益气活血法对射血分数保留的心力衰竭患者临床疗效及左室质量指数的影响

Effect of Method of Replenishing Qi and Activating Blood on Clinical Efficacy and Left Ventricular Mass Index in Patients with Heart Failure with Preserved Ejection Fraction

目的探究运用益气活血法治疗射血分数保留的心力衰竭(HFpEF)患者的临床疗效,同时观察其对左室质量指数的影响。方法选择68例HFpEF患者随机分为对照组和治疗组。对照组采用常规西药治疗,治疗组在对照组基础上给予益气活血的中药汤剂,早、晚两次口服。两组疗程均为4周。观察对比治疗前后两组患者的中医证候、6 min步行试验(6MWT)、舒张早期二尖瓣血流速度/舒张早期二尖瓣环运动速度的比值(E/E′)及左室质量指数(LVMI)。结果与治疗前相比较,治疗组患者的中医证候改善的有效率高于对照组(P<0.05);治疗组E/E′、6MWT改善程度优于对照组,差异具有统计学意义(P<0.05);治疗组与对照组治疗前后各组内LVMI差异有统计学意义(P<0.01),但治疗后两组间差异无统计学意义。结论益气活血法对HFpEF患者的中医证候、运动耐量改善效果明显,显著降低E/E′比值而提高左心室舒张功能,但对左室质量指数降低的疗效差异不显著。

Objective To explore the clinical efficacy of the method of replenishing Qi and activating blood in the treatment of heart failure patients with preserved ejection fraction(HFpEF),and observe its influence on the left ventricular mass index.Methods Sixty-eight patients with HFpEF were randomly divided into control group and treatment group.The control group was treated with conventional western medicine,and the treatment group was given a traditional Chinese medicine decoction for replenishing Qi and activating blood on the basis of the control group,which was taken orally twice respectively in the morning and evening.The course of treatment for both groups was 4 weeks.We observed and compared the TCM syndromes,6-min walk test(6 MWT),early diastolic mitral valve blood flow velocity/early diastolic mitral annulus velocity ratio(E/E′)and left ventricular mass index(LVMI).Results After treatment,the effective rate of TCM syndrome improvement in the treatment group was higher than that in the control group(P<0.05).The improvement of E/E′and 6 MWT in the treatment group was better than that of the control group,and the difference was significant(P<0.05).The LVMI in each group before and after treatment was statistically different(P<0.01)but there was no significant difference between the two groups after treatment.Conclusion The method of replenishing Qi and activating blood has a significant effect on improving TCM symptoms and exercise tolerance of patients with HFpEF.It significantly reduces the E/E′ratio and improves the left ventricular diastolic function,but there is no significant difference in the effect of reducing the left ventricular mass index.