency-blood stasis syndrome
目的:观察灵宝护心丹联合针刺内关穴对老年气虚血瘀型冠状动脉粥样硬化性心脏病(简称冠心病)慢性心力衰竭患者的临床疗效.方法:纳入 200 例老年气虚血瘀型冠心病慢性心力衰竭患者,随机分为对照组及试验组,各 100 例.对照组给予西医基础治疗,试验组在对照组的基础上内服中成药灵宝护心丹联合针刺双侧内关穴,两组疗程均为 4 周.评价两组的临床疗效;治疗前后监测并比较两组患者血清脂蛋白相关磷脂酶 A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、可溶性生长刺激表达基因 2 蛋白(soluble suppression of tumorigenicity 2,sST2)及 N 末端 B 型钠尿肽前体(N-terminal Pro-B-type natriuretic peptide,NT-proBNP)水平.结果:最终完成试验患者共 185 例(试验组 95 例,对照组 90 例),两组剔除/脱落率分别为 5.0%(5/100)与 10.0%(10/100).试验组总有效率高于对照组,中医证候改善率的差异具有统计学意义(χ2=11.623,P=0.009);治疗后两组患者血清 Lp-PLA2、sST2 及 NT-proBNP 水平均明显下降(P＜0.05);经广义估计方程检验,治疗后两组患者的中医证候积分、血清 Lp-PLA2、sST2 及 NT-proBNP 水平的降低均与时间有关(P＜0.01),中医证候积分、血清sST2 及 NT-proBNP 水平降低与分组无关(P＞0.05),仅血清 Lp-PLA2 水平降低与分组有关(P＜0.01),中医证候积分、血清Lp-PLA2、sST2及NT-proBNP水平的降低均与分组和时间交互作用有关(P＜0.01).结论:本研究提示,在完整疗程(4周)的情况下,相对于常规西药治疗方案,加用灵宝护心丹联合针刺内关穴能改善患者临床症状和心力衰竭标志物,但仍需更多临床验证.
Objective:To evaluate the clinical efficacy of Lingbao Huxin Dan(灵宝护心丹)combined with acupuncture at Neiguan acupoit(PC6)in treating patients with chronic heart failure(CHF)due to coronary heart disease(CHD)of Qi deficiency-blood stasis syndrome(气虚血瘀证).Methods:Two hundred patients were randomized into control and experimental groups(100 cases in each).The control group received standard Western therapy,while the experimental group additionally received Lingbao Huxin Dan and bilateral Neiguan acupuncture for 4 weeks.Clinical efficacy and serum levels of Lp-PLA2,sST2,and NT-proBNP were compared.Results:Ninety controls and 95 experimental cases were analyzed.The total effective rate in the experimental group was significantly higher that the control group(χ²=11.623,P=0.009).Post-treatment Lp-PLA2,sST2,and NT-proBNP were decreased in both groups(P<0.05).Generalized estimating equations indicated that reductions in TCM syndrome scores,Lp-PLA2,sST2,and NT-proBNP were time-dependent(P<0.01),while only Lp-PLA2 reduction was group-dependent(P<0.01).Group-time interactions were significant(P<0.01).Conclusion:Lingbao Huxin Dan combined with Neiguan acupuncture can ameliorate symptoms and biomarkers in CHF patients with CHD of Qi deficiency-blood stasis syndrome.
周炜;徐慧竹;陈啸;曹燕萍;任雨婷;侯小慧;戴佳韵;董玲慧
江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000江苏省荣军医院,江苏 无锡,214000
医药卫生
冠状动脉粥样硬化性心脏病慢性心力衰竭气虚血瘀证中成药
Coronary heart diseaseChronic heart failureQi deficiency-blood stasis syndromeChinese patent medicine
《中医临床研究》 2026 (2)
81-87,7
无锡市卫生计生委科研项目计划(Q202244).
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