补阳活血汤联合沙库巴曲缬沙坦钠片治疗阳气亏虚血瘀型慢性心力衰竭急性加重期临床研究

Clinical Study on Buyang Huoxue Prescription Combined with Sacubitril Valsartan Sodium Tablets for Acute Exacerbation of Chronic Heart Failure of Yang Qi Depletion and Blood Stasis Type

目的:观察补阳活血汤联合沙库巴曲缬沙坦钠片治疗阳气亏虚血瘀型慢性心力衰竭急性加重期患者的临床疗效。方法:回顾性分析84例阳气亏虚血瘀型慢性心力衰竭急性加重期患者的临床资料,根据治疗方法不同分为对照组与观察组各42例。2组均予沙库巴曲缬沙坦钠片等药物治疗,观察组加用补阳活血汤治疗。比较2组治疗前后的中医证候积分、6 min步行距离、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、心肌酶[N端脑钠肽前体(NT-proBNP)]及炎症因子指标[白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)],比较2组的临床疗效及不良反应发生率。结果:治疗3个月后,观察组总有效率高于对照组(P<0.05)。2组中医证候积分均较治疗前降低,6 min步行距离均较治疗前增加,差异均有统计学意义(P<0.05)。观察组中医证候积分低于对照组,6 min步行距离长于对照组,差异均有统计学意义(P<0.05)。2组LVEF值均较治疗前上升,LVESD、LVEDD值均较治疗前下降,差异均有统计学意义(P<0.05)。观察组LVEF值高于对照组,LVESD、LVEDD值均低于对照组,差异均有统计学意义(P<0.05)。2组NT-proBNP、IL-6、hs-CRP水平均较治疗前降低(P<0.05)。观察组NT-proBNP、IL-6、hs-CRP水平均低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:采用补阳活血汤联合沙库巴曲缬沙坦钠片治疗阳气亏虚血瘀型慢性心力衰竭急性加重期患者疗效显著,不但能早期缓解症状,同时还能改善心功能,减轻心肌损伤,且安全性高。

Objective:To observe the clinical effect of the therapy of Buyang Huoxue Prescription combined with Sacubitril Valsartan Sodium Tablets on patients with acute exacerbation of chronic heart failure of yang qi depletion and blood stasis type.Methods:Using retrospective analysis,the clinical data of 84 patients with acute exacerbation of chronic heart failure of yang qi depletion and blood stasis type were analyzed,and the 84 patients were divided into the control group and the observation group according to different treatment methods,with 42 cases in each group.Both groups were treated with western medicine such as Sacubitril Valsartan Sodium Tablets,and the observation group was additionally treated with Buyang Huoxue Prescription.The traditional Chinese medicine(TCM)syndrome scores,the 6-minute walk distance,heart function indexes,including left ventricular ejection fraction,left ventricular endsystolic diameter(LVESD)and left ventricular end-diastolic diameter(LVESD),the myocardial enzyme,including N-terminal pro-brain natriuretic peptide(NT-proBNP),and the indexes of inflammatory factors,including interleukin-6(IL-6)and hypersensitive C-reactive protein(hs-CRP)were compared before and after treatment between the two groups;the clinical effects and incidence of adverse reactions were compared between the two groups.Results:After 3 months of treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The TCM syndrome scores in the two groups were decreased when compared with those before treatment,and the 6-minute walk distance in the two groups were increased when compared with those before treatment,differences being significant(P<0.05).The TCM syndrome score in the observation group was lower than that in the control group,and the 6-minute walk distance was longer than that in the control group,differences being significant(P<0.05).The LVEF values in both groups were increased when compared with those before treatment,and the values of LVESD and LVEDD in both groups were decreased when compared with those before treatment,differences being significant(P<0.05).The LVEF value in the observation group was higher than that in the control group,and the values of LVESD and LVEDD were lower than those in the control group,differences being significant(P<0.05).The levels of NT-proBNP,IL-6 and hs-CRP in both groups were decreased when compared with those before treatment(P<0.05),and the above levels in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The therapy of Buyang Huoxue Prescription combined with Sacubitril Valsartan Sodium Tablets has a significant curative effect on patients with acute exacerbation of chronic heart failure of yang qi depletion and blood stasis syndrome type,which can not only mitigate the symptoms earlier,but also improve the heart function,and reduce myocardial injuries with good safety.