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1.辽宁中医药大学,沈阳 110085
2.辽宁中医药大学 附属医院,沈阳 110085
王雅琴,博士,从事中西结合心血管研究,E-mail:360020976@qq.com
张艳,博士,主任医师,教授,博士生导师,从事中西结合心血管研究,Tel:024-82961295,E-mail:yanzhang1016@126.com
收稿日期:2022-10-06,
网络出版日期:2023-01-31,
纸质出版日期:2023-04-05
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王雅琴,张艳,张伟.冠心舒通胶囊治疗心血瘀阻型冠心病心力衰竭的临床疗效[J].中国实验方剂学杂志,2023,29(07):153-159.
WANG Yaqin,ZHANG Yan,ZHANG Wei.Clinical Effect of Guanxin Shutong Capsules in Treating Coronary Heart Failure with Heart Blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(07):153-159.
王雅琴,张艳,张伟.冠心舒通胶囊治疗心血瘀阻型冠心病心力衰竭的临床疗效[J].中国实验方剂学杂志,2023,29(07):153-159. DOI: 10.13422/j.cnki.syfjx.20231494.
WANG Yaqin,ZHANG Yan,ZHANG Wei.Clinical Effect of Guanxin Shutong Capsules in Treating Coronary Heart Failure with Heart Blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(07):153-159. DOI: 10.13422/j.cnki.syfjx.20231494.
目的
2
探讨冠心舒通胶囊用于冠心病心力衰竭心血瘀阻证患者的临床疗效。
方法
2
研究选取2020年6月至2022年8月就诊于辽宁中医药大学附属医院专家门诊并被诊断为冠心病心力衰竭心血瘀阻证的患者98例。将98例患者采用随机表法分为对照组、观察组各49例,两组患者均根据指南采用冠心病心力衰竭规范化治疗,观察组在此基础上加用中成药冠心舒通胶囊,对比两组治疗前后心脏结构功能指标、症状疗效总有效率、运动耐力、心率变异性、生活质量、炎症因子水平。
结果
2
治疗前,两组患者在超敏C反应蛋白(hs-CRP)、6 min步行试验(6MWT)、明尼苏达心力衰竭生活质量量表(MLHFQ)、左室射血分数(LVEF)、肿瘤坏死因子-
α
(TNF-
α
)、左室舒张末内径(LVEDD)、N-末端B型脑钠肽前体(NT-proBNP)、心率变异性(HRV)方面对比差异无统计学意义,资料具有可比性。治疗后,与对照组比较,观察组患者中医证候有效率(
Z
=-2.362,
P
<
0.05)及美国纽约心脏病协会(NYHA)心功能分级有效率(
Z
=-2.175,
P
<
0.05)均优于对照组,差异具有统计学意义。与本组治疗前比较,两组患者治疗后MLHFQ、LVEDD、TNF-
α
、NT-proBNP、hs-CRP水平均明显降低(
P
<
0.05,
P
<
0.01);与对照组治疗后比较,观察组患者改善更明显(
P
<
0.05,
P
<
0.01)。与本组治疗前比较,两组患者治疗后6MWT、LVEF、HRV均显著升高(
P
<
0.01);与对照组治疗后比较,观察组患者改善更显著(
P
<
0.01)。
结论
2
冠心舒通胶囊联合规范化治疗能够改善慢性心力衰竭心血瘀阻证患者的躯体症状,提高患者的运动耐量及生活质量,减轻炎症反应,提高心率变异性,改善心脏结构和功能。
Objective
2
To investigate the clinical effect of Guanxin Shutong capsules (GXSTC) on coronary heart failure with heart blood stasis.
Method
2
A total of 98 coronary heart failure patients with heart blood stasis who visited the expert clinics of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from June 2020 to August 2022 were selected. They were randomized into a control group and an observation group, with 49 in each group. The two groups were given standardized treatment according to the guidelines for coronary heart failure. On this basis, the observation group was treated with Chinese patent medicine GXSTC. The cardiac structural and functional indicators, total effective rate of symptoms, exercise tolerance, heart rate variability (HRV), quality of life and inflammatory factor levels of the two groups before and after treatment were compared.
Result
2
Before treatment, there was no notable difference in high-sensitivity C-reactive protein (hs-CRP), six minute walk test (6MWT), minnesota living with heart failure questionnaire (MLHFQ) score, left ventricular ejection fraction (LVEF), tumor necrosis factor-
α
(TNF-
α
), left ventricular end-diastolic diameter (LVEDD), N-terminal pro-brain natriuretic peptide (NT-proBNP) and HRV between the two groups, and thus the data were comparable. After treatment, the observation group had higher effective rates of traditional Chinese medicine (TCM) symptoms (
Z
=-2.362,
P
<
0.05) and New York heart association class (NYHA) functional classes (
Z
=-2.175,
P
<
0.05) than the control group. The two groups presented decreased LVEDD, TNF-
α
, NT-proBNP and hs-CRP (
P
<
0.05,
P
<
0.01) while increased MLHFQ, 6MWT and HRV(
P
<
0.05,
P
<
0.01) after treatment as compared with those before treatment, and the observation group had more decrease or increase than the control group (
P
<
0.05,
P
<
0.01).
Conclusion
2
GXSTC combined with standardized treatment relieves the physical symptoms of coronary heart failure patients with heart blood stasis, improves exercise tolerance and quality of life, reduces inflammatory reaction, increases HRV, and improves cardiac structure and function.
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