康心导引术联合苓桂术甘汤加味治疗慢性心力衰竭心肾阳虚证患者的临床研究

目的 观察康心导引术联合苓桂术甘汤加味对慢性心力衰竭心肾阳虚证患者心功能和运动耐力及对血清N端前体脑钠肽(N-terminal pro-brain natriuretic peptide,NT-proBNP)、血管紧张素II(angiotensinⅡ,AngⅡ)、血管紧张素(1-7)[angiotensin(1-7),...

Clinical Study of Kangxin Daoyin Combined with Linggui Zhugan Decoction in the Treatment of Chronic Heart Failure Patients with Heart-kidney Yang Deficiency Syndrome

Objective To observe the effects of Lingui Zhugan Decoction combined with Kangxin Daoyin on cardiac function,exercise tolerance and serum N-terminal pro-brain natriuretic peptide(NT-proBNP),angiotensinⅡ(AngⅡ),angiotensin(1-7)[Ang(1-7)]and matrix metalloproteinase-9(MMP-9)on chronic heart failure patients with heart-kidney Yang deficiency syndrome.Methods 180 patients with chronic heart failure were divided into control group,observation group A and observation group B,60 cases in each group.The control group was treated with conventional western medicine;observation group A was treated with Lingui Zhugan Decoction on the basis of conventional western medicine;observation group B was treated with Lingui Zhugan Decoction and Kangxin Daoyin on the basis of conventional western medicine.Two weeks period is a course of treatment,continuous treatment for 4 courses.Cardiac function,including left ventricular ejection fraction(LVEF)and 6-minute walking test(6MWD),exercise tolerance,including anaerobic threshold(AT)and maximum oxygen consumption(VO₂ max),oxygen pulse ratio and serum NT-proBNP,AngⅡ,Ang(1-7),and MMP-9 levels and other laboratory indicators were compared among the three groups before and after treatment.The clinical efficacy and safety of the three groups were evaluated.Results(1)Comparison of the total effective rate of the three groups showed that observation group B was better than the control group(P<0.05).(2)After treatment,LVEF and 6MWD were improved in three groups(P<0.05),and the improvement effect of 6MWD in observation group B was better than that in control group and observation group A(P<0.05).(3)After treatment,the levels of AT,VO₂ max,and oxygen pulse ratio in observation group B were higher than those before treatment(P<0.05),and the effect of observation group B was better than that of control group and observation group A(P<0.05).(4)After treatment,the levels of NT proBNP,AngⅡ,and MMP-9 in three groups were lower than those before treatment(P<0.05),and the level of AngⅡin observation group B was lower than that in observation group A and control group(P<0.05).The levels of Ang(1-7)in observation group A and observation group B were higher than those before treatment(P<0.05),and those in observation group B were higher than those in observation group A(P<0.05).(5)During the treatment,there were no obvious adverse reactions in the three groups.Conclusion Kangxin Daoyin combined with Linggui Zhugan Decoction can improve cardiac function and exercise endurance of chronic heart failure,reduce NT-proBNP,AngⅡ,MMP-9 levels,and increase Ang(1-7)level.