自拟通脉汤早期干预对心肌梗死后心力衰竭患者心功能及生活质量的影响

目的观察自拟通脉汤对心肌梗死后心力衰竭患者心功能及生活质量的影响,探寻中医药早期干预改善此类患者预后的优势。方法将2016年10月—2018年1月在北京市昌平区中医医院心血管病科住院治疗的82例急性心肌梗死后心力衰竭患者随机分为2组,对照组41例给予常规西医治疗,治疗组41例给予自拟通脉汤+常规西医治疗,中药连服12周。统计2组干预12周及1年后心功能改善总有效率,观察2组干预12周及1年后血清脑钠肽(BNP)水平、左室射血分数(LVEF)及生活质量评分变化情况,记录2组不良反应发生情况。结果干预12周后,治疗组和对照组心功能改善总有效率分别为89.5%(34/38)、67.6%(25/37),干预1年后分别为94.7%(36/38)、70.3%(26/37),治疗组总有效率均明显高于同期对照组(P均<0.05)。2组干预12周、1年后BNP水平均明显低于干预前(P均<0.05),LVEF均明显高于干预前(P均<0.05);且治疗组BNP水平均明显低于同期对照组(P均<0.05),LVEF均明显高于同期对照组(P均<0.05)。对照组干预1年后生活质量评分明显低于干预前(P<0.05);治疗组干预12周、1年后生活质量评分均明显低于干预前及同期对照组(P均<0.05)。干预期间治疗组1例、对照组2例出现低血压,调整降压药后恢复,未见其他明显不良反应。结论自拟通脉汤早期干预能显著改善心肌梗死后心力衰竭患者心功能,提高生活质量,且安全。

Effect of early intervention with Zini Tongmai decoction on cardiac function and quality of life in patients with heart failure after myocardial infarction

Objective It is to observe the effect of Zini Tongmai decoction on cardiac function and quality of life in patients with heart failure after myocardial infarction,to explore the advantages of early intervention of traditional Chinese medicine in improving the prognosis of this kind of patients.Methods Eighty-two patients with heart failure after acute myocardial infarction who were hospitalized in the cardiology department of Changping District Hospital of Traditional Chinese Medicine from October 2016 to January 2018 were randomly divided into two groups,the control group(n=41)was treated with conventional western medicine,the treatment group(n=41)were given self-made Tongmai decoction+conventional western medicine,both groups were treated for 12 weeks.The total effective rate of cardiac function improvement after 12 weeks of intervention and in 1 year in the two groups were calculated,and the changes of level of serum brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),and scores of quality of life were observed in the 2 groups after 12 weeks and 1 year of intervention,the occurrence of adverse reactions in the 2 groups were recorded.Results The total effective rates of cardiac function improvement in the treatment group and control group were 89.5%(34/38),67.6%(25/37)after 12 weeks of intervention,,and 94.7%(36/38),70.3%(26/37)after 1 year of intervention,respectively.The total effective rate in the treatment group was significantly higher than that in the control group over the same period(P<0.05).After 12 weeks and 1 year of intervention,the BNP levels in the two groups were significantly lower than those before the intervention(P<0.05),and the LVEF was significantly higher than those before the intervention(P<0.05);and the BNP levels in the treatment group were significantly lower while LVEF were significantly higher than those in the control group at the same period(P<0.05).The score of quality of life after one year of intervention was significantly lower than that before the intervention in the control group(P>0.05);the score after 12 weeks of intervention and one year after the intervention in the treatment group were significantly lower than those before the intervention and in the control group(P<0.05).During the intervention period,there were 1 case with hypotension in the treatment group and 2 cases in the control group,and the pressure recovered after adjusting the antihypertensive drug.No other significant adverse reactions were found.Conclusion The early intervention with self-made Tongmai decoction can significantly improve the cardiac function,improve the quality of life with good safety in patients with heart failure after myocardial infarction.