国际中医中药杂志
國際中醫中藥雜誌
국제중의중약잡지
INTERNATIONAL JOURNAL OF TRIDITIONAL CHINESE MEDICINE
2015年
1期
29-32
,共4页
心力衰竭%肾虚血瘀%利钠肽,脑%心室功能,左%补肾活血汤
心力衰竭%腎虛血瘀%利鈉肽,腦%心室功能,左%補腎活血湯
심력쇠갈%신허혈어%리납태,뇌%심실공능,좌%보신활혈탕
Heart failure%Kidney deficiency and blood stagnation%Natriuretic peptide,brain%Ventricular function,left%Bushen-Huoxue decoction
目的：探讨补肾活血汤对肾虚血瘀型慢性心力衰竭患者血浆脑钠肽（BNP）和心功能的影响。方法将96例肾虚血瘀型慢性心力衰竭患者按随机数字表法分为治疗组（50例）和对照组（46例）。对照组根据病情给予呋塞米（20 mg/d）、螺内酯（20 mg/d）、福辛普利（10 mg/d）、单硝酸异山梨酯缓释胶囊（50 mg/d）或酒石酸美托洛尔片（12.5 mg/次，3次/d）。治疗组在对照组的基础上加服补肾活血汤。疗程均为4周。采用酶联免疫吸附法检测血浆BNP水平。评价治疗前后左心室射血功能、心功能（NYHA分级）和中医证候积分。结果治疗组治疗后血浆BNP水平显著低于对照组[（897.3±286.7）pg/ml比（1423.5±458.7）pg/ml；P＜0.05]，左心室收缩末期内径[(4.8±0.8)cm比(5.4±0.9)cm]、左心室收缩末期容积[(57.23±5.30) ml比(69.78±5.86) ml]均较对照组显著降低（P均＜0.05），每搏输出量[(72.56±7.23)ml比(62.56±5.86) ml]、左心室射血分数[(59.75±6.47)%比(49.87±6.91)%]均较对照组显著增高（P均＜0.05）。治疗组心功能（90.0%比80.4%；χ2＝4.369，P＜0.05）和中医证候评分（94.0%比82.6%；χ2＝3.988，P＜0.05）均较对照组改善。结论补肾活血汤可降低肾虚血瘀型CHF患者血浆BNP水平，改善心功能。
目的：探討補腎活血湯對腎虛血瘀型慢性心力衰竭患者血漿腦鈉肽（BNP）和心功能的影響。方法將96例腎虛血瘀型慢性心力衰竭患者按隨機數字錶法分為治療組（50例）和對照組（46例）。對照組根據病情給予呋塞米（20 mg/d）、螺內酯（20 mg/d）、福辛普利（10 mg/d）、單硝痠異山梨酯緩釋膠囊（50 mg/d）或酒石痠美託洛爾片（12.5 mg/次，3次/d）。治療組在對照組的基礎上加服補腎活血湯。療程均為4週。採用酶聯免疫吸附法檢測血漿BNP水平。評價治療前後左心室射血功能、心功能（NYHA分級）和中醫證候積分。結果治療組治療後血漿BNP水平顯著低于對照組[（897.3±286.7）pg/ml比（1423.5±458.7）pg/ml；P＜0.05]，左心室收縮末期內徑[(4.8±0.8)cm比(5.4±0.9)cm]、左心室收縮末期容積[(57.23±5.30) ml比(69.78±5.86) ml]均較對照組顯著降低（P均＜0.05），每搏輸齣量[(72.56±7.23)ml比(62.56±5.86) ml]、左心室射血分數[(59.75±6.47)%比(49.87±6.91)%]均較對照組顯著增高（P均＜0.05）。治療組心功能（90.0%比80.4%；χ2＝4.369，P＜0.05）和中醫證候評分（94.0%比82.6%；χ2＝3.988，P＜0.05）均較對照組改善。結論補腎活血湯可降低腎虛血瘀型CHF患者血漿BNP水平，改善心功能。
목적：탐토보신활혈탕대신허혈어형만성심력쇠갈환자혈장뇌납태（BNP）화심공능적영향。방법장96례신허혈어형만성심력쇠갈환자안수궤수자표법분위치료조（50례）화대조조（46례）。대조조근거병정급여부새미（20 mg/d）、라내지（20 mg/d）、복신보리（10 mg/d）、단초산이산리지완석효낭（50 mg/d）혹주석산미탁락이편（12.5 mg/차，3차/d）。치료조재대조조적기출상가복보신활혈탕。료정균위4주。채용매련면역흡부법검측혈장BNP수평。평개치료전후좌심실사혈공능、심공능（NYHA분급）화중의증후적분。결과치료조치료후혈장BNP수평현저저우대조조[（897.3±286.7）pg/ml비（1423.5±458.7）pg/ml；P＜0.05]，좌심실수축말기내경[(4.8±0.8)cm비(5.4±0.9)cm]、좌심실수축말기용적[(57.23±5.30) ml비(69.78±5.86) ml]균교대조조현저강저（P균＜0.05），매박수출량[(72.56±7.23)ml비(62.56±5.86) ml]、좌심실사혈분수[(59.75±6.47)%비(49.87±6.91)%]균교대조조현저증고（P균＜0.05）。치료조심공능（90.0%비80.4%；χ2＝4.369，P＜0.05）화중의증후평분（94.0%비82.6%；χ2＝3.988，P＜0.05）균교대조조개선。결론보신활혈탕가강저신허혈어형CHF환자혈장BNP수평，개선심공능。
Objective To investigate the effects of Bushen-Huoxue decoction on the plasma level of brain natriuretic peptide (BNP) and heart function in patients with chronic heart failure (CHF) due to kidney deficiency and blood stasis. Methods A total of 96 patients with CHF due to kidney deficiency and blood stasis were randomized into a treatment group (50 cases) and a control group (46 cases). In the control group, the normal treatment of western medicine was given. In the treatment group, on the basis of the control group, Bushen-Huoxue decoction was added. Both groups were treated for 4 weeks. The plasma BNP level was detected with enzyme-linked immunosorbent assay. The left ventricular ejecting function, New York Heart Association functional classes and score of traditional Chinese medicine syndromes were evaluated before and after the treatment. Results After the treatment, the plasma BNP level in the treatment group was significantly lower than that in the control group (897.3 ± 286.7 pg/ml vs. 1 423.5 ± 458.7 pg/ml;P<0.05);the left ventricular end systolic diameter (4.8 ± 0.8 cm vs. 5.4 ± 0.9 cm) and the left ventricular end systolic volume (57.23 ± 5.30 ml vs. 69.78 ± 5.86 ml) in the treatment group were significantly lower than those in the control group (all P<0.05);the stroke volume (72.56 ± 7.23 ml vs. 62.56 ± 5.86 ml) and the left ventricular ejection fraction (59.75%± 6.47%vs. 49.87%± 6.91%) in the treatment group were significantly higher than those in the control group (all P<0.05). The heart function (90.0%vs. 80.4%;χ2=4.369, P<0.05) and the traditional Chinese medicine syndromes (94.0%vs.82.6%;χ2=3.988, P<0.05) had shown significant improvement in the treatment than those in the control group. Conclusions Bushen-Huoxue decoction can reduced the plasma BNP level, improve the heart function in patients with CHF due to kidney deficiency and blood stasis.
