人参养营汤联合重组人脑利钠肽治疗急性心肌梗死后心力衰竭的效果

Effects of Ginseng Yangying Decoction Combined with Recombinant Human Brain Natriuretic Peptide in Heart Failure After Acute Myocardial Infarction

目的 观察人参养营汤联合重组人脑利钠肽(rhBNP)对急性心肌梗死(AMI)后心力衰竭的疗效。方法 按随机数表法将漯河市中医院2020年3月至2022年2月收治的98例AMI后心力衰竭患者分为两组,每组49例。单一组接受rhBNP治疗,联合组在单一组基础上加用人参养营汤治疗。对比两组疗效、治疗前后中医证候积分、血清炎症因子[白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]、心功能[左室射血分数(LVEF)、左室舒张末内径(LVEDD)]及不良反应发生率。结果 联合组总有效率[89.80%(44/49)]较单一组[69.39%(34/49)]高(P<0.05)。治疗后与单一组比较,联合组胸闷胸痛、心悸气短、神疲乏力积分低,IL-6、hs-CRP、TNF-α水平低,LVEF水平高,LVEDD水平低(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论 人参养营汤联合rhBNP治疗AMI后心力衰竭患者能有效降低炎症因子水平,缓解胸闷胸痛、心悸气短等症状,改善患者心功能,降低不良反应发生率。

Objective To observe the clinical effect of Ginseng Yangying decoction combined with recombinant human brain natriuretic peptide(rhBNP)in the treatment of heart failure after acute myocardial infarction(AMI).Methods Ninety-eight patients with post-AMI heart failure admitted to Luohe Hospital of Traditional Chinese Medicine from March 2020 to February 2022 were divided into two groups with 49 cases in each group by random number table method.The single group was treated with rhBNP,and the combined group was treated with Ginseng Yangying decoction on the basis of single group.The efficacy,TCM syndrome score before and after treatment,serum inflammatory factors[interleukin-6(IL-6),hypersensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)]and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combined group was[89.80%(44/49)]higher than that of the single group[69.39%(34/49)](P<0.05).After treatment,compared with the single group,the scores of chest tightness,chest pain,palpitations,shortness of breath and fatigue in the combined group was lower,the levels of IL-6,hs-CRP and TNF-αin the combined group were lower,the LVEF level was higher,and the LVEDD level was lower(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ginseng Yangying decoction combined with rhBNP can effectively reduce the level of inflammatory factors of patients with heart failure after AMI,relieve chest tightness,chest pain,palpitations,shortness of breath and other symptoms,improve the cardiac function of patients and reduce the incidence of adverse reactions.