参附强心汤治疗射血分数保留慢性心衰的临床研究
Observation on Effect of Shenfu Qiangxin Decoction on Echocardiography and Clinical Effectiveness for Heart Failure with Preserved Ejection Fraction
-
摘要: 目的 观察参附强心汤对射血分数保留的慢性心衰(阴阳两虚,水瘀内停证)患者超声心动图指标的影响及临床疗效情况,并初步探讨其作用机制。方法 选取2014年8月-2015年8月来我院治疗并经检查确诊为射血分数保留的慢性心功能不全(阴阳两虚,水瘀内停证)的患者57例,随机分为对照组(28例)和观察组(29例)。对照组给予常规治疗,观察组在常规治疗基础上加用参附强心汤,2组均2周为1个疗程,1个疗程后进行疗效评估。观察2组治疗前后血浆脑钠肽(BNP)、6min步行距离(6MWT)、超声心动图等指标变化。结果 2组治疗后血浆BNP、6MWT均有改善(P<0.05~0.01),但观察组下降显著(P<0.05);超声心动图指标中左房(LAD)大小2组均未明显改善(P>0.05),二尖瓣环舒张早期最大血流速度(E峰)/二尖瓣环室间隔及左室侧壁组织舒张早期最大速度(Ea)比值、肺动脉收缩压(PSA)2组患者均有明显改善(P<0.05~0.01),与对照组相比,观察组变化幅度更为显著(P<0.05)。结论 参附强心汤能有效改善射血分数保留的慢性心功能不全患者血浆BNP水平、6min步行距离、超声心动图等指标。
-
关键词:
- 射血分数保留慢性心衰 /
- 参附强心汤 /
- 脑钠肽 /
- 6min步行距离 /
- 超声心动图
Abstract: OBJECTIVE To study the effect of Shenfu Qiangxin Decoction on echocardiography indexes and clinical improvement for patients with chronic heart failure with preserved ejection fraction (HFPEF) (deficiency of both yin and yang, blood stasis and water retention), and to investigate its possible mechanism. METHODS 57 patients visited in our hospital and diagnosed as chronic HFPEF (deficiency of both yin and yang, blood stasis and water retention) from Aug. 2014 to Aug. 2015 were selected and randomly divided into the control group (28 cases) and the observation group (29 cases). The control group was given conventional therapy, and the treatment group was treated with Shenfu Qiangxin Decoction on the basis of conventional therapy, and two weeks as a course in both groups. Efficacy evaluation was performed after one course treatment. Indexes changes such as plasma brain natriuretic peptide (BNP), 6-minute walk test (6MWT) and echocardiography in two groups were observed before and after treatment. RESULTS Plasma BNP and 6MWT in both groups improved after treatment (P<0.05~0.01), but the observation group decreased more significantly (P<0.05). Echocardiographic indexes showed that the size of left atrial (LAD) in both groups were not significantly improved (P>0.05), The ratio of early diastolic maximum flow velocity of mitral annulus (E peak)/early diastolic maximum velocity of tricuspid annular interventricular septum and left ventricular lateral wall tissue (Ea) and pulmonary arterial systolic pressure (PSA) of patients in two groups improved significantly(P<0.05~0.01), change extent of the observation group was more significant compared with the control group (P<0.05). CONCLUSION Shenfu Qiangxin Decoction can effectively improve plasma BNP level, 6MWT, and echocardiography of patients with chronic HFPEF.-
Key words:
- HFPEF /
- Shenfu Qiangxin Decoction /
- BNP /
- 6MWT /
- echocardiography
-
[1] YANCY CW,JESUP M,BOZKURT B,et al. 2013 ACCF/AHA guideline for the management of heart failure:a report of the American college of cardiology foundation/American heart association task force on practice guidelines[J].J Am Coll Cardiol, 2013,62:e147-e239. [2] BUI AL,HORWICH TB,FONAROW GC.Epidemiology and risk profile of heart failure[J].Nat Rev Cardiol,2011,8:30-41. [3] 张子彬.充血性心力衰竭[M].北京:科学技术文献出版社,2002:48. [4] ZHANG ZB. Congestive Heart Failure[M]. Beijing: Scientific technical literature publishing house, 2002:48. [5] 何文明,麦一峰,杨国君,等.舒张性心功能不全发生机制及治疗策略再思考[J].现代实用医学,2011,23(10):1199-1200. [6] HE WM, MAI YF, YANG GJ, et al. Reconsideration of occurrence mechanism and therapy of diastolic heart failure[J]. Mod Pract Med, 2011, 23(10): 1199-1200. [7] MAS SB, CARSON PE, MEMUR RJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction[J]. NEJM, 2008, 359(23): 2456-2467. [8] BMUWERS FP,DE BOER RA,VAN DER HARST P,et al.Incidence and epidemiology of new onset heart failure with preserved vs.reduced ejection fraction in a community-based cohort:11- year folow-up of prevend[J]. Eur Heart J,2013,34:1424-1431. [9] 张敬云,杨俊华.老年射血分数保留的心力衰竭患者超声心动图特征分析[J]. 中华实用诊断与治疗杂志,2016,30 (7):704-706. [10] ZHANG JY, YANG JH. Echocardiographic characteristics of elderly heart failure with preserved ejection fraction[J]. J Chin Prac Diag Ther, 2016, 30 (7): 704-706. [11] 王洁妤,华琦.左心室射血分数保留的心力衰竭研究进展[J]. 中华老年心脑血管病杂志,2016,18(7):766-769. [12] WANG JY, HUA Q. Research progress of heart failure with preserved ejection fraction[J]. Chin J Geriatr Heart Brain Ves Dis, 2016, 18(7): 766-769. [13] KHAN SQ, DHILON O, Kely D, et al. Plasma N-terminal B-Type natriuretic peptide as an indicator of long-term survival after a-cute myocardial infarction:comparison with plasma midregional pro-atrial natriuretic peptide:The LAMP(Leicester Acute Myo-cardial Infarction Peptide)study[J]. J Am Col Cardiol, 2008, 51(19): 1857-1864. [14] GLEZEVA N, BAUGH JA. Role of inflammation in the pathogenesis of heart failure with preserved ejection fraction and its potential as a therapeutic target[J]. Heart Fail Rev, 2014, 19(5): 681-694. [15] 中华医学会心血管病学分会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095. [16] Chinese Society of Cardiology. Guidelines for the diagnosis and management of chronic heart failure[J]. Chin J Cardiol, 2007,35(12): 1076-1095. [17] 王筠默.中药药理学[M].上海:上海科学技术出版社,1988:49-114. [18] WANG JM. Chinese Medicine Pharmacology[M]. Shanghai: Shanghai Science Technology Press, 1988: 49-114.
点击查看大图
计量
- 文章访问数: 1144
- HTML全文浏览量: 1
- PDF下载量: 1564
- 被引次数: 0