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温阳利水方联合西药治疗充血性心力衰竭临床研究

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目的:观察温阳利水方联合西药治疗充血性心力衰竭的临床疗效。方法:采用随机数字表法将2021年1月—2023年3月舟山市中医院收治的100例充血性心力衰竭患者分为对照组、治疗组各50例。对照组给予常规西药对症治疗,治疗组在对照组基础上加服温阳利水方治疗,2组均连续治疗4周。比较2组治疗前后中医证候积分、心肌能量代谢指标[左心室收缩末圆周室壁应力(cESS)、心肌能量消耗(MEE)]、左心室射血分数(LVEF)、心率变异性时域参数[相邻正常R-R间期差值均方根(RMSSD)、窦性心律R-R间期总体标准差(SDNN)]、心肌损伤标志物[N端B型利钠肽原(NT-proBNP)、游离脂肪酸(FFA)、肌钙蛋白I(cTnI)]水平,并评估2组临床疗效及不良反应发生情况。结果:治疗组总有效率94。00%(47/50),对照组总有效率80。00%(40/50),2组比较,差异有统计学意义(P<0。05)。治疗后,2组中医证候积分、FFA、心肌能量代谢指标(cESS、MEE)及血清NT-proBNP、cTnI水平均较治疗前降低(P<0。05),LVEF、心率变异性时域参数(RMSSD、SDNN)水平升高(P<0。05),且治疗组中医证候积分、FFA、心肌能量代谢指标及血清NT-proBNP、cTnI水平均低于对照组(P<0。05),LVEF、心率变异性时域参数水平高于对照组(P<0。05)。对照组不良反应发生率4。00%(2/50),治疗组不良反应发生率2。00%(1/50),2组比较,差异无统计学意义(P>0。05)。结论:温阳利水方联合西药治疗充血性心力衰竭疗效确切,能够减轻患者心肌能量代谢障碍与心肌损伤,降低心率变异性,安全性较高。
Clinical Study on Wenyang Lishui Prescription Combined with Western Medicine for Congestive Heart Failure
Objective:To observe the clinical efficacy of Wenyang Lishui Prescription combined with western medicine on congestive heart failure.Methods:A total of 100 cases of patients with congestive heart failure admitted to Zhoushan City Hospital of Traditional Chinese Medicine from January 2021 to March 2023 were divided into the control group and the treatment group according to the random number table method,each with 50 cases.The control group was given conventional western medicine symptomatic treatment,and the treatment group was additionally treated with Wenyang Lishui Prescription based on the treatment of the control group.Both groups were treated continuously for four weeks.The scores of traditional Chinese medicine(TCM)syndrome and the levels of myocardial energy metabolism indicators[left ventricular end-systolic circumferential wall stress(cESS),myocardial energy expenditure(MEE)],left ventricular ejection fraction(LVEF),heart rate variability indicators[root mean square of successive differences(RMSSD),standard deviation of all normal R-R intervals(SDNN)],and myocardial injury markers[N-terminal pro-B-type natriuretic peptide(NT-proBNP),free fatty acids(FFA),cardiac troponin I(cTnI)]were compared before and after treatment in the two groups;the clinical efficacy and adverse reactions were evaluated.Results:The total effective rate was 94.00%(47/50)in the treatment group and 80.00%(40/50)in the control group,the difference being significant(P<0.05).After treatment,the scores of TCM syndrome symptoms and the levels of FFA,myocardial energy metabolism indicators(cESS,MEE)and NT-proBNP and cTnI in serum in the two groups were reduced when compared with those before treatment(P<0.05),LVEF,and heart rate variability indicators(RMSSD,SDNN)were increased(P<0.05);the scores of TCM syndrome,FFA,myocardial energy metabolism indicator,and levels of NT-proBNP and cTnI in serum in the treatment group were lower than those in the control group(P<0.05),LVEF and heart rate variability indicator was higher than that in the control group(P<0.05).The incidence of adverse reactions in the control group was 4.00%(2/50),and that in the treatment group was 2.00%(1/50),there being no significant difference(P>0.05).Conclusion:The combination of Wenyang Lishui Prescription with western medicine has a definite curative effect on the treatment of congestive heart failure,which can alleviate myocardial energy metabolism disorders and myocardial injury,reduce heart rate variability,and has high safety.

Congestive heart failureWenyang Lishui PrescriptionMyocardial energy metabolismHeart rate variabilityMyocardial injury

蒋泽磊、郝宗霞、罗晗予

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舟山市中医院急诊内科,浙江 舟山 316000

充血性心力衰竭 温阳利水方 心肌能量代谢 心率变异性 心肌损伤

2025

新中医
广州中医药大学 中华中医药学会

新中医

影响因子:0.595
ISSN:0256-7415
年,卷(期):2025.57(1)