滋阴助阳抗衰汤联合西药治疗阳虚水泛型慢性心力衰竭疗效及对患者氧化应激、生活质量的影响

发布时间：2018-05-31 20:16

本文选题：滋阴助阳抗衰汤 + 西药治疗　；参考：《中国实验方剂学杂志》2017年16期

【摘要】：目的:探讨阳虚水泛型慢性心力衰竭(CHF)应用滋阴助阳抗衰汤联合西药治疗的临床效果及对患者氧化应激、生活质量的影响。方法:选取石河子大学医学院第一附属医院2014年6月—2016年6月收治的116例CHF患者,根据随机数字表法均分为两组。所有患者均采取常规基础治疗,对照组在此基础上,给予西医标准抗心衰药物治疗;观察组在对照组基础上,予以滋阴助阳抗衰汤治疗。记录比较两组中医证候疗效、心功能疗效,超声心动图指标及血浆氨基末端脑钠肽前体(NT-proBNP)水平,氧化应激指标,明尼苏达心力衰竭生活质量调查表(MLHFQ)总评分,用药安全性评价。结果:连续治疗3个月后,观察组中医证候总有效率、心功能总有效率分别为90.6%,84.9%,均明显高于对照组的75.5%,67.9%(P0.05)。与治疗前比较,两组治疗后左心室射血分数(LVEF),二尖瓣血流E/A(E/A),左室收缩末期内径(LVESD),左室舒张末期内径(LVEDD)及血浆NT-proBNP水平均显著改善(P0.01);且与对照组同期比较,观察组治疗后超声心动图指标及血浆NTproBNP水平改善程度更为显著(P0.01)。与治疗前比较,两组治疗后血浆氧化应激指标丙二醛(MDA)水平显著下降(P0.01),过氧化氢酶(CAT),超氧化物歧化酶(SOD)及谷胱甘肽过氧化物酶(GSH-Px)水平均显著上升(P0.01);且观察组治疗后血浆氧化应激指标水平改善效果均显著优于对照组同期(P0.01)。与治疗前比较,两组治疗后MLHFQ总评分均显著下降(P0.01);且观察组治疗后MLHFQ总评分较对照组同期显著降低(P0.01)。观察组不良反应率与对照组比较差异无统计学意义。结论:CHF患者应用滋阴助阳抗衰汤联合西药治疗更能短期内改善中医证候,提高心功能,维持机体氧化-抗氧化系统平衡,延缓心肌重构,提升生活质量,疗效显著且安全性高。可为临床防治CHF提供新方向。
[Abstract]:Objective: to investigate the clinical effect of Ziyin Zhuyang Kangshuai decoction combined with western medicine and its effect on oxidative stress and quality of life of patients with chronic heart failure induced by yang deficiency and water deficiency. Methods: 116 patients with CHF were selected from the first affiliated Hospital of Shihezi University Medical College from June 2014 to June 2016. The patients were divided into two groups according to the random digital table method. All the patients were treated with routine basic therapy, the control group was treated with western standard anti-heart failure medicine on this basis, and the observation group was treated with Ziyin Zhuyang anti-aging decoction on the basis of the control group. The therapeutic effects of TCM syndromes, cardiac function, echocardiography, plasma levels of NT-proBNPs, oxidative stress index, quality of life questionnaire (MLHFQQ) of Minnesota heart failure were recorded and compared between the two groups, and the safety of drug use was evaluated. Results: after 3 months of continuous treatment, the total effective rate of TCM syndromes and cardiac function in the observation group were 90.6 and 84.9, respectively, which were significantly higher than that in the control group (75.5%) and 67.9% (P 0.05). After treatment, left ventricular ejection fraction (LVEF), mitral flow (E / A / A), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDDD) and plasma NT-proBNP levels were significantly improved in both groups compared with control group (P 0.01). The indexes of echocardiography and the level of plasma NTproBNP were significantly improved after treatment in the observation group (P 0.01). Compared with pre-treatment, After treatment, the levels of plasma MDA, catalase CATX, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were significantly increased in both groups, and the plasma oxidative stress was significantly increased in the observation group after treatment. The improvement effect of the index level was significantly better than that of the control group in the same period (P 0.01). Compared with before treatment, the total score of MLHFQ in the two groups decreased significantly after treatment, and the total score of MLHFQ in the observation group was significantly lower than that in the control group in the same period. There was no significant difference in adverse reaction rate between the observation group and the control group. Conclusion the combination of Ziyin and Yang-Kangshuai decoction combined with western medicine can improve TCM syndromes, improve cardiac function, maintain the balance of oxidation-antioxidation system, delay myocardial remodeling and improve the quality of life in patients with CHF. The curative effect is significant and the safety is high. It can provide a new direction for clinical prevention and treatment of CHF.
【作者单位】：石河子大学医学院第一附属医院;
【基金】：新疆兵团科技攻关计划课题项目(2016AD020)
【分类号】：R541.6

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