炙甘草汤合生脉散加减治疗非瓣膜性房颤疗效及对心功能和血清Ps、ICAM-1、tPA水平的影响

Curative Effect of Using Zhigancao Decoction Combined with Modified Shengmai Powder and Western Medicine in the Treatment of Non-valvular Atrial Fibrillation and the Influences on Cardiac Function, Serum P-selectin, ICAM-1 and tPA Levels

目的:探讨炙甘草汤合生脉散加减联合西药对非瓣膜性心房颤动(NVAF)患者疗效、心功能及血清P-选择素(Ps)、细胞间粘附分子-1(ICAM-1)、组织型纤溶酶原激活物(tPA)水平的影响。方法:选取2020年9月~2021年9月在本院收治的72例NVAF患者,采用随机数字表法分为观察组与对照组各36例,对照组采取西药治疗,观察组在对照组的基础上联合炙甘草汤合生脉散加减治疗,持续治疗4周后比较两组患者临床疗效。观察并记录两组中医证候积分及心功能指标[左室舒张末内径(LVEDD)、左室射血分数(LVEF)、N末端B型尿钠肽原(NT-proBNP)]、血清Ps、ICAM-1、tPA水平的差异变化,并记录两组不良反应发生率。结果:观察组的临床治疗总有效率为91.67%,高于对照组的72.22%(P<0.05)。治疗后,观察组中医证候积分低于对照组(P<0.05),观察组LVEDD、NT-proBNP水平低于对照组(P<0.05),LVEF水平高于对照组(P<0.05),观察组血清Ps、ICAM-1水平低于对照组(P<0.05),tPA水平高于对照组(P<0.05)。两组不良反应发生率无明显差异(P>0.05)。结论:炙甘草汤合生脉散加减联合西药治疗NVAF,可减轻患者血液黏附分子水平,改善患者心功能,提高临床疗效。

Objective:To explore the curative effect of Zhigancao Decoction combined with Modified Shengmai Powder and western medicine for patients with non-valvular atrial fibrillation(NVAF)and the influences on cardiac function,levels of serum P-selectin(Ps),intercellular adhesion molecule-1(ICAM-1)and tissue plasminogen activator(tPA).Methods:A total of 72 patients with NVAF admitted to the hospital were enrolled between September 2020 and September 2021.According to random number table method,they were divided into an observation group and a controlled group,36 cases in each group.The controlled group was treated with western medicine,while the observation group was additionally treated with Zhigancao Decoction combined with Modified Shengmai Powder.After 4 weeks of continuous treatment,clinical curative effect between the two groups was compared.The differences in scores of TCM syndromes,cardiac function indexes[left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),N-terminal B-type natriuretic peptide(NT-proBNP)],and levels of serum Ps,ICAM-1 and tPA in the two groups were observed and recorded.The incidence of adverse reactions in both groups was recorded.Results:The total response rate of clinical treatment in the observation group was higher than that in the controlled group(91.67%vs 72.22%)(P<0.05).After treatment,scores of TCM syndromes in the observation group were lower than those in the controlled group(P<0.05),levels of LVEDD and NT-proBNP were lower than those in the controlled group(P<0.05),LVEF level was higher than that in the controlled group(P<0.05),levels of serum Ps and ICAM-1 were lower than those in the controlled group(P<0.05),and tPA level was higher than that in the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Zhigancao Decoction combined with Modified Shengmai Powder and western medicine can reduce levels of blood adhesion factors,improve cardiac function and clinical curative effect in NVAF patients.