益气养心汤治疗缺血性心肌病气虚血瘀证临床研究

Clinical Study of Ischemic Cardiomyopathy of Qi Deficiency and Blood Stasis Syndrome Treated with Yiqi Yangxin Decoction(益气养心汤)

目的:观察益气养心汤对缺血性心肌病气虚血瘀证患者的临床疗效。方法:选择缺血性心肌病气虚血瘀证患者98例,治疗时间为2021年3月至2022年3月,按随机数字表法分为西医组、中医组各49例,西医组给予西医基础治疗,中医组在西医基础治疗同时给予益气养心汤。治疗前后检测两组患者循环内皮微颗粒(EMP)、血管性血友病因子(vFW)、抗凋亡蛋白B细胞淋巴瘤因子-2(Bcl-2)、一氧化氮(NO)、肌酸激酶同工酶(CK-MB)、可溶性凋亡因子配体(sFasL)、谷胱甘肽过氧化物酶(GSH-Px)、抗超氧阴离子自由基(抗O2-)活力、丙二醛(MDA)水平,检测患者肺血管阻力(Rp-V)、平均血流量(Qmean)、左心室收缩末期容积(LVESV)、左心室收缩末期内径(LVESD),比较中医证候评分及临床疗效。结果:治疗后,中医组GSH-Px、抗O2-活力、Bcl-2、NO、Qmean含量较西医组明显升高(P<0.05),中医组MDA、vFW、EMP、CK-MB、sFasL、Rp-V、LVESV、LVESD含量较西医组明显降低(P<0.05),中医组胸痛胸闷、神疲乏力、心悸气短、面色紫暗评分较西医组改善明显,总有效率较西医组明显升高(P<0.05)。结论:益气养心汤治疗缺血性心肌病患者,可改善氧化应激反应及血管内皮功能,抑制复氧损伤,改善血流动力学、心室重构及心肌细胞功能,缓解患者临床疗效,提升其临床疗效。

Objective:To observe the clinical effect of Yiqi Yangxin Decoction(益气养心汤)on patients with ischemic cardiomyopathy of qi deficiency and blood stasis syndrome.Methods:From March 2021 to March 2022,98 patients with ischemic cardiomyopathy of qi deficiency and blood stasis syndrome were included and divided into western medicine group and traditional Chinese medicine(TCM)group using random number table,49 patients in each group.The western medicine group was treated with routine western medicine,while the TCM group was further treated with Yiqi Yangxin decoction.Circulating endothelial microparticles(EMP),von Willeblower factor(vFW),anti-apoptotic protein B-cell lymphoma factor-2(Bcl-2),nitric oxide(NO),creatine kinase isoenzyme(CK-MB),soluble apoptotic factor ligand(sFasL),glutathione peroxidase(GSH-Px),and antisuperoxideanion free radical(ASAFR),and malondialdehyde(MDA)were detected before and after treatment.Peripheral resistance(Rp-V),mean blood flow(Qmean),left ventricular end-systolic volume(LVESV),and left ventricular end-systolic inner diameter(LVESD)were measured.TCM syndrome scores were calculated to compare the difference on clinical efficacy between TCM group and western medicine group.Results:Levels of GSH-Px,ASAFR,Bcl-2,NO and Qmean in TCM group were significantly higher than those in western medicine group(P<0.05),while levels of MDA,vFW,EMP,CK-MB,sFasL,Rp-V,LVESV and LVESD in TCM group were significantly lower than those in western medicine group(P<0.05).Scores of chest pain,chest tightness,fatigue,palpitation shortness of breath,purple and dark face were significantly lower in TCM group than in western medicine group,and the total effective rate was significantly higher in TCM group than in western medicine group(P<0.05).Conclusions:In the treatment of patients with ischemic cardiomyopathy of qi deficiency and blood stasis syndrome,Yiqi Yangxin Decoction could improve oxidative stress response and vascular endothelial function,inhibit reoxygenation injury,improve hemodynamics,ventricular remodeling and cardiomyocyte function,alleviate the clinical efficacy of patients,and improve the clinical efficacy.