加味苓桂术甘汤治疗慢性心力衰竭临床研究
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R541.6

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Clinical Study on Modified Linggui Zhugan Tang for Chronic Heart Failure
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    摘要:

    目的:观察加味苓桂术甘汤对慢性心力衰竭的疗效及对血清氨基末端脑钠尿肽前体(NT-proBNP)、可溶性生长刺激表达因子-2(sST2) 含量的影响。方法:将74 例慢性心力衰竭患者随机分为研究组和对照组各37 例。对照组给予降压、降脂、抗凝等慢性心力衰竭常规治疗,研究组在对照组的基础上给予加味苓桂术甘汤治疗。2 组均连续治疗4 周,治疗结束后分析比较2 组临床疗效,比较2 组治疗前后中医证候积分;检测2 组治疗前后左室射血分数(LVEF)、左室舒张末期直径(LVEDd) 和左室收缩末期直径(LVESd);检测2 组治疗前后血清NT-proBNP、sST2 水平;治疗期间监测患者呼吸、心率、血压等生命体征,记录不良反应发生情况。结果:治疗后,研究组临床疗效优于对照组,经秩和检验,差异有统计学意义(P<0.05)。治疗前,2 组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2 组中医证候积分均较治疗前降低(P<0.05),且研究组中医证候积分低于对照组(P<0.05)。治疗前,2 组LVEF、LVEDd、LVESd 水平比较,差异无统计学意义(P>0.05);治疗后,2 组LVEF 水平较治疗前升高(P<0.05),LVEDd、LVESd 水平较治疗前降低(P<0.05),且研究组上述指标改善较对照组更显著(P<0.05)。治疗前, 2 组血清NT-proBNP、sST2 含量比较, 差异无统计学意义(P>0.05); 治疗后, 2 组血清NT-proBNP、sST2 含量均较治疗前降低(P<0.05),且研究组NT-proBNP、sST2 含量均低于对照组(P<0.05)。治疗期间,2 组患者呼吸、心率、血压等均未出现明显异常,也未出现其他不良反应。结论:加味苓桂术甘汤治疗慢性心力衰竭疗效肯定,可有效缓解患者临床症状,降低血清中sST2、NT-proBNP 水平,改善心功能,且安全性良好。

    Abstract:

    Abstract: Objectives: To observe the curative effect of Modified Linggui Zhugan tang on chronic heart failure and its effect on the contents of N-terminal pro-B-type natriuretic peptide(NT-proBNP) and soluble growth stimulation expressed gene 2(sST2) in serum. Methods: A total of 74 cases of patients with chronic heart failure were randomly divided into the study group and the control group,with 37 cases in each group. The control group was treated with routine treatment for chronic heart failure such as antihypertensive, lipid- lowering and anticoagulation treatment, and the study group was additionally treated with modified Linggui Zhugan tang based on the treatment of the control group. The two groups were continuously treated for four weeks. After treatment,the clinical effect in the two groups was analyzed and compared,and the Chinese medicine syndrome scores in the two groups before and after treatment were compared. Before and after treatment, the levels of left ventricular ejection fraction(LVEF), left ventricular end- diastolic diameter(LVEDd) and left ventricular end-systolic diameter(LVESd) and the levels of NT-proBNP and sST2 in serum in the two groups were detected. During treatment, vital signs such as respiration, heart rate and blood pressure were monitored, and the incidences of adverse reactions were recorded. Results:After treatment,the clinical effect in the study group was better than that in the control group,the difference being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of Chinese medicine syndrome scores between the two groups(P>0.05). After treatment,Chinese medicine syndrome scores in the two groups were lower than those before treatment(P<0.05),and the score in the study group was lower than that in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of the levels of LVEF, LVEDd, and LVESd between the two groups(P>0.05). After treatment, the levels of LVEF in the two groups were increased when compared with those before treatment(P<0.05), the levels of LVEDd and LVESd were decreased(P<0.05),and the improvement of the above levels in the study group was more significant than that in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of the contents of NT-proBNP and sST2 in serum between the two groups(P>0.05). After treatment,the contents of NT-proBNP and sST2 in serum in the two groups were decreased when compared with those before treatment(P<0.05), and the contents of NT-proBNP and sST2 in the study group were lower than those in the control group(P<0.05). During treatment, there were no obvious abnormality in respiratory,heart rate and blood pressure in the two groups,and no obvious adverse reactions. Conclusion:Modified Linggui Zhugan tang for patients with chronic heart failure has definite curative effect,which can effectively alleviate clinical symptoms, reduce levels of sST2 and NT- proBNP in serum, and improve heart function, with good safety.

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史珍珍,张彦来.加味苓桂术甘汤治疗慢性心力衰竭临床研究[J].新中医,2021,53(20):31-35

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  • 在线发布日期: 2021-10-22
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