标题：益气养心汤联合西药治疗慢性心力衰竭的疗效及对患者内生化指标的影响

      作者：赵运 1，康启 1，王琼 1，邢雪 1，张媛媛 2    陕西中医药大学第二附属医院心血管三病区 1、药剂科 2，陕西 咸阳 712000

      卷次： 2019年30卷17期

      【摘要】 目的 研究益气养心汤联合西药治疗慢性心力衰竭(CHF)的疗效及其对患者内生化指标的影响。方法 选取2016年5月至2018年5月陕西中医药大学第二附属医院收治的96例CHF患者进行前瞻性研究，采用随机数表法将患者分为观察组和对照组，每组48例，对照组患者采用美托洛尔等常规西药治疗，观察组患者在对照组治疗的基础上联合益气养心汤治疗。治疗4周后，比较两组患者的心功能改善情况、脑钠素(BNP)和氨基末端脑钠肽前体(NT-proBNP)水平，以及心肌酶谱中乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)及α-羟丁酸脱氢酶(α-HBDH)水平。结果 治疗前，观察组患者的BNP、NT-proBNP、LDH、CK、CK-MB、α-HBDH与对照组比较差异均无统计学意义(P>0.05)；治疗后，观察组患者心功能改善的总有效率为93.75%，明显高于对照组的77.08%，差异有统计学意义(P<0.05)；治疗后，观察组和对照组患者BNP [(284.27±85.80) pg/mL vs (355.62±98.87) pg/mL]、NT-proBNP[(521.38 ± 185.25) pg/mL vs (957.41 ± 155.2) pg/mL]、LDH [(224.26 ± 25.85) μ g/mL vs (245.63 ± 28.9) μ g/mL]、CK[(141.45±25.20) μg/mL vs (177.39±25.21) μg/mL]、CK-MB [(28.91±7.50) μg/mL vs (39.56±6.36) μg/mL]、α-HBDH[(148.69±41.80) μg/mL vs (195.7±42.38) μg/mL]水平比较，观察组明显低于对照组，差异均有统计学意义(P<0.05)。结论 益气养心汤联合西药治疗慢性心力衰竭患者可以改善患者的心功能，降低患者的BNP、NT-proBNP水平以及心肌酶谱中各种酶指标水平，减少患者心肌损害的发生，值得临床上推广。
      【关键词】 益气养心汤；西医；慢性心力衰竭；内生化指标；疗效
      【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350（2019）17—2188—03

Effect of Yiqi Yangxin Decoction combined with western medicine on chronic heart failure and its effect onpatients' internal biochemical indicators.
ZHAO Yun 1, KANG Qi 1, WANG Qiong 1, XING Xue 1, ZHANG Yuan-yuan 2.The 3rd Cardiovascular Department 1, Pharmacy Department 2, the Second Affiliated Hospital of Shaanxi University of ChineseMedicine, Xianyang 712000, Shaanxi, CHINA
【Abstract】 Objective To study the efficacy of Yiqi Yangxin Decoction combined with western medicine in thetreatment of chronic heart failure (CHF) and its effect on patients' internal biochemical indicators. Methods A prospec-tive study was conducted on 96 patients with CHF admitted to the Second Affiliated Hospital of Shaanxi University ofChinese Medicine from May 2016 to May 2018. The patients were divided into observation group and control group byrandom number table method, with 48 cases in each group. The patients in the control group were treated with conven-tional western medicine such as metoprolol. The patients in the observation group were additionally treated with YiqiYangxin Decoction on the basis of the treatment of the control group. After 4 weeks of treatment, the improvement ofcardiac function, the levels of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP)were compared between the two groups, as well as the levels of lactate dehydrogenase (LDH), creatine kinase (CK), cre-atine kinase MB isoenzyme (CKMB), and alpha-hydroxybutyrate dehydrogenase (α-HBDH) in the myocardial enzymes.Results Before treatment, there were no significant differences in the levels of BNP, NT-proBNP, LDH, CK, CK-MB,and α-HBDH between the observation group and the control group (P>0.05). After treatment, the total effective rate ofimprovement of cardiac function in the observation group was 93.75%, which was significantly higher than 77.08% inthe control group, and the difference was statistically significant (P<0.05). After treatment, comparison between observa-tion group and control group on the levels of BNP, NT-proBNP, LDH, CK, CK-MB, α-HBDH showed that indicators inthe observation group were significantly lower than those in the control group, and all differences were statistically sig-nificant: (284.27 ± 85.80) vs (355.62 ± 98.87), (521.38 ± 185.25) vs (957.41 ± 155.2), (224.26 ± 25.85) vs (245.63 ± 28.9),(141.45±25.20 vs (177.39±25.21), (28.91±7.50) vs (39.56±6.36), (148.69±41.80) vs (195.7±42.38), P<0.05. Conclusion YiqiYangxin Decoction combined with western medicine in the treatment of patients with chronic heart failure can improvethe heart function, reduce the levels of BNP, NT-proBNP and various enzyme indexes in myocardial enzymes, and re-duce the occurrence of myocardial damage in patients. It is worthy of clinical promotion.
      【Key words】 Yiqi Yangxin Decoction; Western medicine; Chronic heart failure; Internal biochemical indicators;Efficacy