木防己汤加味治疗慢性心力衰竭急性发作的疗效及对患者心功能、NT-proBNP水平的影响

Efficacy of modified Mufangji Decoction in treating acute attack of chronic heart failure and its influence on patients'heart function and NT-proBNP level

目的探讨木防己汤加味治疗慢性心力衰竭急性发作的疗效及对患者心功能、N末端B型利钠肽原(NT-proBNP)水平的影响。方法选择2018年8月至2020年2月广州市海珠区中医医院内二科收治的60例慢性心力衰竭急性发作患者作为研究对象,采用随机数表法分为观察组和对照组,每组30例。对照组患者给予西医治疗(利尿、强心、扩管等),观察组患者在对照组治疗基础上联合木防己汤加味治疗。治疗2周后,比较两组患者的疗效,治疗前后的左心室收缩末期内径(LVEDD)、左心室舒张末期内径(LVESD)、左心室射血分数(LVEF)和NT-proBNP、胱抑素(CysC)、糖链抗原125(CA125)水平,统计不良反应发生情况。结果观察组患者的治疗总有效率为96.67%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组患者的LVEDD、LVESD明显缩小,且观察组分别为(45.13±3.13)mm、(37.12±2.98)mm,明显小于对照组的(49.87±2.98)mm、(41.39±3.81)mm,差异均有统计学意义(P<0.05);治疗后,两组患者的LVEF明显升高,且观察组为(56.12±4.09)%,明显高于对照组的(50.87±3.78)%,差异有统计学意义(P<0.05);治疗后,两组患者的NT-proBNP、CysC、CA125水平明显降低,且观察组分别为(986.11±31.21)ng/L、(1.01±0.25)mg/L、(87.11±8.34)U/mL,明显低于对照组的(1965.12±81.12)ng/L、(1.34±0.30)mg/L、(98.12±7.33)U/mL,差异均有统计学意义(P<0.05);观察组和对照组患者的不良反应发生率分别为6.66%、13.33%,差异无统计学意义(P>0.05)。结论木防己汤加味治疗慢性心力衰竭急性发作可有效改善患者的心功能,降低NT-proBNP、CysC、CA125水平,临床治疗效果显著,安全性高,值得推广应用。

Objective To explore the curative effect of modified Mufangyi Decoction in the treatment of acute attack of chronic heart failure and its effect on patients'heart function and the level of N-terminal pro-B-type natriuretic peptide(NT-proBNP).Methods Sixty patients with acute onset of chronic heart failure who were admitted to the Second Department of Internal Medicine,Haizhu District Hospital of Traditional Chinese Medicine in Guangzhou from August 2018 to February 2020 were selected as the research objects.Using random number table,they were divided into observation group and control group,with 30 patients in each group.The patients in the control group were treated with western medicine(diuresis,heart strengthening,tube expansion,etc.),and the patients in the observation group were combined with Mufangji Decoction on the basis of the treatment of the control group.After 2 weeks of treatment,the curative effects of the two groups were compared.The left ventricular end-systolic diameter(LVEDD),left ventricular end-diastolic diameter(LVESD),left ventricular ejection fraction(LVEF),NT-proBNP,and cystatin(CysC),sugar chain antigen 125(CA125)levels,and adverse reactions were also compared.Results The total effective rate of treatment in the observation group was 96.67%,which was significantly higher than 80.00%in the control group(P<0.05);after treatment,the inner diameters of LVEDD and LVESD of the two groups were significantly reduced,which were(45.13±3.13)mm and(37.12±2.98)mm in the observation group versus(49.87±2.98)mm and(41.39±3.81)mm in the control group,with statistically significant differences(P<0.05);after treatment,the LVEF of the two groups increased significantly,which was(56.12±4.09)%in the observation group,significantly higher than(50.87±3.78)%of the control group(P<0.05);after treatment,the levels of NT-proBNP,CysC,and CA125 in the two groups were significantly reduced,and the levels in the observation group were(986.11±31.21)ng/L,(1.01±0.25)mg/L,(87.11±8.34)U/mL,significantly lower than(1965.12±81.12)ng/L,(1.34±0.30)mg/L,(98.12±7.33)U/mL in the control group(P<0.05);the incidence of adverse reactions in the observation group and the control group were 6.66%and 13.33%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Modified Mufangyi Decoction for the treatment of acute episodes of chronic heart failure can effectively improve the heart function of patients and reduce the levels of NT-proBNP,CysC,and CA125.It has significant clinical treatment effect and high safety,and is worthy of popularization and application.