TCM-HIN2Vec:A strategy for uncovering biological basis of heart qi deficiency pattern based on network embedding and transcriptomic experiment

Objective:To elucidate the biological basis of the heart qi deficiency(HQD)pattern,an in-depth understanding of which is essential for improving clinical herbal therapy.Methods: We predicted and characterized HQD pattern genes using the new strategy,TCM-HIN2Vec,which involves heterogeneous network embedding and transcriptomic experiments.First,a heterogeneous network of traditional Chinese medicine(TCM)patterns was constructed using public databases.Next,we predicted HQD pattern genes using a heterogeneous network-embedding algorithm.We then analyzed the functional characteristics of HQD pattern genes using gene enrichment analysis and examined gene expression levels using RNA-seq.Finally,we identified TCM herbs that demonstrated enriched interactions with HQD pattern genes via herbal enrichment analysis.Results: Our TCM-HIN2Vec strategy revealed that candidate genes associated with HQD pattern were significantly enriched in energy metabolism,signal transduction pathways,and immune processes.Moreover,we found that these candidate genes were significantly differentially expressed in the transcriptional profile of mice model with heart failure with a qi deficiency pattern.Furthermore,herbal enrichment analysis identified TCM herbs that demonstrated enriched interactions with the top 10 candidate genes and could potentially serve as drug candidates for treating HQD.Conclusion: Our results suggested that TCM-HIN2Vec is capable of not only accurately identifying HQD pattern genes,but also deciphering the basis of HQD pattern.Furthermore our finding indicated that TCM-HIN2Vec may be further expanded to develop other patterns,leading to a new approach aimed at elucidating general TCM patterns and developing precision medicine.

Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Observation on the Nursing Effect of Ginger Moxibustion on Gastrointestinal Symptoms in Patients with Heart Failure Due to Yang Qi Deficiency

Objective:To evaluate the nursing measures and effects of ginger moxibustion in the treatment of heart failure(yang qi deficiency type)with gastrointestinal symptoms.Methods:86 patients with heart failure(yang qi deficiency type)accompanied by gastrointestinal symptoms who were admitted to the hospital between January 2023 and January 2024 were selected and divided into 43 cases in each group by random number table grouping;Group I implemented integrated care,while Group II adopted conventional care.The indicators of care were compared between the two groups.Results:After the nursing care,the digestive symptom scores of Group I were lower than those of Group I,and the psychological scores were lower than those of Group II(P<0.05).Conclusion:Ginger moxibustion can improve gastrointestinal symptoms and enhance the psychological health of patients with heart failure(yang qi deficiency type)with gastrointestinal symptoms.

Serum proteomic approach in patients with Qi deficiency and blood stasis syndrome in coronary heart disease:to explore therapeutic mechanism of Yiqi Huoxue decoction

OBJECTIVE To explore the curative effect and mechanism of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.METHODS The patients with coronary heart disease of Qi deficiency and blood stasis syndrome were treated with Yiqi Huoxue decoction for 3 months,and the changes of cardiac function were observed.61 serum samples(including 29 cases of disease group and 32 cases of Yiqi Huoxue expression group)were analyzed by non labeled proteomics.The disease group was used as the control group,and the protein with expression level difference of more than 1.2 folds(P<0.05)was screened.The molecular function,biological pathway and protein interaction of the different proteins were analyzed by bioinformatics,so as to identify the molecular and biological pathway of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.RESULTS Clinical treatment found that Yiqi Huoxue decoction can improve TCM syndrome score and left ventricular ejection fraction,regulate blood glucose and blood lipid levels,prolong thrombin time,and improve heart function.The results of proteomic quantitative analysis showed that there were 69 proteins with different expression levels in the disease group.Bioinformatics analysis results showed that Yiqi Huoxue decoction may regulate ApoA1,alpha-2 and other proteins to act on HDL assembly,platelet degradation,PI3K Akt signaling pathway,and then play a therapeutic role in coronary heart disease with Qi deficiency and blood stasis syndrome.CONCLUSION Yiqi Huoxue decoction can effectively improved the heart function decline caused by Qi deficiency and blood stasis syndrome of coronary heart disease.It mainly act on energy metabolism and platelet activation pathway by activating HDL assembly and platelet degradation signal pathway proteins.This study can provide reference for the follow-up treatment mechanism of Qi deficiency and blood stasis syndrome of coronary heart disease.

Study on the relationship between syndrome characteristics degree and inflammatory factor and negative emotional scale in"double heart disease"patients with Qi stagnation blood stasis and heart gallbladder heat stagnation

Objective:To Discuss the correlation between Hypersensitivity C-reactive Protein(Hs-CRP),Total Cholesterol(TC),Triglyceride(TG),negative emotion scale and TCM syndrome scores in“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation.Method:Fifty-two patients in Western Medicine Diagnosis of Double Heart Disease,in TCM syndrome identified as Qi stagnation blood stasis Heart gallbladder heat stagnation syndrome,detects it Hs-CRP,TC,TG levels by ELISA,use TCM Syndromes Scale to evaluate TCM Syndrome,use the Pittsburgh Sleep Quality Index(PSQI)and Self-rating symptom scale(SCL-90)to assess anxiety and sleep levels,analyze the correlation between TCM syndrome scores and Hs-CRP,TC,TG level,PSQI index,SCL-90 index.Result:There was a significant positive correlation between Hs-CRP,TG level and TCM Syndrome scores(P<0.05);TC level was postively correlated with TCM Syndrome scores,but there was no statistical significance(P>0.05);There was a significant positive correlation between PSQI index,SCL-90 index and TCM Syndrome scores(P<0.05).Conclusion:In“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation,there have characteristic syndrome changes in terms of inflammatory factor level,blood lipid level and negative emotion score;Which the above indexes can reflect the severity of TCM syndromes to a certain extent and provide the basis for the effective intervention treatment of TCM.

益气活血方调控METTL3/HAND2/TGF-β1信号轴对冠心病气虚血瘀证大鼠的影响

目的观察益气活血方调控METTL3/HAND2/TGF-β1信号轴对冠心病气虚血瘀证大鼠的影响。方法将48只雄性SD大鼠随机分为假手术组、模型组、益气活血方组和西药(单硝酸异山梨酯)组,每组12只。除假手术组外,其余各组采用左冠状动脉前降支结扎结合游泳力竭法制备冠心病气虚血瘀证大鼠模型。造模结束后,益气活血方组及西药组灌胃干预28d。观察大鼠一般状况,采集心电图,超声心动图检测大鼠心功能,血液流变学检测血瘀程度,HE染色观察心肌组织形态,免疫组化法检测心肌组织甲基化转移酶3(METTL3)、转化生长因子(TGF)-β1、Smad2、Smad3表达,RT-PCR和Western blot检测心肌组织METTL3、心脏神经嵴衍生物表达蛋白2(HAND2)、TGF-β1、Smad2、Smad3mRNA和蛋白表达。结果与假手术组比较,模型组大鼠出现精神萎靡、行动迟缓、嗜睡、体质量降低等气虚表现,心电图ST段显著抬高,左室射血分数(LVEF)、左室短轴缩短率(LVFS)下降(P<0.01),左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVEDs)升高(P<0.01),红细胞聚集指数、卡松黏度及全血黏度升高(P<0.01);心肌细胞肿大、坏死,心肌纤维排列紊乱,心肌组织有炎性细胞浸润,心肌组织METTL3、TGF-β1、Smad2、Smad3mRNA和蛋白表达均升高(P<0.05,P<0.01),HAND2 mRNA和蛋白表达均降低(P<0.01)。与模型组比较,益气活血方组和西药组大鼠精神状态明显改善,心电图ST段明显回落,LVEF、LVFS升高(P<0.01),LVEDV、LVESV、LVEDd、LVEDs下降(P<0.05,P<0.01),红细胞聚集指数、卡松黏度及全血黏度下降(P<0.01);心肌纤维排列整齐,心肌细胞结构及形态改善,炎性细胞浸润减少,心肌组织METTL3、TGF-β1、Smad2、Smad3 mRNA和蛋白表达降低(P<0.05,P<0.01),HAND2mRNA和蛋白表达升高(P<0.05,P<0.01)。结论益气活血方能减轻冠心病气虚血瘀证大鼠心肌组织病理损伤,提高心功能,抑制炎症反应,其作用机制可能与调控METTL3/HAND2/TGF-β1信号轴有关。

Effect of Shenqiyixin prescription on myocardial energy metabolism in patients with chronic heart failure

Objective:To observe the heart function、MEE and serum FFA of Shenqiyixin prescription for heart qi(yang)deficiency with blood stasis and fluid retention type of chronic heart failure patients,to evaluate the clinical efficacy and safety.Methods:64 cases with chronic heart failure of heart qi(yang)deficiency with blood stasis and fluid retention were randomly divided into two groups,3 cases were excluded,31 cases in the control group and 30 cases in the treatment group.The control group was treated with western medicine,and the treatment group was treated with Shenqiyixin prescription additionally.The course of treatment was 3 weeks.Observe the changes of TCM syndrome score,6MWD,LVEF,cESS,MEE,serum NTproBNP,serum FFA and safety indexes of each group before and after treatment.Results:after treatment,the TCM Syndromes of each group were improved.The total effective rate of the treatment group was 93.33%,and the control group was 83.87%.The treatment group was more effective(P<0.05).After treatment,the TCM syndrome score,cESS,MEE,NTproBNP and FFA of each group were decreased,6MWD and LVEF were increased(P<0.05),and the treatment group was superior to the control group(P<0.05).Conclusion:Shenqiyixin prescription can improve the TCM syndrome and heart function in patients with chronic heart failure of heart qi(yang)deficiency with blood stasis and fluid retention,at the same time,it can reduce the level of MEE and serum FFA in patients with heart failure.

Efficacy of Zhenjingdingzhi decoction in treating insomnia with Qi-deficiency of heart and gallbladder:a randomized,double-blind,controlled trial

OBJECTIVE: To evaluate the clinical efficacy of Zhenjingdingzhi decoction in treating insomnia with Qi-deficiency of heart and gallbladder.METHODS: We conducted a double-blind,randomized,controlled trial involving 100 patients with insomnia of Qi-deficiency of heart and gallbladder.Patients were randomly divided into the treatment group(n = 50) and the control group(n = 50) according to a random number table. The treatment group was given Zhenjingdingzhi decoction,while the control group was treated with Suanzaoren decoction. the pharmacological treatment lasted for 8weeks. The clinical efficacy was assessed by using Spiegel scale,Pittsburgh sleep quality index(PSQI)and Traditional Chinese Medicine(TCM) syndrome scores.RESULTS: Comparing Spiegel scores between the two groups at 4 and 8 weeks,the differences in curative effect between the two groups were both significant(both P < 0.05). The total effective rate was46% in the treatment group and 27.7% in the control group at 4 weeks,and 80% and 53.2% at 8weeks,respectively; After 8 weeks,PSQI scores showed that the total effective rates differed significantly between the two groups(P < 0.01): 84% in the treatment group and 59.6% in the control group; In improving sleep quality and sleep duration,the curative effect of the treatment group was better than that of the control group(P < 0.05).TCM syndrome,especially insomnia and palpitation,was improved better in the treatment group after 8 weeks as compared to that in the control group(P < 0.05). The total effective rate of the two groups was 84% and 66%,respectively.CONCLUSION: Zhenjingdingzhi decoction is effective and safe for the treatment of insomnia with Qi-deficiency of heart and gallbladder,especially for improving sleep quality and sleep duration.

Advances in Research on Treatment of Heart Failure with Yangxinshi Tablet

The advances in the treatment of heart failure with Yangxinshi tablet are reviewed in this paper.Yangxinshi tablet has effects of nourishing myocardia,improving myocardial metabolism,reducing myocardial oxygen consumption,dilating coronary artery,improving cardiac blood supply,reducing blood viscosity and improving microcirculation,and it can improve the functions of heart and curative effect of heart failure.

Evaluation of Chinese medicine on heart failure based on NMR metabolomics

Objective:To evaluate the efficacy of traditional Chinese herbs on heart failure(HF)using nuclear magnetic resonance(NMR)metabolomics.Methods:Plasma metabolomics was conducted on both patients with HF and healthy controls.The partial least squares model was applied to determine potential metabolic markers and related metabolic pathways of the disease.HF patients with the traditional Chinese syndrome pattern of qi deficiency and blood stasis were divided into two groups,and treated,respectively,with conventional medicine and a combination of conventional and Chinese herbs,aimed at tonifying qi and activating blood.Healthy participants served as a control group for comparison.Results and conclusion:Both conventional and herbal treatments appear to regulate disorders of amino acid and glucose metabolism.Combined treatment appears to be more comprehensive,indicating that herbal and conventional medicines exert their effects through different mechanisms in treating HF.It can be further inferred that herbs that tonify qi and activate blood may regulate different essential metabolites.

Metabonomic phenotype and identification of “heart blood stasis obstruction pattern” and “qi and yin deficiency pattern” of myocardial ischemia rat models

The traditional Chinese medicine concepts of "Xinxueyuzuzheng (heart blood stasis obstruction pattern)" and "Qiyinliangxuzheng (qi and yin deficiency pattern)" for myocardial ischemia rat models were constructed in the present study. Endogenous metabolites in rat plasma were analyzed using the GC/TOF-MS-based metabonomic method. Significant metabolic differences were observed between the control and two model groups, and the three groups were distinguished clearly by pattern recognition. Compared with those of the control, the levels of hydroxyproline, threonic acid, glutamine and citric acid were strikingly up or down-regulated in model rats. The metabolites contributing most to the classification between the two "pattern" rats were identified, such as valine, serine, threonine, ornithine, hydroxyproline, lysine, 2-hydroxybutanoic acid, 3-hydroxybutanoic acid, galactofuranose and inositol. These compounds were indicated as the potential biomarkers. The results suggested that the two "patterns" are involved in dysfunction in oxidative stress, energy metabolism and amino acid metabolism. These findings also provided the substantial foundation for exploring the scientific connotation of these two "Zhengxing (pattern types)" of myocardial ischemia, and "Bianzheng (pattern identification)".

中医证候动物模型建立及评价方法研究

中医证候动物模型是揭示中医基础理论、促进中医药临床发展的重要载体,更是促进中医药现代化与国际化不可或缺的重要工具。目前,中医证候动物模型建立方法多样,评价标准不一。基于五脏的主要生理功能,以临床常见的心气虚证、肝郁证、脾气虚证、肺气虚证、肾阳虚证为代表,总结分析近年来最常用的中医证候动物模型的构建及评价方法,为建立更为科学客观的中医证候动物模型构建方法及评价体系提供参考。

利用磁珠法结合MALDI-TOF MS进行慢性心衰气阴虚证血液蛋白质组学研究的方法学探讨

目的:建立磁珠法结合MALDI-TOF MS进行慢性心衰气阴虚证血液蛋白质组学研究的实验方法。方法:采用MALDI-TOF-MS技术检测不同磁珠分离的患者血液蛋白质谱,从采集、蛋白提取、反复冻融、重复性、基质样品比例等方面分析其影响。结果:血清质谱峰均多于血浆,弱阳离子磁珠出峰数量优于铜螯合磁珠,气阴虚证患者与健康组比较蛋白表达有明显差异。结论:该方法作为一种高通量、快速分离、制备和鉴定的蛋白质组学技术,整个实验体系稳定、可靠、重复性好,适用于中医证候蛋白质组学的研究。

中医治疗慢性心衰研究进展

慢性心力衰竭是在原有心脏病基础上,出现的心脏泵血能力下降,心输出量不足难以满足机体代谢需要,主要以胸闷、气短、肢体水肿为临床症状的慢性疾病。中医认为慢性心力衰竭基本病机为本虚标实,以心气心阳虚为主对本脏产生影响甚至影响其他脏腑,进而加重心衰症状。中医运用整体观在慢性心衰的临床治疗中取得很好的疗效,成为现阶段治疗慢性心衰不可或缺的力量。文章根据经典阐述了中医对慢性心衰的病因病机以及治疗的原则和方法,并对近些年中医治疗慢性心衰的方法进行简要综述,确定以扶心阳为主,兼顾祛邪的治疗思想,重视精、气、血以及整体气机的调理,最终从根本上治疗和预防慢性心衰的发生。

基于肠道菌-神经递质-脑轴探讨补益心脾法对产后抑郁心脾两虚证患者情绪的改善作用

【目的】观察基于肠道菌-神经递质-脑轴(简称脑肠轴)理论运用补益心脾法治疗产后抑郁心脾两虚证患者的临床疗效,探讨其对患者抑郁、焦虑情绪的改善作用。【方法】将2021年6月至2023年7月在中国人民解放军联勤保障部队第九〇八医院就诊的136例产后抑郁心脾两虚证患者按随机数字表法随机分为常规治疗组(对照组)和补益心脾组(观察组),每组各68例。对照组给予常规抗抑郁药物治疗,观察组在对照组的基础上联合补益心脾法(参芪解郁方)治疗,2组均连续治疗6周。观察2组患者治疗前后中医证候主症积分、汉密尔顿抑郁量表(HAMD)评分、广泛性焦虑自评量表(GAD-7)评分和血清神经递质5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)及肠道菌群代谢产物短链脂肪酸(SCFAs)、谷氨酸(GLU)、γ-氨基丁酸(GABA)水平的变化情况,并评价2组患者的临床疗效和用药安全性。【结果】(1)疗效方面,治疗6周后,观察组的总有效率为89.71%(61/68),对照组为73.53%(50/68),组间比较(χ^(2)检验),观察组的疗效明显优于对照组(P <0.05)。(2)中医证候积分方面,治疗后,2组患者的情志不畅、思维困顿、食欲减退、腹胀便溏等各项主症积分均较治疗前降低(P <0.05),且观察组的降低幅度均明显优于对照组(P <0.01)。(3)抑郁、焦虑情绪方面,治疗后,2组患者的HAMD评分和GAD-7评分均较治疗前降低(P <0.05),且观察组的降低幅度均明显优于对照组(P <0.01)。(4)神经递质方面,治疗后,2组患者的血清5-HT、DA、NE水平均较治疗前升高(P <0.05),且观察组的升高幅度均明显优于对照组(P <0.01)。(5)肠道菌群代谢产物方面,治疗后,2组患者的血清SCFAs、GLU、GABA水平均较治疗前提高(P <0.05),且观察组的提高幅度均明显优于对照组(P <0.01)。(6)安全性方面,观察组的不良反应发生率为8.82%(6/68),对照组为5.88%(4/68),组间比较,差异无统计学意义(P> 0.05)。【结论】基于脑肠轴理论使用补益心脾法治疗产后抑郁心脾两虚证患者疗效显著,可通过改善患者神经递质失衡及肠道菌群代谢来减轻抑郁、焦虑情绪,且具有较高的安全性。

曹守沛从脾胃论治冠心病经验

曹守沛教授认为,“脾虚内伤,痰浊、瘀血内生痹阻心脉”是冠状动脉粥样硬化性心脏病(简称冠心病)发生的常见病因,“心脾气虚,痰瘀阻络”为其常见病机。曹教授注重“心脾同治”,倡导从脾胃论治冠心病,以健脾益气、化痰通络为主要治疗原则,将“健脾益气通脉”的思想贯穿冠心病治疗的始终,自拟“调脾通络方”加减辨治冠心病。曹教授治疗过程中,药物用量均衡,标本兼顾,痰瘀并治,同时衷中参西,对“证”亦对“病”、对“症”,分别施以针对性用药,实现全面辨治,整体调护。气虚血瘀者,因其痰浊证素不显,兼有血虚之候,以自拟方合桃红四物汤加减治之;痰浊、血瘀并见者则以自拟方合枳实薤白桂枝汤或二陈汤加减,以痰瘀同治。

益气活血方联合耳穴压豆治疗对气虚血瘀证老年冠心病PCI术后康复的影响

目的:观察益气活血方联合耳穴压豆治疗气虚血瘀证老年冠心病经皮冠状动脉介入术(PCI)术后患者的临床疗效。方法:将98例2023年3—9月河南中医药大学第一附属医院诊治的气虚血瘀证老年冠心病PCI术后患者,按随机数字表法分为联合组、西医组各49例,西医组给予常规治疗,联合组在西医治疗基础上给予益气活血方联合耳穴压豆。治疗4周后,比较2组临床疗效、中医证候评分、心脏功能[左心室射血分数(LVEF)和每分钟心输出量]、运动耐力[6 min步行试验(6MWT)]和西雅图心绞痛(SAQ)量表评分。结果:联合组总有效率为93.88%(46/49),西医组为79.59%(39/49),2组比较,差异有统计学意义(P<0.05)。治疗后,2组各项中医证候评分均较治疗前降低(P<0.05),且联合组各项评分均低于西医组(P<0.05)。治疗后,2组LVEF、每分钟心输出量均较治疗前升高(P<0.05),且联合组LVEF、每分钟心输出量均高于西医组(P<0.05)。治疗后,2组6MWT距离较治疗前延长(P<0.05),且联合组长于西医组(P<0.05)。治疗后,2组躯体受限程度、疾病稳定状态、疾病发作情况、疾病认知程度、疗效满意度评分均较治疗前升高(P<0.05),且联合组SAQ量表各维度评分均高于西医组(P<0.05)。结论:益气活血方联合耳穴压豆治疗冠心病PCI术后气虚血瘀证疗效肯定,可明显改善患者中医证候,增强术后心脏功能及运动耐力,提高患者生活质量。

归脾汤加减联合常规西药治疗气虚血瘀型慢性心力衰竭的效果

目的:观察归脾汤加减联合常规西药治疗气虚血瘀型慢性心力衰竭的效果。方法:选取2023年1—10月菏泽市成武县大田集镇中心卫生院收治的60例气虚血瘀型慢性心力衰竭患者为研究对象,随机分为对照组和观察组,各30例。对照组采用常规西药治疗,观察组在对照组基础上联合归脾汤加减治疗。比较两组症状评分,心功能,C反应蛋白(CRP)、N末端脑钠肽前体(NT-proBNP)水平及不良反应发生情况。结果:治疗前,两组心悸、气短、下肢浮肿评分比较,无统计学差异(P>0.05);治疗后,两组心悸、气短、下肢浮肿评分降低,观察组低于对照组(P<0.05)。治疗前,两组左室舒张末期内径、左心室射血分数比较,无统计学差异(P>0.05);治疗后,两组左室舒张末期内径减小,左心室射血分数升高,观察组优于对照组(P<0.05)。治疗前,两组CRP、NT-proBNP水平比较,无统计学差异(P>0.05);治疗后,两组CRP、NT-proBNP水平降低,观察组低于对照组(P<0.05)。两组不良反应总发生率比较,无统计学差异(P>0.05)。结论:归脾汤加减联合常规西药治疗气虚血瘀型慢性心力衰竭的效果显著,可改善患者症状评分和心功能,降低CRP及NT-proBNP水平,且不会增加不良反应发生率。

真武汤治疗老年慢性心力衰竭临床研究

目的:比较真武汤治疗气虚血瘀型老年慢性心力衰竭和心肾阳虚型老年慢性心力衰竭的临床疗效。方法:根据中医辨证标准,选择53例气虚血瘀证患者为气虚血瘀组,55例心肾阳虚证患者为心肾阳虚组,两组患者均给予常规西医治疗及口服真武汤。比较两组患者的临床疗效及治疗前后中医证候积分、平均血压、心功能等级、6分钟步行试验(6 minute walk test,6MWT)、呼吸困难程度评分、心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)和左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)]变化情况。结果:治疗前心肾阳虚组中医证候积分高于气虚血瘀组(P<0.05),两组患者治疗后中医证候积分低于本组治疗前(P<0.05),但两组患者治疗后比较,差异无统计学意义(P>0.05);两组治疗前后平均血压比较,差异均无统计学意义(P>0.05)。气虚血瘀组有效率为75.5%,心肾阳虚组有效率为90.9%,两组患者有效率比较,差异具有统计学意义(P<0.05)。治疗前心肾阳虚组6MWT小于气虚血瘀组(P<0.05),治疗后两组6MWT大于本组治疗前,且心肾阳虚组差值大于气虚血瘀组(P<0.05);两组治疗后Brog评分低于本组治疗前(P<0.05),但组间比较,差异无统计学意义(P>0.05)。两组患者治疗前NYHA心功能等级比较,差异无统计学意义(P>0.05),两组患者治疗后心功能等级较治疗前有所改善(P<0.05),但组间比较,差异无统计学意义(P>0.05)。治疗前,心肾阳虚组LVEF低于气虚血瘀组(P<0.05);治疗后心肾阳虚组LVEF高于气虚血瘀组,LVESD及LVEDD低于气虚血瘀组,但差异无统计学意义(P>0.05)。结论:真武汤治疗气虚血瘀型老年慢性心力衰竭和心肾阳虚型老年慢性心力衰竭,均可改善患者的临床症状和心功能,但心肾阳虚证患者的临床疗效优于气虚血瘀证。

芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证的临床效果

目的:探讨芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证的临床效果。方法:选取2022年1月—2024年1月南京中医药大学附属苏州市中医医院收治的86例胸痹心痛气虚血瘀证患者作为研究对象,按随机数表法将患者分为对照组与观察组,各43例。对照组给予常规西医治疗,观察组在对照组基础上给予芪蛭三七汤治疗。比较两组临床疗效、中医症候评分、凝血指标、心功能及不良反应。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组胸闷、胸痛、心悸、气短、神倦乏力评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)长于治疗前,观察组长于对照组,两组纤维蛋白原(FIB)低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组左室射血分数(LVEF)高于治疗前,且观察组高于对照组,两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)短于治疗前,且观察组短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证患者可缓解症状,改善凝血功能,促进心功能改善,安全可靠。