苓桂术甘汤加减联合曲美他嗪治疗慢性心力衰竭临床研究

Clinical Study on Modified Linggui Zhugan Decoction Combined with Trimetazidine for Chronic Heart Failure

目的:观察苓桂术甘汤加减联合曲美他嗪治疗慢性心力衰竭的临床疗效及对心功能、血清炎性因子水平的影响。方法:选择114例慢性心力衰竭患者,按随机数字表法分为观察组和对照组各57例。对照组接受常规抗心衰及曲美他嗪治疗,观察组在对照组基础上给予苓桂术甘汤加减治疗。比较2组临床疗效及治疗前后心功能指标、炎症因子水平的变化。结果:观察组总有效率为87.72%,高于对照组71.93%,差异有统计学意义(P<0.05)。治疗后,2组N端脑钠肽前体(NT-proBNP)水平较治疗前降低,左室射血分数(LVEF)及6 min步行距离较治疗前升高(P<0.05),且观察组NT-proBNP水平低于对照组,LVEF及6 min步行距离高于对照组(P<0.05)。治疗后,2组血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平较治疗前降低(P<0.05),且观察组血清hs-CRP、TNF-α、IL-6水平低于对照组(P<0.05)。结论:苓桂术甘汤加减联合曲美他嗪治疗慢性心力衰竭能够有效抑制炎症反应,改善心功能,提高临床疗效。

Objective:To observe the clinical effect of modified Linggui Zhugan Decoction combined with Trimetazidine on chronic heart failure and its effect on the heart function and levels of serum inflammatory factors.Methods:A total of 114 patients with chronic heart failure were selected and divided into the observation group and the control group according to the random number table method,with 57 cases in each group.The control group was given the routine treatment of anti-heart failure and Trimetazidine,and the control group was additionally treated with modified Linggui Zhugan Decoction based on the treatment of the control group.The clinical effects,and the changes of indexes of heart function and levels of inflammatory factors were compared between the two groups before and after treatment.Results:The total effective rate was 87.72%in the observation group,higher than that of 71.93%in the control group,the difference being significant(P<0.05).After treatment,the levels of Nterminal pro-brain natriuretic peptide(NT-proBNP)in both groups were decreased when compared with those before treatment,and the left ventricular ejection fraction(LVEF)and 6-minute walking distance were increased when compared with those before treatment(P<0.05);the NT-proBNP level in the observation group was lower than that in the control group,and the LVEF and 6-minute walking distance were higher than those in the control group(P<0.05).After treatment,the levels of serum hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups were decreased when compared with those before treatment(P<0.05),and the above three levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Modified Linggui Zhugan Decoction combined with Trimetazidine for chronic heart failure can effectively inhibit the inflammatory responses,improve the heart function and enhance the clinical effect.