真武汤合血府逐瘀汤对冠心病心力衰竭患者心功能及血浆NT-proBNP的影响

Influence of Zhenwu Decoction and Xuefu Zhuyu Decoction on Cardiac Function and Plasma NT-proBNP in Patients with Heart Failure Induced by Coronary Heart Disease

目的观察真武汤合血府逐瘀汤对冠心病心力衰竭患者心功能及血浆NT-proBNP水平的影响。方法100例患者随机分为对照组和治疗组各50例。对照组予以西医内科常规治疗,治疗组在对照组的基础上加用真武汤合血府逐瘀汤,2周为1个疗程,2个疗程后,观察患者临床疗效、中医证候积分、左室射血分数(LVEF)、左室收缩期末容积(LVESV)、左室舒张期末容积(LVEDV)以及血浆NT-proBNP水平的变化。结果治疗2个疗程后治疗组总有效率92.00%优于对照组的78.00%(P<0.05),治疗后两组LVEF、LVESV、LVEDV较治疗前均明显改善(P<0.05),且治疗组LVEF、LVESV改善优于对照组(P<0.05),但治疗组LVEDV改善较对照组无明显差异(P>0.05);治疗组中医证候疗效总有效率86.00%优于对照组的64.00%(P<0.05);两组治疗后血浆NT-proBNP水平较治疗前均明显改善(均P<0.01),且治疗组优于对照组(P<0.05)。结论真武汤合血府逐瘀汤治疗冠心病心力衰竭,可改善患者临床症状、体征,改善心功能,且能降低血浆NT-proBNP水平。

Objective： To observe the effect of Zhenwu decoction and Xuefu Zhuyu decoction on cardiac function and plasma NT-proBNP in patients with heart failure induced by coronary heart disease. Methods： A total of 100 patients were randomly divided into treatment group and control group,50 cases in each group. Both groups received standard therapy,the treatment group was treated with Zhenwu decoction and Xuefu Zhuyu decoction at the same time. One course of treatment was 2 weeks,and the two groups were treated for 2 courses. The clinical efficacy, symptoms score, LVEF, LVESV, LVEDV and plasma levels of NT-proBNP were compared before and after treatment. Results： After a 2-course treatment,the total effective rate was 92.00% in the treatment group which was better than 78.00% in the control group （P〈 0.05）. The LVEF,LVESV,LVEDV were obviously improved in both groups after treatment（P〈 0.05）,and the improvement of LVEF and LVESV in the treatment group was better than that in the control group （P〈 0.05）,but there was no significant difference on LVEDV （P〉 0.05）. The total effective rate on TCM syndrome was 86.00% in the treatment group which was better than 64.00% in the control group （P〈 0.05）. Plasma NT-proBNP was obviously reduced in both groups （all P〈 0.01）,lower in the treatment group than in the control group （P〈 0.05）. Conclusion： Zhenwu decoction and Xuefu Zhuyu decoction can not only improve the clinical symptoms and signs of patients with heart failure induced by coronary heart disease, and improve cardiac function,but also can decrease the level of plasma NT-proBNP.