活血复脉汤对缺血型心肌病心力衰竭的多参数分析研究

Effects of Huoxuefumaitang on ischemic cardiomyopathy patients with heart Failure

目的:观察自组方活血复脉汤治疗缺血型心肌病心力衰竭的临床疗效。方法:88例患者随机分为观察组41例和对照组57例,两组患者均接受西医规范化治疗、观察组此基础上加活血复脉汤治疗,每天1剂,联服21天后进行心功能分级(heart function)(NYHA分级法),6分钟步行试验(six minute walking distance,6MWD)、脑钠肽(plsma brainnatricular peptide,BNP)、左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末容积(left ventricular end-dias-tolic dimension,LVEDD)、β2微球蛋白、血尿素氮、血肌酐、血尿酸、血钾、血钠、血氯、T3、T4、胆固醇、甘油三酯、低密度胆固醇临床评价。结果:观察组治疗前后比较心功能[(3.39±0.49)级与(2.73±0.81)级]、6分钟步行试验[(317.51±108.84)米与(415.15±105.85)米]、脑钠肽[(370.73±70.83)pg/mL与(291.20±86.49)pg/mL]、血胆固醇[(4.86±0.61)mmol/L与(4.53±0.44)mmol/L]、低密度胆固醇[(2.89±0.50)mmol/L与(2.47±0.48)mmol/L]经统计学处理有极显著性差异(P<0.01),左室舒张末期内径[(58.24±3.10)mm与(56.96±3.11)mm]、左室射血份数[(43.11±8.21)%与(47.04±6.02)%]、β2微球蛋白[(3.13±0.52)mg/L与(2.96±0.48)mg/L]经统计学处理有显著性差异(P<0.05);对照组治疗前后比较以上参数经统计学处理有显著性差异(P<0.05),仅低密度胆固醇[(2.82±0.55)mmol/L与(2.50±0.48)mmol/L]治疗后经统计学处理有极显著性差异(P<0.01)。治疗后,两组之间比较,心功能[(2.73±0.81)级与(3.09±0.65)级]、6分钟步行试验[(415.15±105.85)米与(368.98±105.62)米]、脑钠肽[(291.20±86.49)pg/mL与(332.83±91.08)pg/mL]有显著性差异(P<0.05)。结论:活血复脉汤能增加缺血型心肌病心力衰竭的临床疗效。

Objective：To explore the effects of huoxuefumaitang on Ischemic cardiomyopathy patients with heart failure.Methods：88cases were randomly divided into two groups,the therapeutic group（n=41） were treated with conventional therapy combined with huoxuefumaitang 1 dose/d for 21 days and the contral guoup（47）were only treated with conventional therapy.Then all the patients data of heart function,six minute walking distances（6MWD）,plsma brain natricular peptide（BNP）,left ventricular ejection fraction（LVEF）,left ventricular end-diastolic dimension（LVEDD）,serum β2–microglobulin,serum urea nitrogen,serum creatinine,serum uric acid,serum potassium,serum sodium,serum chloride,serum T3,serum T4,serum total cholesterin,serum triglyceride,and serum Low Density Lipoprotein-Cholesterol were obtained to analysis.Results： Before and after therapy,for the therapy group,there were significant differences in heart function[（3.39±0.49）（NYHA）VS（2.73±0.81）（NYHA）,（P〈0.01）],six minute walking distance[（317.51±108.84）m VS（415.15±105.85）m,（P〈0.01）] and blood brain natriuretic peptide（BNP） [（370.73±70.83）pg/mL VS（291.20±86.49）pg/mL,（P〈0.01）],total cholesterin[（4.86±0.61）mmol/L±（4.53±0.44）mmol/L,（P〈0.01）],serum triglyceride [（1.51±0.36）mmol/L VS（1.40±0.21）mmol/L],（P〈0.05）,Low Density Lipoprotein-Cholesterol[（2.89±0.50）mmol/L VS（2.47±0.48）mmol/L,（P〈0.01）],LVEF[（58.24±3.10）% VS（56.96±3.11）%,（P〈0.05）],LVEDD[（43.11±8.21）mm VS（47.04±6.02）mm,（P〈0.05）],β2-microglobulin [（3.13 ±0.52）mg/L VS（2.96 ±0.48）mg/L,（P〈0.05）];for contral group,there were significant differences in heart function[（3.36±0.49）（NYHA）VS（3.09±0.65）（NYHA）（P〈0.05）],six minute walking distance[（320.47±112.24）m VS（368.98±105.62）m,（P〈0.05）] and blood brain natriuretic peptide（BNP）[（364.62±74.97）pg/mL±（332.83±91.08）pg/mL,（P〈0.05）],total cholesterin[（4.76±0.50）mmol/L VS（4.60±0.24）mmol/L,（P〈0.05）],serum triglyceride[（1.59±0.53）mmol/L VS（1.43±0.26）mmol/L,（P〈0.05）];Low Density Lipoprotein-Cholesterol [（2.82±0.55）mmol/L VS（2.50±0.48）mmol/L,（P〈0.01）],LVEF[（58.05±2.73）% VS（57.19±2.61）%,（P〈0.05）],LVEDD[（44.13±8.13）m VS（47.35±6.32）m,（P〈0.05）],β2-microglobulin[（3.13±0.5）mg/L VS（2.98±0.40）mg/L,（P〈0.05）].significant differences were also oberseved between theary group and control group in heart function[（2.73±0.81）（NYHA）VS（3.09±0.65）（NYHA）,（P〈0.05）],six minute walking distance[（415.15±105.85）m VS（368.98±105.62）m,（P〈0.05）] and blood brain natriuretic peptide（BNP）[（291.20±86.49）pg/mL VS（332.83 ±91.08）pg/mL,（P〈0.05）].Conclusions： It is an effective and reasonable way to treat the ischemic cardiomyopathy patients with heart failure with tradtional therapy plus huoxuefumaitang.