Application effect of exercise rehabilitation therapy in elderly patients with chronic heart failure

Objective:To investigate the effects of rehabilitation exercise therapy on 6-minute walking distance (6 minute walk distance, 6MWD), brain natriuretic titanium (Brain natriuretic peptide, BNP) and (Minnesota heart failure quality of life scale, MLHFQ score in elderly patients with chronic heart failure (CHF).Methods: Choose xi'an medical college affiliated hospital heart treated with 96 cases of elderly patients with chronic heart failure (from January 2016 to January 2018), according to random number table method, divide the patients as control group and observation group 48 cases/group, control group to implement regular heart failure treatment, the observation group in the control group, the implementation of rehabilitation exercise therapy on the basis of comparing the clinical curative effect of two groups of indicators, heart colour to exceed, 6 MWDS, BNP levels, plate movement, MLHFQ score. Results: (1) compared with the control group, the total effective rate of the observation group was higher than that of the control group (P<0.05). (2). After treatment, the left ventricular end-diastolic diameter (Left ventricular end diastolic diameter, LVEDD) and the left ventricular end-systolic diameter (Left ventricular end systolic diameter, LVESD), BNP) in the observation group were higher than those in the control group. All the MLHFQ scores were lower than those in the control group (P<0.05). The left ventricular ejection fraction (Left ventricular ejection fraction, LVEF), stroke output (Stroke volume, SV) and treadmill metabolic equivalent (Metabolic equivalent, METs) were higher than those in the control group (P<0.05). The treadmill exercise time was longer than that in the control group (P<0.05), and its 6MWD was higher than that in the control group (P<0.05).Conclusion: Rehabilitation exercise therapy in elderly patients with chronic heart failure can effectively improve the cardiac function, enhance their exercise endurance and energy metabolism level, and improve the clinical efficacy and quality of life.

Echocardiographic Evaluation of Qiangxin Decoction Combined with Cardiac Resynchronization Therapy for Patients with Chronic Heart Failure

OBJECTIVE: To explore the echocardiographic evaluation of patients with chronic heart failure (CHF) after Qiangxin Decoction combined with cardiac resynchronization therapy. METHODS: A total of 140 CHF patients admitted to our hospital were randomly divided into combined group (Qiangxin Decoction and cardiac resynchronization, n = 70) and routine group (cardiac resynchronization, n = 70), and they were treated for 2 courses (16 weeks), with 8 weeks as a course. The improvement of heart function classification (HYHA) was observed before and after treatment, and the therapeutic effects were evaluated according to the improvement of heart function classification (markedly effective, effective, invalid, and worsening). The traditional Chinese medicine (TCM) diagnostic criteria was the main symptoms (0 to 6 points), secondary symptoms (0 to 3 points), tongue picture (0 to 1 point) and pulse condition (0 to 1 point), and the higher the score was, the more obvious the symptoms were. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and cardiac output (CO) were observed and recorded according to the heart color ultrasound before and after treatment. And the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to evaluate the life quality before and after treatment, and the highest score of the scale was 105 points. The higher the score was, the obvious the symptoms were, and the worse the life quality was. And the adverse reactions were recorded in the 2 groups. RESULTS: After the treatment, the total effective rate in the routine group was significantly lower than that in the combined group (75.71% vs . 94.30%), and there was statistically significant difference (P < 0.05). After the treatment, the TCM syndrome score in the routine group was higher than that in the combined group ((14.37±3.59) points vs.(10.53±3.11) points), and there was statistically significant difference (P < 0.05). After the treatment, the levels of LVEDD and LVESD in the routine group were higher than those in the combined group, and there were statistically significant differences (P < 0.05). The levels of LVEF and CO in the routine group were lower than those in the combined group, and there were statistically significant differences (P < 0.05). After the treatment, the score of MLHFQ scale in the routine group was higher than that in the combined group ((57.38±8.53) points vs.(46.39±7.14) points), and there was statistically significant difference (P < 0.05). CONCLUSION: Qiangxin Decoction combined with cardiac resynchronization therapy has good echocardiographic evaluation in patients with chronic heart failure.

Effects of Digoxin and Tongxinluo capsule combination treatment on oxidative stress, cytokines and vascular endothelial function in patients with chronic heart failure

Objective:To explore the effect of digoxin and Tongxin capsule combined therapy on oxidative stress, cytokines and vascular endothelial function in patients with chronic heart failure, and provide help for clinical treatment of patients with chronic heart failure.Methods:95 cases of chronic heart failure in our hospital were randomly divided into observation group (47 cases) and control group (48 cases). Control group patients were given basic treatment, and observation group received combination therapy of digoxin and Tongxinluo capsule, to detect and to investigate the changes of oxidative stress, cytokines and vascular endothelial function in two groups of patients before and after treatment.Results:There was no significant difference in oxidative stress, cytokines and vascular endothelial function between the two groups of chronic heart failure patients before treatment (P>0.05). Compared with before treatment, the malondialdehyde (MDA) and cytokines [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6) and brain natriuretic peptide (BNP)] in two groups of patients with chronic heart failure after treatment decreased significantly (P<0.05), while indexes related to endothelial function [hyperemic brachial artery diameter after reactive hyperemia, brachial artery diameter change rate, brachial artery endothelial dependent diastolic function (FMD), and brachial artery endothelium dependent diastolic function (NMD)] and related indexes of oxidative stress [glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and catalase (CAT)] were significantly increased (P<0.05). The related indexes and oxidative stress indexes (GSH-Px, CAT and SOD) of observation group after the combined treatment in patients with endothelial function were significantly higher than the control group after treatment (P<0.05). After treatment, cytokines and MDA levels were significantly lower than the control group (P<0.05).Conclusions:Tongxinluo capsule combined with digoxin treatment significantly improved the oxidative stress, cytokines and vascular endothelial function levels in patients with chronic heart failure, and has important clinical significance for the treatment of patients with chronic heart failure.

Treatment of Chronic Heart Failure Complicated with Anxiety and Depression Using Traditional Chinese and Western Medicine

Chronic heart failure(CHF)is the terminal stage of various heart diseases,and is the main cause of death from cardiovascular disease.In recent years,the prevalence of CHF combined with anxiety and depressive state has shown an upward trend,and this paper was aimed to provide a reference for the diagnosis and treatment of CHF combined with anxiety and depression using Traditional Chinese medicine(TCM)and Western medicine.

Effect of thermal therapy using hot water bottles on brain natriuretic peptide in chronic hemodialysis patients

Introduction: The use of repeated thermal therapy for improving the symptoms of chronic heart failure (CHF) has been recently demonstrated. Usually, thermal therapy requires an infrared dry sauna. However, it is difficult for small clinics to acquire such an expensive and extensive system. The author assessed the efficacy of its substitution with hot water bottles. Moreover, there are no prior studies demonstrating the efficacy of thermal therapy in hemodialysis patients with chronic heart failure. Methods: The author evaluated plasma brain natriuretic peptide (BNP) levels in 98 hemodialysis patients in a clinic. A total of nine patients whose BNP levels were more than 500 pg/mL agreed to be enrolled in this study and received thermal therapy using hot water bottles. Results: Plasma BNP levels, a potential marker for CHF, tended to decrease (891 ± 448 pg/mL to 680 ± 339 pg/mL), but the difference was not significant (P = 0.0845). The oral temperature changed from 36.44℃± 0.45℃ to 37.04℃ ± 0.48℃ (+0.597℃, P < 0.0001). No side effects were experienced during the therapy. Moreover, most patients had an improvement in their symptoms and the ability to perform activities of daily living. Conclusion: Thermal therapy using hot water bottles is very safe and tends to reduce plasma BNP levels in hemodialysis patients with CHF.

Decrease of plasma N-terminal pro p-type natriuretic peptide as a predictor of clinical improvement after cardiac resynchronization therapy for heart failure

Background N-terminal pro β-type natriuretic peptide （NT pro BNP） has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy （CRT）. Methods A total of 44 patients with chronic heart failure （34 male and 10 female, mean age of （58±13） years, New York Heart Association （NYHA） class 3.3±0.5, QRS duration （150±14） milliseconds） who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data. Results After a mean of （16.3±5.5） months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP （（1.70±1.28） vs （1.07±0.88） pmol/ml, P 〈0.001） in responders. Percentage change in NT pro BNP level （△BNP%） was a statistically significant predictor of long term clinical improvement at 3 months of follow-up. Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.

Cardiac resynchronization therapy improved the clinical outcomes in pacemaker patients upgraded to biventricular device

The right ventricular pacing （RVP） is the standard treat- ment for patients with severe bradyarrhythmias; however, it may cause and exacerbate heart failure symptoms in a long run under some circumstances.{1] In fact, significant left ventricular （LV） systolic dysfimction and symptomatic heart failure （HF） is commonly found in patient population with pacemaker implantations.

Unmodified autologous stem cells at point of care for chronic myocardial infarction

BACKGROUND Numerous studies investigated cell-based therapies for myocardial infarction(MI).The conflicting results of these studies have established the need for developing innovative approaches for applying cell-based therapy for MI.Experimental studies on animal models demonstrated the potential of fresh,uncultured,unmodified,autologous adipose-derived regenerative cells(UAADRCs)for treating acute MI.In contrast,studies on the treatment of chronic MI(CMI;>4 wk post-MI)with UA-ADRCs have not been published so far.Among several methods for delivering cells to the myocardium,retrograde delivery into a temporarily blocked coronary vein has recently been demonstrated as an effective option.AIM To test the hypothesis that in experimentally-induced chronic myocardial infarction(CMI;>4 wk post-MI)in pigs,retrograde delivery of fresh,uncultured,unmodified,autologous adipose-derived regenerative cells(UA-ADRCs)into a temporarily blocked coronary vein improves cardiac function and structure.METHODS The left anterior descending(LAD)coronary artery of pigs was blocked for 180 min at time point T0.Then,either 18×106 UA-ADRCs prepared at“point of care”or saline as control were retrogradely delivered via an over-the-wire balloon catheter placed in the temporarily blocked LAD vein 4 wk after T0(T1).Effects of cells or saline were assessed by cardiac magnetic resonance(CMR)imaging,late gadolinium enhancement CMR imaging,and post mortem histologic analysis 10 wk after T0(T2).RESULTS Unlike the delivery of saline,delivery of UA-ADRCs demonstrated statistically significant improvements in cardiac function and structure at T2 compared to T1(all values given as mean±SE):Increased mean LVEF(UA-ADRCs group:34.3%±2.9%at T1 vs 40.4±2.6%at T2,P=0.037;saline group:37.8%±2.6%at T1 vs 36.2%±2.4%at T2,P>0.999),increased mean cardiac output(UA-ADRCs group:2.7±0.2 L/min at T1 vs 3.8±0.2 L/min at T2,P=0.002;saline group:3.4±0.3 L/min at T1 vs 3.6±0.3 L/min at T2,P=0.798),increased mean mass of the left ventricle(UA-ADRCs group:55.3±5.0 g at T1 vs 71.3±4.5 g at T2,P<0.001;saline group:63.2±3.4 g at T1 vs 68.4±4.0 g at T2,P=0.321)and reduced mean relative amount of scar volume of the left ventricular wall(UA-ADRCs group:20.9%±2.3%at T1 vs 16.6%±1.2%at T2,P=0.042;saline group:17.6%±1.4%at T1 vs 22.7%±1.8%at T2,P=0.022).CONCLUSION Retrograde cell delivery of UA-ADRCs in a porcine model for the study of CMI significantly improved myocardial function,increased myocardial mass and reduced the formation of scar tissue.

Exercise Training Post Cardiac Resynchronization Therapy Improves Exercise Tolerance and Quality of Life

Background: Cardiac resynchronization therapy (CRT) results in improved morbidity, mortality, symptoms, quality of life (QOL) and exercise capacity, in appropriate chronic heart failure (CHF) patients. Moreover, combined exercise training (ET) and CRT maximize these improvements in these patients. The study evaluated the effect of ET on these patients in terms of QOL, functional class, exercise capacity and left ventricular ejection fraction (LVEF). Results: There were significant improvements in the QOL, functional class, exercise capacity, and LVEF compared with the Control Group. Comparison of both groups confirmed the cumulative effects of ET with CRT. The QOL improved by the end of training in the exercise group (p = 0.001), compared to the Control Group (p = 0.850). NYHA functional class improved significantly in the Exercise Group (p = 0.013). Percent-predicted peak oxygen consumption (VO2 peak) had significantly improved in the trained (p < 0.001) versus the untrained CRT Group (p= 0.596). There was a mean percent rise of the ejection fraction from 39.2 ± 12.86 to 44.40% ± 14.42% in the Exercise Group compared to a non-significant change in the Control Group. Conclusion: ET in resynchronized CHF patients is feasible and further enhances QOL and exercise tolerance in addition to the improvements seen after CRT. The study therefore recommends for the prescription of ET after implantation in order to maximize the expected benefit.

有氧八段锦联合踏车运动训练对慢性阻塞性肺疾病合并慢性心力衰竭的干预效果

目的:观察有氧八段锦联合踏车运动训练对慢性阻塞性肺疾病(COPD)合并慢性心力衰竭(CHF)的干预效果。方法:纳入2019年1月至2021年6月间绵阳市中心医院收治的COPD合并CHF患者180例,根据随机数字表法均分为对照组(基础治疗及干预)和试验组(在对照组基础上给予有氧八段锦联合踏车运动训练),两组均干预12周。比较两组干预前、4周、8周和12周后的慢阻肺评估测试量表(CAT)评分、左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)和左心室舒张末期容积(LVEDV)、改良呼吸困难指数(mMRC)和明尼苏达心力衰竭生活质量问卷(MLHFQ)评分。结果:干预12周期间,两组CAT评分、LVESV、LVEDV、mMRC及MLHFQ评分呈逐渐降低趋势,LVEF呈逐渐升高趋势(P<0.05或<0.01)。与对照组相比,干预12周后试验组CAT评分[(17.47±3.96)分比(13.36±3.42)分]、LVEDV[(139.44±7.12)ml比(131.74±6.47)ml]、LVESV[(81.84±8.54)ml比(74.29±9.18)ml]、mMRC评分[(1.67±0.47)分比(1.42±0.50)分]和MLHFQ各维度分及总分[(40.07±6.86)分比(32.54±6.61)分]均显著降低,LVEF[(41.29±4.76)%比(44.56±4.42)%]显著升高,P均<0.001。结论:在基础治疗上增加有氧八段锦联合踏车运动训练,可显著改善COPD合并CHF患者的心肺功能,缓解呼吸困难并提高生活质量,值得推广。

益气活血法对慢性心力衰竭大鼠心肌能量代谢及炎性因子的影响

目的:基于益气活血法探讨全真一气汤合补阳还五汤对慢性心力衰竭(CHF)大鼠心肌能量代谢及炎性因子的影响。方法:将30只健康雄性SD大鼠随机分为对照组、模型组和中药组,每组10只。采用腹腔注射阿霉素制备CHF模型,中药组给予全真一气汤合补阳还五汤干预。采用酶联免疫吸附法(ELISA)检测三磷酸腺苷(ATP)、二磷酸腺苷(ADP)、一磷酸腺苷(AMP)、白细胞介素6(IL-6)、N末端脑钠肽前体(NT-proBNP)水平;采用逆转录定量聚合酶链式反应(qRT-PCR)检测miR-21水平。结果:与对照组比较,模型组ATP、ADP、AMP降低(P<0.05),IL-6、NT-proBNP、miR-21表达均升高(P<0.05);与模型组比较,中药组ATP、ADP、AMP均升高(P<0.05),IL-6、NT-proBNP、miR-21表达均降低(P<0.05)。结论:益气活血法治疗可提高CHF大鼠心肌能量供应,减轻炎症反应,改善心功能。

MTWA技术联合血清miR-130a对心脏再同步化治疗后CHF患者室性心律失常的预测价值

目的探讨微伏级T波电交替(MTWA)技术联合血清微小RNA-130a(miR-130a)对心脏再同步化治疗(CRT)后慢性心力衰竭(CHF)患者室性心律失常的预测价值。方法前瞻性选取2021年3月至2022年1月郑州大学第一附属医院收治的130例经CRT治疗的CHF患者,均于CRT前、CRT 6个月后进行MTWA检查和血清miR-130a检测。所有患者均随访12个月,失访7例,根据随访期间是否发生室性心律失常分为发生组26例和未发生组97例,比较两组患者CRT前和CRT 6个月后的MTWA参数、血清miR-130a水平;采用Spearman相关系数法分析MTWA参数、血清miR-130a与CHF患者室性心律失常的相关性;采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析MTWA、血清miR-130a预测CHF患者室性心律失常的价值。结果CRT前、CRT 6个月后发生组V1导联MTWA_(max)、V1导联8:00 am MTWA、V5导联MTWA_(max)、V5导联8:00 am MTWA、miR-130a均高于未发生组,差异均有统计学意义(P<0.05);Spearman相关系数法分析结果显示,CRT前、CRT 6个月后V1导联MTWA_(max)、V1导联8:00 am MTWA、V5导联MTWA_(max)、V5导联8:00 am MTWA及miR-130a均与CHF患者室性心律失常发生呈正相关(P<0.05);ROC曲线分析结果显示,CRT前、CRT 6个月后V1导联MTWA_(max)、V1导联8:00 am MTWA、V5导联MTWA_(max)、V5导联8:00 am MTWA及血清miR-130a联合预测的AUC分别为0.912、0.933(P<0.05)。结论MTWA参数、血清miR-130a与CHF患者室性心律失常存在一定线性关系,CRT治疗前后MTWA参数和血清miR-130a联合预测CHF患者发生室性心律失常具有一定的价值。

个性化的容量管理联合运动疗法对慢性心力衰竭病人预后的影响

目的:探讨个性化的容量管理联合运动疗法对慢性心力衰竭(CHF)病人预后的影响。方法:选择医院2020年5月—2023年2月收治的80例慢性心力衰竭病人作为研究对象,使用随机数字表法将其分为研究组与对照组,每组40例,对照组采取CHF常规治疗方案以及临床管理干预,研究组在其基础上采取个性化的容量管理联合运动疗法干预,两组均干预2个月,比较两组干预前后心功能指标、心功能级别、6 min步行距离、生活质量,随访至出院后12周,比较两组随访期间再入院和病死率情况。结果:干预后两组左心室射血分数(LVEF)均明显升高(P<0.05),LVEDD和NT-proBNP均明显降低(P<0.05),研究组各指标变化均较对照组更加明显(P<0.05);干预后两组心功能级别均明显降低,6 min步行距离均明显升高(P<0.05),研究组变化较对照组更加明显(P<0.05);干预后研究组MLHFQ评分明显降低(P<0.05),且低于对照组(P<0.05);研究组再入院率明显低于对照组(P<0.05),两组病死率无显著差异(P>0.05)。结论:个性化的容量管理联合运动疗法能显著改善了慢性心力衰竭病人的心功能、预后和生活质量。

浅析益气温阳 活血利水法治疗慢性心力衰竭

慢性心力衰竭是多种心脏疾病的并发症,亦是临床常见危重疾病,其发病率高,严重危害人体健康。中医药在治疗慢性心力衰竭疾病方面具有独特优势,中医学认为慢性心力衰竭病位在心,以心气(阳)虚为本,血瘀水停为标,属本虚标实之证,临床上运用益气温阳、活血利水法治疗慢性心力衰竭患者收效良好,可减轻临床症状、改善心功能,抑制心脏重构,提高生活质量。

基于双心理论的强心康颗粒+耳穴贴压联合西药治疗慢性心衰合并中重度焦虑临床观察

目的观察强心康颗粒+耳穴贴压联合氟哌噻吨美利曲辛片对慢性心力衰竭(以下简称“心衰”)合并中重度焦虑的疗效。方法纳入合并中重度焦虑[广泛性焦虑量表(GAD-7)测评≥10分]的慢性心衰患者72例,纽约心脏病协会(NYHA)心功能分级Ⅱ~Ⅲ级,分为观察组与对照组,各36例;两组均给予血管紧张素转化酶抑制剂(ACEI)、β受体阻滞剂等心衰基础治疗,观察组给予强心康颗粒+耳穴贴压联合氟哌噻吨美利曲辛片,对照组给予强心康颗粒。观察两组的心功能分级、6 min步行试验、N末端B型脑钠肽原(NT-proBNP)、中医证候评分、GAD-7评分。结果治疗后,两组患者的心功能分级疗效、6 min步行试验、NT-proBNP、中医证候评分、GAD-7评分等指标均较治疗前明显改善,且观察组优于对照组(P<0.05)。结论强心康颗粒+耳穴贴压联合氟哌噻吨美利曲辛片可明显提高慢性心衰合并中重度焦虑患者的临床疗效。

严氏苍山太阳炷燎穴位敷贴治疗阳虚血瘀型慢性心力衰竭的临床研究

目的观察严氏苍山太阳炷燎穴位敷贴治疗阳虚血瘀型慢性心力衰竭的临床疗效。方法将145例阳虚血瘀型慢性心力衰竭患者随机分为对照组73例、治疗组72例,两组均给予标准化西药治疗,对照组加用空白自发热贴膏,治疗组加用“严氏苍山太阳炷燎穴位敷贴”药物自发热贴膏,两组疗程均为90 d。观察临床疗效,比较中医证候积分、中医主次症与兼症分层、明尼苏达心力衰竭生活质量量表(MLHFQ)评分、纽约心脏病协会(NYHA)心功能分级、6 min步行试验(6MWT)距离以及B型钠尿肽(BNP)水平等指标的变化情况。结果①试验过程中,对照组脱落8例、治疗组脱落7例,最终完成试验者130例,其中治疗组65例、对照组65例。②治疗前后组内比较,两组中医证候积分均降低(P<0.05);组间治疗后比较,治疗组积分下降更为明显(P<0.05)。③治疗后,治疗组中医主次症与兼症分层得到改善(P<0.05),且治疗组的改善情况优于对照组(P<0.05)。④治疗前后组内比较,两组MLHFQ评分均降低(P<0.05);组间治疗后比较,治疗组MLHFQ评分较对照组显著降低(P<0.05)。⑤治疗后,两组NYHA心功能分级均得到改善(P<0.05),且治疗组的改善情况优于对照组(P<0.05)。⑥治疗前后组内比较,两组6MWT距离均较治疗前增加(P<0.05);组间治疗后比较,治疗组6MWT距离增加较对照组更明显(P<0.05)。⑦治疗前后组内比较,两组BNP水平均降低(P<0.05);组间治疗后比较,治疗组BNP水平显著低于对照组(P<0.05)。⑧两组各项安全性指标均未见明显异常。结论严氏苍山太阳炷燎穴位敷贴对阳虚血瘀型慢性心力衰竭患者临床症状与BNP的改善、运动耐量的提升及生活质量的提高都具有积极促进作用,且安全性好。

益气活血法治疗慢性心力衰竭的数据挖掘与临床疗效

目的:通过数据挖掘,探索益气活血法治疗慢性心力衰竭(CHF)的用药规律和“药物-指标”关联关系,并回顾分析益气活血法的临床疗效。方法:选取2021年9月至2023年8月在安徽中医药大学第一附属医院心内科治疗CHF的患者病例资料,根据是否使用中药大于7 d,分为中药组和对照组,录入中药处方、检验和检查数据,使用聚类分析、关联分析、网络可视化等探索用药规律和“药物-指标”关联关系,运用倾向评分法、Kaplan-Meier法回顾中药治疗CHF的疗效。结果:共采集956例CHF患者的资料,其中785例中药组,对照组171例。对785首处方中出现频率前15名的药物进行聚类分析,发现治疗CHF的2组常用中药。第一组中药功在益气温阳,活血利水。第二组中药侧重于益气健脾,淡渗利湿。关联分析得到高频中药组合6对,进一步将“药物-疗效”进行关联分析发现,中药配伍与CHF相关指标的改善有较强的相关性。进行1∶1倾向性匹配,匹配出155对病例样本,统计结果显示,与西药常规治疗比较,使用中药明显降低肌酸激酶、B型脑钠肽、低密度脂蛋白胆固醇、C反应性蛋白、空腹血糖、收缩压和舒张压,显著升高高密度脂蛋白胆固醇水平、左室射血分数、24 h尿量。结论:中药益气活血法可提高CHF患者心功能,改善临床症状,提高生命质量。

补肾启枢强心颗粒治疗慢性心力衰竭临床观察

目的观察补肾启枢强心颗粒对慢性心力衰竭的临床疗效。方法选取120例江西中医药大学附属医院心血管科2019年1月—2020年12月收治的住院患者,采用随机数字表分为治疗组和对照组,各60例,对照组常规西药治疗,治疗组在常规西药治疗基础上加用补肾启枢强心颗粒,疗程8周。观察比较2组患者中医证候积分、左室射血分数、左室舒张末期内径、左室收缩末期内径、心功能分级变化、脑钠肽水平、6 min步行距离、明尼苏达生活质量量表调查积分等的改善情况。结果治疗组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论补肾启枢强心颗粒治疗慢性心力衰竭临床效果显著,值得推广应用。

中医药益气温阳、活血利水法治疗慢性心力衰竭作用机制的研究进展

综述中医药益气温阳、活血利水法治疗慢性心力衰竭作用机制的研究进展。慢性心力衰竭可依据阳气虚弱、心血瘀阻、水饮内停的病机,采用中医药益气温阳、活血利水法治疗。研究显示,该法治疗慢性心力衰竭的临床疗效显著,其机制主要与改善心肌纤维化及心室重构、调节氧化应激反应、改善血流动力学障碍与心肌能量代谢、干预相关信号通路、缓解利尿剂抵抗等有关。

益气温阳活血利水方治疗慢性心力衰竭阳气亏虚、血瘀兼痰饮证的疗效及对心室重构和肾素-血管紧张素-醛固酮系统的影响

目的观察益气温阳活血利水方治疗慢性心力衰竭(CHF)阳气亏虚、血瘀兼痰饮证的疗效及对心室重构(VR)和肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法将60例CHF阳气亏虚、血瘀兼痰饮证患者按照随机数字表法分为2组,对照组30例予常规西药治疗,治疗组30例在对照组治疗基础上应用益气温阳活血利水方治疗,2组均治疗4周。比较2组疗效;比较2组治疗前后中医证候评分、VR参数、心力衰竭标志物水平、RAAS相关指标变化;观察2组不良反应发生情况。结果治疗组总有效率93.33%(28/30),对照组总有效率73.33%(22/30),治疗组疗效优于对照组(P<0.05)。2组治疗后主症、次症评分及总评分均较本组治疗前降低(P<0.05),治疗后治疗组主症、次症评分及总评分均低于对照组(P<0.05)。2组治疗后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、室间隔厚度(IVSd)、左心室质量指数(LVMI)均较本组治疗前降低(P<0.05),右心室内径(RVD)、左心室射血分数(LVEF)均较本组治疗前升高(P<0.05);治疗后治疗组LVEDD、LVESD、IVSd、LVMI均低于对照组(P<0.05),RVD、LVEF均高于对照组(P<0.05)。2组治疗后心肌钙蛋白I(cTnI)、N末端脑利钠肽前体(NT-proBNP)水平均较本组治疗前降低(P<0.05),治疗后治疗组cTnI、NT-proBNP水平均低于对照组(P<0.05)。2组治疗后肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)水平均较本组治疗前降低(P<0.05),治疗后治疗组PRA、AngⅡ、ALD水平均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论益气温阳活血利水方治疗CHF阳气亏虚、血瘀兼痰饮证,能抑制RAAS过度激活,减轻心肌损伤,改善VR,临床效果显著,安全性高。