Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

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.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

High Density Lipoprotein Phospholipids as a Marker of Coronary Heart Disease of Shen-Yang Deficiency Syndrome

Objective: To seek a new biochemical index for diagnosis of coronary heart disease (CHD) of shen-Yang deficiency syndrom (CHD-SYD). Methods: Sixty-one patients with CHD were divided into 3 groups according to their TCM Syndrome type, 10 patients in the group without Xin-Qi deficiency (Group A), 25 in the group with Xin-Qi deficiency but without Shen-Yang deficiency (Group B) and 26 in the group both with Xin-Qi deficiency and Shen-Yang deficiency (Group C). Levels of 17-hydroxy-corticoste-roid in urine (urinary 17-OHCS) per 24 hrs, and serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipid (HDL-PL) in them were determined in synchrostep and compared with those in the control group of 23 healthy aged persons, urinary 17-OHCS per 24 hrs was taken as the diagnostic standard to screen a new index for diagnosis of Shen-Yang deficiency Syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-SYD patients( Group C) was 616+157 mg/L, which was obviously lower than that in the patients of Group A and B. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-SYD, the sensitivity was 73%, the specificity 86% and the accuracy 80%. Conclusion: HDL-PL <650 mg/L could be adopted as an index for CHD-SYD diagnosis, which is simple and practical.

Clinical Research of Zhenwu Decoction Combined with Tingli Dazao Xiefei Decoction in the Treatment of Chronic Heart Failure with Edema Syndrome due to Yang Deficiency

[Objectives]The paper was to investigate the clinical effects of Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction in the treatment of chronic heart failure with edema syndrome due to yang deficiency.[Methods]Eighty patients with chronic heart failure were randomly divided into 2 groups(control group and treatment group),with 40 cases in each group.The patients in the control group were treated with conventional western medicine for 14 d,and the patients in the treatment group were treated with Zhenwu Decoction and Tingli Dazhao Xiefeng Decoction on the basis of the control group for 14 d.The curative effect of traditional Chinese medicine(TCM)syndrome score,left ventricular ejection fraction(LVEF),plasma N-terminal brain natruretic peptide precursor(NT-proBNP)and New York Heart Association(NYHA)functional class were compared between the two groups before and after treatment.Minnesota living with heart failure questionnaire in the principle of Chinese civilization and traditional medicine characteristics(C-MLHF)at admission and 1 month after discharge were compared between the two groups.[Results]After treatment,the total effective rate of TCM syndrome score in the treatment group was 82.50%,and that in the control group was 67.50%.The curative effect of TCM syndrome score in the treatment group was better than that in the control group(P<0.05).After treatment the LVEF in both groups was increased compared with that before treatment,and the NT-proBNP level was decreased compared with that before treatment(P<0.05),and those in the treatment group were better than those in the control group.The total effective rate of cardiac function in the treatment group was 87.50%,and that in the control group was 65.00%.The improvement of cardiac function in the treatment group was better than that in the control group(P<0.05).One month after discharge,C-MLHF scores in both groups were decreased compared with those before treatment,and that in the treatment group was lower than in the control group(P<0.05).[Conclusions]Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction based on traditional western medicine treatment could improve the clinical efficacy,symptoms and quality of life of patients in the treatment of chronic heart failure with edema syndrome due to yang deficiency.

Exploration of the Treatment of Hypothyroid Heart Disease by Dredging-Tonifying Method

Hypothyroid heart disease is a syndrome that has a deficiency origin and an excess superficiality. Deficiency in origin is typified by a deficiency of kidney yang primarily, and the fundamental objective of treatment should be "regulating and tonifying". An excess of superficiality is closely related to phlegm, dampness, blood stasis, etc. The most appropriate treatment is a combined method of dredging and tonifying, which should be the primary approach. It is crucial to adhere to the theoretical principles of both dredging and tonifying in the treatment plan. This approach allows for the treatment of both the underlying cause and the presenting symptoms, which can facilitate the harmonization of qi and blood.

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.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model

OBJECTIVE:To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.METHODS:The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone,and contents of the hormones of the pituita- ry-thyroid axis:thyroid stimulating hormone(TSH),3,3',5-triiodothyronine(T_3) and thyroxine(T_4);hormones of the pituitary-adrenal gland axis:adrenocorticotropic hormone(ACTH) and Cortisol(CORT);and hormones of the pituitary-gonadal axis:luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T),were determined in the early,middle,and advanced stages.Ten support vector regression(SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.RESULTS:The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Kong deficiency.The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage.Relative errors of the jackknife test of the SVR models all were less than 10%.CONCLUSION:Imbalances in mutual regulation among the hormones of the pituitary-target gland axes,especially loss of effectiveness of the pituitary-adrenal axis,is one pathogenesis of kidney-Yang deficiency.The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

Effect of Jiawei Shenfu decoction on tumor necrosis factor-alpha and nuclear factor-kappa B in patients who have chronic heart failure with syndromes of deficiency of heart Yang

OBJECTIVE:To examine the clinical efficacy of Jiawei Shenfu decoction on tumor necrosis factor-alpha (TNF-cα) and nuclear factor-kappa B (NF-KB) levels in patients who have chronic heart failure with syndromes of deficiency of heart Yang.METHODS:A total of 63 patients with syndromes of deficiency of heart Yang (chronic heart failure)were enrolled.Patients were randomly divided into the control group and Jiawei Shenfu group.All patients received standard medications for treatment of chronic heart failure.Patients in the Jiawei Shenfu group were additionally provided Jiawei Shenfu decoction one dose daily.Treatments continued for 4 consecutive weeks.The primary endpoint was the change in plasma B-type natriuretic peptide (BNP),NF-KB,and TNF-cα levels during 4 weeks of treatment.RESULTS:At the 4-week follow-up,a significant reduction in BNP levels compared with baseline was observed in both groups,but the Jiawei Shenfu decoction group showed a significantly greater reduction than did the control group.The Jiawei Shenfu group also showed superior performance regarding the Minnesota Living with Heart Failure Questionnaire score,the Chinese medicine syndrome score,heart rate,left ventricular ejection fraction,and 6-min walking distance compared with the control group.The degree of changes in NF-KB and TNF-α levels in the Jiawei Shenfu group was more significant than that in the control group.CONCLUSION:Routine medicine combined with Jiawei Shenfu decoction for patients with heart Yang deficiency syndrome in chronic heart failure can improve the left ventricular ejection fraction and cardiac function,and reduce BNP levels.The mechanism may be related to inhibition of pro-inflammatory cytokines and the NF-KB-induced kinase pathway,leading to amelioration of the inflammatory response.

The Effect of Hormones of the Hypothalamic-pituitary-target Gland Axes in a Kidney-Yang Deficiency Syndrome Model

Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.

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。

心衰Ⅰ号方治疗阳虚水泛证射血分数保留型心衰临床研究

目的:基于炎症因子白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)、高敏C反应蛋白(hs-CRP)、心衰标志物血清可溶性生长刺激表达基因2蛋白(sST2)、氨基末端脑钠肽前体(NT-proBNP)研究心衰I号方对射血分数保留型心衰(HFpEF)患者(阳虚水泛证)的临床疗效。方法:选择60例HFpEF心衰患者,均分为对照组和试验组各30例。对照组接受标准抗心衰治疗,试验组则在此基础上加用心衰Ⅰ号中药方剂。在治疗前及治疗14 d后,对两组患者中医症候进行评估,并监测sST2、NT-proBNP、IL-1β、IL-18及hs-CRP等指标变化。结果:治疗后两组患者的中医症候积分(单项及总分)和sST2水平均明显低于本组治疗前(P<0.05),且试验组较对照组均明显降低(P<0.05);治疗后两组患者IL-1β和hs-CRP水平较治疗前均明显降低,且试验组IL-1β水平较对照组降低显著(P<0.01),试验组hs-CRP水平也显著低于对照组,差异具有统计学意义(P<0.05);治疗后两组NT-proBNP和IL-18较治疗前下降(P<0.05),且试验组低于对照组。结论:心衰Ⅰ号方与标准抗心衰治疗联合应用,可以明显改善HFpEF患者的临床症候,改善心脏功能,其作用机制可能与抑制炎症反应相关。

芪苈扶正强心汤联合比索洛尔治疗阳虚水泛瘀血内阻型心力衰竭的临床疗效观察

目的:探索芪苈扶正强心汤联合比索洛尔治疗阳虚水泛、瘀血内阻型心力衰竭患者的临床疗效。方法:选择2022年11月—2023年11月安徽中医药大学附属太和中医院收治的80例阳虚水泛、瘀血内阻型心力衰竭患者,随机分为对照组和治疗组,每组40例。对照组给予一般治疗与常规抗心衰西药治疗,治疗组在对照组的基础上给予芪苈扶正强心汤,比较2组的临床疗效、中医证候积分、NT-proBNP、心脏超声各项指标及六分钟步行距离,疗程为28d。结果:治疗后,对照组临床总有效率明显低于治疗组(P<0.05);2组患者中医证候积分的总有效率中,对照组显著低于治疗组(P<0.05);2组患者各项心功能指标均优于治疗前,且治疗后治疗组较对照组指标明显改善(P<0.05);2组患者NT-proBNP水平较治疗前明显降低(P<0.05),且对照组高于治疗组(P<0.05);2组患者六分钟步行距离水平较治疗前均明显提高,且对照组测得距离明显低于治疗组(P<0.05)。结论:芪苈扶正强心汤联合比索洛尔治疗阳虚水泛、瘀血内阻型心力衰竭的临床疗效显著,可有效地改善其临床症状与心功能,并且提高患者的日后生活质量。

“新四联”药物联合真武汤治疗阳虚水泛型心力衰竭的临床效果观察

目的:探析“新四联”药物联合真武汤治疗阳虚水泛型心力衰竭的临床效果。方法:选取仁怀市中医院心病科2023年1月—2024年5月收治的60例阳虚水泛型心力衰竭患者为研究对象,随机分为对照组(行“新四联”药物治疗),观察组(在对照组基础上联合真武汤治疗),各30例。对比两组心功能指标、中医证候积分。结果:治疗前,两组左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)水平比较,差异无统计学意义(P>0.05);治疗后,两组LVEF水平均升高,LVEDD、LVESD水平均降低,观察组优于对照组(P<0.05)。治疗前,两组心悸、水肿、畏寒肢冷、气短评分对比,差异无统计学意义(P>0.05);治疗后,两组心悸、水肿、畏寒肢冷、气短评分均降低,观察组低于对照组(P<0.05)。结论:“新四联”药物联合真武汤治疗阳虚水泛型心力衰竭效果显著,可有效改善患者心功能,减轻临床症状。

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。

Clinical study on long-snake moxibustion plus Western medicine in treating chronic heart failure due to heart-kidney yang deficiency

Objective To observe the clinical efficacy of long-snake moxibustion plus Western medicine for chronic heart failure due to heart-kidney yang deficiency.Methods A total of 80 patients were randomized into a control group and an observation group,with 40 cases in each group.The control group was treated with routine Western medicine,and the observation group was treated with long-snake moxibustion therapy on the basis of routine Western medicine.Left ventricular ejection fraction(LVEF),stroke volume(SV)and left ventricular end-diastolic diameter(LVEDd)were measured before and after treatment,and the heart function was assessed.The serum brain natriuretic peptide(BNP)level was measured,the 6 min walking distance was recorded,and the Minnesota living with heart failure questionnaire(MLHFQ)was assessed and scored.The serum galectin-3(Gal-3)and soluble growth stimulation expressed gene 2(sST2)protein levels were measured.Clinical efficacy was evaluated after treatment.Results The total effective rate of the observation group was higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05).After treatment,LVEF and LVEDd in both groups were significantly improved(all P<0.05),and LVEF,SV and LVEDd in the observation group were superior to those in the control group(all P<0.05).The heart function classification in both groups were improved after treatment(both P<0.05),and the heart function classification in the observation group was superior to that in the control group(P<0.05).The serum BNP level in both groups decreased(both P<0.05),and the serum BNP level in the observation group was lower than that in the control group(P<0.05).The 6 min walking distance and MLHFQ scores in both groups were improved(all P<0.05),and the 6 min walking distance and MLHFQ score in the observation group were superior to those in the control group(both P<0.05).The serum Gal-3 and sST2 levels in the observation group decreased significantly(both P<0.05),and all lower than those in the control group(both P<0.05).Conclusion Long-snake moxibustion plus Western medicine has significant efficacy in treating chronic heart failure due to heart-kidney yang deficiency;it can improve heart function,reduce the serum BNP level,and improve the exercise endurance and quality of life in the patients.This may be related to the down-regulation of serum Gal-3 and sST2 levels.