活血复脉汤对缺血型心肌病心力衰竭的多参数分析研究

目的:观察自组方活血复脉汤治疗缺血型心肌病心力衰竭的临床疗效。方法:88例患者随机分为观察组41例和对照组57例,两组患者均接受西医规范化治疗、观察组此基础上加活血复脉汤治疗,每天1剂,联服21天后进行心功能分级(heart function)(NYHA分级法),6分钟步行试验(six minute walking distance,6MWD)、脑钠肽(plsma brainnatricular peptide,BNP)、左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末容积(left ventricular end-dias-tolic dimension,LVEDD)、β2微球蛋白、血尿素氮、血肌酐、血尿酸、血钾、血钠、血氯、T3、T4、胆固醇、甘油三酯、低密度胆固醇临床评价。结果:观察组治疗前后比较心功能[(3.39±0.49)级与(2.73±0.81)级]、6分钟步行试验[(317.51±108.84)米与(415.15±105.85)米]、脑钠肽[(370.73±70.83)pg/mL与(291.20±86.49)pg/mL]、血胆固醇[(4.86±0.61)mmol/L与(4.53±0.44)mmol/L]、低密度胆固醇[(2.89±0.50)mmol/L与(2.47±0.48)mmol/L]经统计学处理有极显著性差异(P<0.01),左室舒张末期内径[(58.24±3.10)mm与(56.96±3.11)mm]、左室射血份数[(43.11±8.21)%与(47.04±6.02)%]、β2微球蛋白[(3.13±0.52)mg/L与(2.96±0.48)mg/L]经统计学处理有显著性差异(P<0.05);对照组治疗前后比较以上参数经统计学处理有显著性差异(P<0.05),仅低密度胆固醇[(2.82±0.55)mmol/L与(2.50±0.48)mmol/L]治疗后经统计学处理有极显著性差异(P<0.01)。治疗后,两组之间比较,心功能[(2.73±0.81)级与(3.09±0.65)级]、6分钟步行试验[(415.15±105.85)米与(368.98±105.62)米]、脑钠肽[(291.20±86.49)pg/mL与(332.83±91.08)pg/mL]有显著性差异(P<0.05)。结论:活血复脉汤能增加缺血型心肌病心力衰竭的临床疗效。

Effects of Huoxuefumaitang on ischemic cardiomyopathy patients with heart Failure

Objective:To explore the effects of huoxuefumaitang on Ischemic cardiomyopathy patients with heart failure.Methods:88cases were randomly divided into two groups,the therapeutic group(n=41) were treated with conventional therapy combined with huoxuefumaitang 1 dose/d for 21 days and the contral guoup(47)were only treated with conventional therapy.Then all the patients data of heart function,six minute walking distances(6MWD),plsma brain natricular peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic dimension(LVEDD),serum β2–microglobulin,serum urea nitrogen,serum creatinine,serum uric acid,serum potassium,serum sodium,serum chloride,serum T3,serum T4,serum total cholesterin,serum triglyceride,and serum Low Density Lipoprotein-Cholesterol were obtained to analysis.Results: Before and after therapy,for the therapy group,there were significant differences in heart function[(3.39±0.49)(NYHA)VS(2.73±0.81)(NYHA),(P<0.01)],six minute walking distance[(317.51±108.84)m VS(415.15±105.85)m,(P<0.01)] and blood brain natriuretic peptide(BNP) [(370.73±70.83)pg/mL VS(291.20±86.49)pg/mL,(P<0.01)],total cholesterin[(4.86±0.61)mmol/L±(4.53±0.44)mmol/L,(P<0.01)],serum triglyceride [(1.51±0.36)mmol/L VS(1.40±0.21)mmol/L],(P<0.05),Low Density Lipoprotein-Cholesterol[(2.89±0.50)mmol/L VS(2.47±0.48)mmol/L,(P<0.01)],LVEF[(58.24±3.10)% VS(56.96±3.11)%,(P<0.05)],LVEDD[(43.11±8.21)mm VS(47.04±6.02)mm,(P<0.05)],β2-microglobulin [(3.13 ±0.52)mg/L VS(2.96 ±0.48)mg/L,(P<0.05)];for contral group,there were significant differences in heart function[(3.36±0.49)(NYHA)VS(3.09±0.65)(NYHA)(P<0.05)],six minute walking distance[(320.47±112.24)m VS(368.98±105.62)m,(P<0.05)] and blood brain natriuretic peptide(BNP)[(364.62±74.97)pg/mL±(332.83±91.08)pg/mL,(P<0.05)],total cholesterin[(4.76±0.50)mmol/L VS(4.60±0.24)mmol/L,(P<0.05)],serum triglyceride[(1.59±0.53)mmol/L VS(1.43±0.26)mmol/L,(P<0.05)];Low Density Lipoprotein-Cholesterol [(2.82±0.55)mmol/L VS(2.50±0.48)mmol/L,(P<0.01)],LVEF[(58.05±2.73)% VS(57.19±2.61)%,(P<0.05)],LVEDD[(44.13±8.13)m VS(47.35±6.32)m,(P<0.05)],β2-microglobulin[(3.13±0.5)mg/L VS(2.98±0.40)mg/L,(P<0.05)].significant differences were also oberseved between theary group and control group in heart function[(2.73±0.81)(NYHA)VS(3.09±0.65)(NYHA),(P<0.05)],six minute walking distance[(415.15±105.85)m VS(368.98±105.62)m,(P<0.05)] and blood brain natriuretic peptide(BNP)[(291.20±86.49)pg/mL VS(332.83 ±91.08)pg/mL,(P<0.05)].Conclusions: It is an effective and reasonable way to treat the ischemic cardiomyopathy patients with heart failure with tradtional therapy plus huoxuefumaitang.