利心水方联合美托洛尔对老年冠心病心力衰竭患者的影响

Effect of Lixinshui Formula Combined with Metoprolol on Elderly Patients with Coronary Heart Disease and Heart Failure

目的 研究利心水方联合美托洛尔对老年冠心病心力衰竭患者心肌纤维化的影响。方法 选取濮阳市中医医院于2019年11月至2021年10月期间收治的98例老年冠心病心力衰竭患者,按随机数表法分为两组,各49例。对照组单用美托洛尔治疗,研究组采用利心水方联合美托洛尔治疗。比较两组治疗前后中医证候积分、心功能[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、血管内皮功能[内皮素-1(ET-1)、一氧化氮(NO)、内皮舒张功能(FMD)]、心肌纤维化[血清Ⅰ型胶原吡啶交联终肽(ICTP)、Ⅲ型前型胶原氨基端肽(PⅢNP)、Ⅰ型前胶原羧基端前肽(PICP)]及不良反应。结果 治疗后,两组中医症候积分均低于治疗前,且研究低于对照组,差异有统计学意义(P<0.05)。治疗后两组LVEDD、LVESD均低于治疗前,且研究低于对照组,差异有统计学意义(P<0.05)。治疗后两组LVEF均高于治疗前,且研究高于对照组,差异有统计学意义(P<0.05)。治疗后两组血清ET-1、ICTP、PⅢNP、PICP水平均低于治疗前,且研究低于对照组,差异有统计学意义(P<0.05)。治疗后两组血清NO水平、FMD均高于治疗前,且研究高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较(8.16%VS 4.08%),差异无统计学意义(P> 0.05)。结论 利心水方联合美托洛尔能有效缓解老年冠心病心力衰竭患者临床症状,改善心功能,提供血管内皮功能,抑制心肌纤维化,且不增加不良反应,优势明显,具有进一步应用价值。

Objective To study the effect of Lixinshui decoction combined with metoprolol on myocardial fibrosis in elderly patients with coronary heart disease and heart failure.Methods A total of 98 elderly patients with coronary heart disease and heart failure admitted to Puyang Hospital of Traditional Chinese Medicine from November 2019 to October 2021 were selected and divided into two groups according to the random number table method,with 49 cases in each group.The control group was treated with metoprolol alone,and the study group was treated with Lixinshui prescription combined with metoprolol.Traditional Chinese medicine syndrome scores,cardiac function [left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],vascular endothelial function [endothelin-1(ET-1),nitric oxide(NO),endothelial diastolic function(FMD)] and myocardial fibrosis [serum type Ⅰ collagen pyridine cross-linking terminal peptide(ICTP),type Ⅲ procollagen amino-terminal peptide(PⅢNP),type Ⅰ procollagen carboxyl-terminal propeptide(PICP)] and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the TCM symptom scores of the two groups were lower than before treatment,and the study was lower than the control group,the difference was statistically significant(P<0.05).After treatment,LVEDD and LVESD of the two groups were lower than before treatment,and the study was lower than the control group,the difference was statistically significant(P<0.05).After treatment,LVEF in both groups was higher than before treatment,and the study was higher than the control group,the difference was statistically significant(P<0.05).After treatment,the levels of serum ET-1,ICTP,PⅢNP,and PICP in the two groups were lower than before treatment,and the study group was lower than the control group,the difference was statistically significant(P<0.05).After treatment,the serum NO level and FMD of the two groups were higher than those before treatment,and the study group was higher than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(8.16% VS 4.08%)(P>0.05).Conclusion Lixinshui Formula combined with metoprolol can effectively relieve the clinical symptoms of elderly patients with coronary heart disease and heart failure,improve cardiac function,provide vascular endothelial function,and inhibit myocardial fibrosis.It does not increase adverse reactions,has obvious advantages,and has further application value.