温经通络运瘀熏洗方联合常规西医对慢性心力衰竭患者的疗效观察

Effect of Wenjing Tongluo Yunyu Xunxi formula combined with conventional Western medicine on patients with chronic heart failure

目的观察温经通络运瘀熏洗方联合常规西医对慢性心力衰竭患者心室重构及基质金属蛋白酶9(Matrix Metalloprotein-9,MMP 9)、基质金属蛋白酶抑制剂1(Tissue inhibitor of metalloproteinases-1,TIMP-1)水平的影响。方法选择于驻马店市中医院治疗的慢性心力衰竭患者120例,治疗时间为2022年1月—2022年10月,根据随机数字表法分组,60例患者为常规西医组,给予西医规范治疗,60例患者为研究组,在西医规范治疗基础上给予患者温经通络运瘀熏洗方治疗,治疗前、后检测两组患者内皮素-1(ET-1)、TIMP-1、肿瘤坏死因子-α(TNF-α)、MMP-9水平,检测患者射血分数(LVEF)、左室舒张早/晚峰期流速(E/A)、左室收缩末期内径(LVESD)、左室心肌质量指数(LVMI)、左心室后壁舒张末期厚度(LVPWd),治疗前、后评价患者6min步行距离(6MWT)、证候评分,给予患者明尼苏达心衰生活质量量表评分(MLHFQ)评价,比较常规西医组及研究组临床疗效。结果研究组TIMP-1含量高于常规西医组(P<0.05),研究组患者ET-1、TNF-α、MMP 9含量较常规西医组明显低(P<0.05),研究组患者外周阻力指数低于常规西医组(P<0.05),研究组每搏输出量、速度指数高于常规西医组(P<0.05),研究组LVEF、E/A高于常规西医组(P<0.05),研究组LVESD低于常规西医组(P<0.05),研究组患者LVMI、LVPWd低于常规西医组(P<0.05),研究组患者MLHFQ、证候评分低于常规西医组(P<0.05),研究组患者6MWT高于常规西医组(P<0.05),研究组患者总有效率(98.33%)高于常规西医组(88.33%)(P<0.05)。结论温经通络运瘀熏洗方联合常规西医治疗慢性心力衰竭患者,可调节TIMP-1、MMP 9平衡,减低ET-1、TNF-α水平,改善血流动力学,提升心功能,提升患者运动功能、临床疗效及生活质量。

Objective To observe the effect of Wenjing Tongluo Yunyu Xunxi formula combined with conventional Western medicine on ventricular remodeling and the levels of Matrix Metalloprotein-9(MMP 9)and Tissue inhibitor of metalloproteinases-1(TIMP-1)in patients with chronic heart failure.Methods Totally 120 patients with chronic heart failure were selected for hospital treatment.The treatment period was from January 2022 to October 2022.According to the random number table method 60 patients were in the conventional Western medicine group,and received standard Western medicine treatment.60 patients were the study group.Based on the standard treatment of Western medicine,the patients were treated with Wenjing Tongluo Yunyu Xunxi formula.Endothelin-1(ET-1),TIMP-1,Tumor necrosis factor-α(TNF-α),and MMP-9 levels in the two groups were detected before and after treatment.Left ventricular ejection fractions(LVEF),left ventricular early/late peak diastolic flow velocity(E/A),left ventricular internal diameter in systole(LVESD),left ventricular mass index(LVMI),left ventricular posterior wall diastole(LVPWd),the 6-Minute walking distance(6MWT)and TCM syndrome score of the patients were evaluated before and after treatment.The patients were given the Minnesota living the heart failure questionnaire(MLHFQ).The clinical efficacy of conventional western medicine group and research group was compared.Results The content of TIMP-1 in study group was higher than that in conventional Western medicine group(P<0.05),the content of ET-1,TNF-αand MMP 9 in study group were lower than those in conventional Western medicine group(P<0.05),and the peripheral resistance index in study group was lower than that in conventional Western medicine group(P<0.05).Stroke output and speed index of the study group were higher than those of conventional Western medicine group(P<0.05),LVEF and E/A of the study group were higher than those of conventional Western medicine group(P<0.05),LVESD of the study group was lower than those of conventional Western medicine group(P<0.05),LVMI and LVPWd of the study group were lower than those of conventional Western medicine group(P<0.05).The MLHFQ and syndrome scores of the study group were lower than those of the conventional Western medicine group(P<0.05),the 6MWT of the study group was higher than that of the conventional Western medicine group(P<0.05),and the total effective rate of the study group(98.33%)was higher than that of the conventional Western medicine group(88.33%)(P<0.05).Conclusion In the treatment of patients with chronic heart failure,Wenjing Tongluo Yunyu Xunxi formula combined with conventional Western medicine can adjust the balance of TIMP-1 and MMP 9,and reduce the levels of ET-1 and TNF-α,improve hemodynamics,cardiac function and motor function of patients.It can relieve patients'clinical symptoms,improve their motor function,clinical efficacy and quality of life.