温阳利水汤联合抗心衰药物对慢性心力衰竭患者的疗效及N端-B型钠尿肽前体水平的影响

Effect of Wenyang Lishui Decoction combined with anti-heart failure drugs on chronic heart failure patients and influence of N-terminal-B type natriuretic peptide precursor level

目的:分析温阳利水汤联合抗心衰药物对慢性心力衰竭(CHF)患者的疗效及血清N端-B型钠尿肽前体(NT-proBNP)水平的影响。方法:选择2020年10月至2022年10月我院收治的CHF患者92例,采用随机数字表法分两组,每组各46例。对照组给予抗心衰药物治疗,观察组在对照组的基础上加温阳利水汤治疗,两组均治疗10 d。治疗后比较两组疗效,记录治疗前后中医证候积分、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)]、心肌功能指标[NT-proBNP和心肌钙蛋白Ⅰ(cTnⅠ)]、炎症因子[白细胞介素(IL)-6、C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)]及不良反应发生率。结果:治疗10 d后观察组总有效率为91.30%,优于对照组的71.74%(P<0.05)。两组治疗10 d后中医证候积分较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组治疗10 d后LVEF较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);两组治疗10 d后LVESD、LVEDD较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组治疗10 d后NT-proBNP、cTnⅠ较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组治疗10 d后IL-6、CRP、TNF-α较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组不良反应发生率无统计学差异(P>0.05)。结论:温阳利水汤联合抗心衰药物治疗CHF疗效确切,能有效保护心肌功能,改善心脏功能,抑制炎症反应,且安全可靠,值得临床积极推广。

Objective:To analyze the effect of Wenyang Lishui Decoction combined with anti-heart failure drugs on chronic heart failure(CHF)patients and the influence of serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level.Methods:92 patients with CHF admitted to our hospital from October 2020 to October 2022 were selected for this study,according to random number table method,they were divided into two groups,each group was 46 cases.The control group was treated with antiheart failure drugs,and the observation group was treated with warm Yanglishui decoction on the basis of the control group.Both groups were treated for 10 days.After treatment,the curative effects of the two groups were compared,and the Chinese medicine syndrome scores,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)],myocardial function indexes[NT-proBNP and cardiac tropo-nin I(cTn I)J,inflammatory factors[interleukin(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)J and the incidence of adverse reactions were recorded before and after treatment.Results:After 10 days of treatment,the total effective rate of the observation group was 91.30%,which was better than 71.74%of the control group(P<0.05).After 10 days of treatment,the Chinese medicine syndrome scores in both groups decreased compared to before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After 10 days of treatment,LVEF in both groups was higher than that before treatment(P<0.05),and the observation group was higher than the control group(P<0.05);After 10 days of treatment,LVESD and LVEDD in the two groups were lower than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After 10 days of treatment,NT-proBNP and cTn I were lower in both groups than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After 10 days of treatment,IL-6,CRP and TNF-αwere decreased in both groups compared with before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Wenyang Lishhui Decoction combined with anti-heart failure drugs has definite curative effect in the treatment of CHF,which can effectively protect myocardial function,improve cardiac function and inhibit inflammatory response,and is safe and reliable,worthy of active clinical promotion.