苓桂养心汤治疗心气阳虚证扩张型心肌病的疗效及对抗心肌抗体的影响

Clinical Effects of Linggui Yangxin Decoction in the Treatment of Dilated Cardiomyopathy with Xinqi-Yang Deficiency Syndrome and Influence on Anti-myocardial Antibody

目的:研究心气阳虚证扩张型心肌病(DCM)患者应用苓桂养心汤治疗的效果及对抗心肌抗体的影响。方法:抽取平顶山市中医医院于2018年12月至2020年12月期间收治的心气阳虚证DCM患者82例,参照随机抽样法分成对照组(41例,实施西医常规治疗)和观察组(41例,实施西医常规治疗联合苓桂养心汤治疗)。比较两组患者的治疗效果、不良反应发生情况及治疗前后的心功能指标和抗心肌抗体水平变化。结果:治疗前,两组患者心功能指标比较,差异无统计学意义(P>0.05);治疗后,观察组患者左心室射血分数(LVEF)水平高于对照组,左心室舒张末期内径(LVEDD)水平低于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗总有效率为95.1%,高于对照组的78.0%,差异具有统计学意义(P<0.05)。治疗前,两组患者抗心肌抗体水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者抗肌球蛋白重链自身抗体(Ant–MHC)、抗β1肾上腺能受体自身抗体(Ant–β1)、抗腺嘌呤核苷转位酶自身抗体(Ant–ANT)与抗毒蕈碱–2受体自身抗体(Ant–M2)水平均低于对照组,差异具有统计学意义(P<0.05)。观察组患者不良反应总发生率4.9%,低于对照组的19.5%,差异具有统计学意义(P<0.05)。结论:苓桂养心汤治疗对于改善心气阳虚证患者的心功能指标,下调抗心肌抗体水平等有重要意义。

Objective To investigate the clinical effects of Linggui Yangxin decoction in the treatment of dilated cardiomyopathy(DCM)with Xinqi-Yang deficiency syndrome and influence on anti-myocardial antibody.Methods A total of 82 DCM patients with Xinqi-Yang deficiency syndrome admitted to Pingdingshan Hospital of Traditional Chinese Medicine from December 2018 to December 2020 were selected and divided into control group(41 cases,receiving conventional western medicine treatment)and observation group(41 cases,receiving conventional western medicine treatment combined with Linggui Yangxin decoction)according to random sampling method.The therapeutic effect,the occurrence of adverse reactions,the changes of cardiac function indexes and anti-myocardial antibody levels before and after treatment were compared between the two groups.Results Before treatment,there was no significant difference in cardiac function indexes between the two groups(P>0.05).After treatment,the level of left ventricular ejection fraction(LVEF)in the observation group was higher than that in the control group,and the level of left ventricular end diastolic diameter(LVEDD)was lower than that in the control group,the differences were statistically significant(P<0.05).The total effective rate of the observation group was 95.1%,higher than 78.0%of the control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the level of anti-myocardial antibody between the two groups(P>0.05);After treatment,the levels of anti-myosin heavy chain autoantibodies(Ant-MHC),anti-β1 adrenergic receptor autoantibodies(Ant-β1),anti-adenine nucleoside transsitase autoantibodies(Ant-ANT)and anti-muscarinic receptor autoantibodies(Ant-M2)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 4.9%,lower than 19.5%in the control group,the difference was statistically significant(P<0.05).Conclusion Linggui Yangxin decoction treatment is of great significance for improving cardiac function indexes in patients with dilated cardiomyopathy of Xinqi-Yang deficiency syndrome and reducing the level of anti-myocardial antibodies.