通痹化瘀膏贴敷经穴体外反搏治疗对慢性心衰患者心功能、血管内皮功能及氧化应激损伤的影响

Effects of Tongbi Huayu Ointment on Cardiac function,Vascular Endothelial Function and Oxidative Stress Injury in Patients with Chronic Heart Failure

目的:探究通痹化瘀膏贴敷经穴体外反搏治疗对慢性心力衰竭(chronic heart failure,CHF)患者心功能、血管内皮功能及氧化应激损伤的影响。方法:选取2019年1月~2020年1月于西安市第五医院内科确诊为CHF患者108例作为研究对象,按照随机、对照的研究方法,将入组患者随机平均分为经穴体外反搏组、体外反搏组和对照组,各组患者36例,观察并分析三组患者的心功能指标改善情况及不良反应发生等情况。结果:经治疗,经穴体外反搏组患者的临床总有效率(88.89%)显著性优于体外反搏组及对照组患者(80.56%、63.89%);三组患者的中医证候积分均明显降低,与对照组患者相比较,经穴体外反搏组、体外反搏组患者的中医证候积分降低的更显著,且经穴体外反搏组更佳;与对照组患者相比较,经穴体外反搏组、体外反搏组患者的心功能指标(LVEF、CO、LVEDD)显著性改善,且经穴体外反搏组更明显;经穴体外反搏组、体外反搏组患者的vWF、ET-1水平显著性低于对照组患者,且NO水平显著性高于对照组患者,且经穴体外反搏组更优;经穴体外反搏组患者的氧化应激指标(MDA、SOD、CAT、SDH、GSH-Px)改善情况明显优于体外反搏组患者和对照组患者,且三组之间两两比较均有统计学差异(P<0.05);在治疗过程中及治疗后,三组患者均未发生明显的不良反应事件。结论:通痹化瘀膏贴敷经穴体外反搏治疗对CHF患者心功能改善具有促进作用,临床症状得以缓解,能够明显改善血管内皮功能,修复氧化应激损伤,且临床安全性较高。

Objective:To explore the effects of Tongbi Huayu ointment on cardiac function,vascular endothelial function and oxidative stress injury in patients with chronic heart failure.Methods:108patients diagnosed with CHF in the internal medicine department of Xi'an No.5Hospital from January 2019to January 2020were selected as study subjects.According to the randomized and controlled study method,the enrolled patients were divided into a ratio of 1∶1∶1.The patients were divided into acupoint external counterpulsation group,external counterpulsation group and control group,with 36patients in each group.Observation and analysis of three groups of patients with cardiac function index[left heart ejection fraction(LeftVentricularEjectionFraction,LVEF)and cardiac output(CO)CardiacOutput,and left ventricular end-diastolic diameter(LVEDD LeftVentricularEndDiastolicDiameter,)],endothelial function index[von willebrand factor(vonWillebrandFactor,vWF),Endothelin(Endothelin-1,ET-1),nitric oxide(NO)],oxidative stress index[serum malondialdehyde,Malonaldehyde(MDA),superoxide dismutase(SOD),SuperoxideDismutase(SOD),Catalase(Catalase,CAT)and succinate dehydrogenase(SuccinicDehydrogenase,SDH),glutathione peroxidase(GlutathionePeroxidase,gsh-px)]and adverse reactions in the three groups were observed and analyzed.Results:After treatment,the total clinical effective rate(88.89%)of the patients in the acupoint external counterpulsation group was significantly better than that of the patients in the external counterpulsation group and control group(80.56%,63.89%)(P<0.05).The TCM syndrome scores of patients in the three groups were significantly reduced(P<0.05).Compared with the control group,the TCM syndrome scores of patients in the acupoint external counterpulsation group and the external counterpulsation group were more significantly reduced(P<0.05),and the acupoint external counterpulsation group was better(P<0.05).Compared with the control group,the cardiac function indicators(LVEF,CO,and LVEDD)of the patients in the acupoint external counterpulsation group and the external counterpulsation group were significantly improved(P<0.05),and the indicators in the acupoint external counterpulsation group were more significant(P<0.05).The levels of vWF and ET-1in the acupoint external counterpulsation group and the external counterpulsation group were significantly lower than those in the control group(P<0.05),and the levels of NO were significantly higher than those in the control group(P<0.05),and the acupoint external counterpulsation group was better(P<0.05).The improvement of oxidative stress indexes(MDA,SOD,CAT,SDH,GSH-PX)in the patients of the acupoint external counterpulsation group was significantly better than that in the patients of the external counterpulsation group and the control group,and pairwise comparison between the three groups showed statistical difference(P<0.05).During and after treatment,no significant adverse events occurred in the three groups(P>0.05).Conclusion:Tongbi Huayu ointment can promote the improvement of cardiac function in PATIENTS with CHF,relieve clinical symptoms,significantly improve vascular endothelial function,repair oxidative stress injury,and improve the quality of life of patients,with high clinical safety.