芪苈真武汤对慢性心功能不全患者心功能及血浆脑钠肽的影响

Effect of Qilizhenwu Decoction on Cardiac Function and Plasma Brain Natriuretic Eeptide in Patients with Chronic Heart Failure

目的:探讨芪苈真武汤对慢性心功能不全患者心功能及血浆脑钠肽(BNP)的影响。方法:采用前瞻性研究方法,2013年8月至2016年1月选择在我院就诊的慢性心功能不全患者112例,根据随机对照分组方法分为观察组与对照组各56例,对照组给予常规西医治疗,观察组在对照组治疗的基础上给予芪苈真武汤治疗,2组都治疗观察4周。结果:治疗后观察组与对照组的总有效率分别为96.4%和89.3%,观察组明显高于对照组(P<0.05)。观察组与对照组治疗后的LVEF值分别为(77.24±5.22)%和(70.24±4.56)%,都明显高于治疗前的(60.24±4.20)%和(60.11±5.10)%(P<0.05),同时观察组治疗后的LVEF值也明显高于对照组(P<0.05)。观察组与对照组治疗后的血浆BNP值分别为(1 673.42±256.30)pg/m L和(1 655.09±309.87)pg/m L,都明显低于治疗前的(180.24±45.10)pg/m L和(341.09±50.19)pg/m L(P<0.05),同时观察组治疗后的血浆BNP值也明显低于对照组(P<0.05)。观察组治疗后的低切和高切全血黏稠度都明显低于治疗前(P<0.05),组间比较,差异有统计学意义(P<0.05),对照组在组内比较,差异无统计学意义。结论:芪苈真武汤在慢性心功能不全患者在应用能有效改善心功能与血流动力学,促进血浆BNP表达下降,从而提高总体治疗疗效。

Objective： To investigate the effects of Qilizhenwu decoction on cardiac function and plasma brain natriuretic peptide（ BNP） in patients with chronic heart failure. Methods： Using the prospective study method,112 patients with chronic heart failure who came to our hospital from August 2013 to January 2016 were randomized into an observation group and a control group,56 cases in each. The control group were treated with routine western medicine,the observation group extra Qilizhenwu decoction,both observed for 4 weeks. Results： After treatment,the total effective rates of the observation group and the control group were96. 4% and 89. 3% respectively,observation group significantly higher than that of the control group（ P 〈 0. 05）. The LVEF values in the observation group and control group after treatment were（ 7. 724 ± 5. 22） % and（ 70. 24 ± 4. 56） %,significantly higher than those before treatment,（ 60. 24 ± 4. 20） % and（ 60. 11 ± 5. 10） %,（ P 〈 0. 05）,and the LVEF values in the observation group after treatment were significantly higher than those in control group（ P 〈 0. 05）. The plasma BNP values in the observation group and the control group after treatment were（ 1 673. 42 ± 256. 30） pg/m L and（ 1 655. 09 ± 309. 87） pg/m L,significantly lower than those before treatment,（ 180. 24 ± 45. 10） pg/m L and（ 341. 09 ± 50. 19） pg/m L,（ P 〈 0. 05）,and observation group was also significantly lower than those in the control group（ P 〈 0. 05）. The low shear and high shear viscosity of whole blood in the observation group after treatment were significantly lower than those before treatment（ P 〈 0. 05）,with significant group differences（ P 〈 0. 05）. Conclusion： Qilizhenwu decoction used in chronic heart function patients can effectively improve the cardiac function and hemodynamics and promote plasma BNP expression decreased to improve the overall treatment effect.