子午流注择时耳穴压豆对慢性心力衰竭患者炎症细胞因子及NT-proBNT水平的影响

Effects of Ziwu Liuzhu auricular points pressing beans on inflammatory cytokines and NT-proBNP levels in patients with chronic heart failure

目的观察子午流注择时耳穴压豆对慢性心力衰竭(chronic heart failure,CHF)患者炎症细胞因子及末端脑钠肽(NT-proBNP)水平的影响。探讨子午流注择时耳穴压豆改善CHF患者中医症候、心功能与活动耐力的作用机制。方法选择2019年1月—2020年6月于黑龙江中医药大学附属第一医院门诊就诊的80例CHF患者,使用随机数字表法将80例CHF患者随机分为对照组和观察组,每组40例(对照组脱落2例,观察组脱落1例)。对照组给予常规基础治疗;观察组在对照组基础上采用子午流注择时耳穴压豆治疗。观察2组患者治疗前后左心室射血分数(LVEF)、6 min步行距离(6MWD)变化,血清IL-6、超敏C反应蛋白(hs-CRP)和NT-proBNP水平变化,比较2组患者临床疗效与中医症候疗效。结果治疗后,观察组LVEF与6MWD较治疗前明显提高(P<0.05),观察组优于对照组(P<0.05)。治疗后,观察组血清IL-6、hs-CRP和NT-proBNP水平较治疗前显著减低(P<0.05),观察组优于对照组(P<0.05)。观察组中医症候总有效率为92.3%(36/39),明显优于对照组的34.2%(13/38),差异有统计学意义(P<0.05)。观察组临床总有效率为71.8%(28/39),对照组为44.7%(17/38),差异有统计学意义(P<0.05)。结论子午流注择时耳穴压豆能明显提升CHF患者临床疗效,改善CHF患者中医症候、心功能与活动耐力,降低CHF患者血清IL-6、hs-CRP和NT-proBNP水平。

Objective To observe the effect of time-controlled Ziwu Liuzhu auricular points pressing beans on inflammatory cytokines and N-terminal pro-Brain natriuretic peptide(NT-proBNP)levels in patients with chronic heart failure(CHF).To investigate the mechanism of Ziwu Liuzhu auricular points pressing beans and earlobes to improve TCM symptoms,heart function and exercise tolerance in patients with CHF.Methods A total of 80 patients with CHF who admitted in the Outpatient Clinic in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2019 to June 2020 were selected and divided into a control group and an observation group by using the random number table method,with 40 cases in each group(2 cases dropped off in the control group and 1 case dropped off in the observation group).The control group received routine basic treatment,while the observation group was treated by Ziwu Liuzhu auricular points pressing beans on the basis of the control group.Changes in serum left ventricular ejection fraction(LVEF),6-min walking distance(6MWD),IL-6,hypersensitive C-reactive protein(hs-CRP)and NT-proBNP in both groups were observed before and after treatment.The clinical efficacy and efficacy of TCM symptoms were compared between the two groups.Results After treatment,the LVEF and 6MWD in the observation group were significantly improved compared to before treatment(P<0.05),and the observation group was superior to the control group(P<0.05);The serum levels of IL-6,hs-CRP,and NT-proBNP in the observation group were significantly reduced compared to before treatment(P<0.05),and the observation group was superior to the control group(P<0.05).The total effective rate of active TCM symptoms in the observation group was 92.3%(36/39),which was significantly better than that in the control group[34.2%(13/38),P<0.05].The total clinical effective rate of the observation group was 71.8%(28/39),while the control group was 44.7%(17/38),with a statistically significant difference(P<0.05).Conclusion Ziwu Liuzhu auricular points pressing beans may significantly improve the clinical efficacy of CHF patients,improve CHF patients'TCM symptoms,cardiac function and activity endurance,and reduce serum IL-6,hs-CRP and NT-proBNP levels in CHF patients.