真武汤加减联合新活素治疗急性心肌梗死后继发心衰临床观察

Clinical Observation of Modified Zhenwu Decoction Combined with rh-BNP on Patients with Secondary Heart Failure after Acute Myocardial Infarction

目的 观察真武汤加减联合新活素对急性心肌梗死后继发心衰患者的疗效并探讨其作用机制。方法 80例患者随机分为对照组与观察组各40例。对照组采用常规治疗加新活素泵入,观察组在对照组基础上加用真武汤加减口服,观察两组患者疗效。结果 两组治疗后N末端脑钠肽前体(NT-proBNP)均较治疗前下降(P <0.05),左室射血分数(LVEF)值均较治疗前上升(P <0.05),且观察组NT-proBNP低于对照组,而LVEF值高于对照组(P <0.05)。两组治疗后中医证候积分均较治疗前降低(均P <0.05),且观察组均低于对照组(均P <0.05)。两组治疗后各炎症因子水平均较治疗前降低(均P <0.05),且观察组均优于对照组(均P <0.05)。两组治疗后血清一氧化氮(NO)、硫化氢(H2S)水平与治疗前比较均升高(均P <0.05),内皮素-1(ET-1)水平则下降(P <0.05);且观察组NO、H2S高于对照组,ET-1低于对照组(P <0.05)。结论 真武汤加减联合新活素能有效减轻急性心肌梗死继发心衰患者临床症状,改善心脏功能,提高临床疗效,其机制可能与该方能抑制急性心衰患者炎症反应,保护血管内皮功能有关。

Objective:To observe the therapeutic effect of Modified Zhenwu Decoction combined with rh-BNP on patients with secondary heart failure after acute myocardial infarction.Methods:A total of 80 patients were randomly divided into a control group and an observation group,40 cases in each group.The control group was treated with conventional therapy and rh-BNP pump,while the observation group was added with Zhenwu Decoc⁃tion on the basis of the control group.The curative effects of the two groups were observed.Results:After treat⁃ment,the NT-proBNP levels decreased(P<0.05)and LVEF values increased(P<0.05)in both groups,while NT proBNP in the observation group was lower than that in the control group,and the LVEF value was higher than that in the control group(P<0.05).The scores of TCM symptoms in both groups were lower than those before treatment(both P<0.05),and the observation group was lower than that in the control group(P<0.05).The levels of inflammatory factors in both groups were lower than those before treatment(P<0.05),and the observation group was better than the control group(P<0.05).The levels of NO and H2S increased after treatment(P<0.05)and de⁃creased(P<0.05)after treatment,and the NO and H2S levels in the observation group were higher than those in the control group,while ET-1 was lower than that in the control group(P<0.05).Conclusion:Modified Zhenwu Decoction combined with rh-BNP can effectively alleviate clinical symptoms,improve cardiac function,and improve clinical efficacy in patients with acute myocardial infarction secondary to heart failure.The mechanism may be related to its ability to inhibit inflammatory reactions and protect vascular endothelial function in patients with acute heart failure.