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李敏, 鞠娟, 徐志红, 朱云仙, 王俊, 伯广干, 邢俊武.葛丹生脉养心合剂治疗慢性心力衰竭患者疗效及对血管内皮功能的影响[J].湖南中医药大学学报,2025,45(6):1083-1088[点击复制] |
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| 葛丹生脉养心合剂治疗慢性心力衰竭患者疗效及对血管内皮功能的影响 |
| 李敏,鞠娟,徐志红,朱云仙,王俊,伯广干,邢俊武 |
| (南京市中西医结合医院心内科, 江苏 南京 210018) |
| 摘要: |
| 目的 观察葛丹生脉养心合剂治疗慢性心力衰竭（CHF）气阴两虚兼痰瘀互阻证患者的临床疗效及对血管内皮功能的影响。方法 选取2023年1月至2024年7月于本院进行治疗的CHF气阴两虚兼痰瘀互阻证患者98例，随机分为观察组和对照组，各49例。对照组采用常规西医治疗，观察组采用葛丹生脉养心合剂联合常规西医治疗，均持续治疗4周。对比两组患者临床疗效，评估两组患者中医证候积分、心脏功能[超声指标：左室射血分数（LVEF）、左心室舒张末期内径（LVEDD）及每搏输出量（SV）；纽约心脏病学会（NYHA）心功能分级]、运动耐量[6分钟步行试验（6MWT）]、血管内皮功能[血清血管内皮细胞生长因子（VEGF）、内皮素-1（ET-1）、一氧化氮（NO）]及生活质量[明尼苏达心力衰竭量表（MLHFQ）评分]，并评价治疗安全性。结果 观察组总有效率（93.88%）高于对照组（77.55%）（P<0.05）。治疗后，两组各中医证候积分降低（P<0.05），且观察组低于对照组（P<0.05）；观察组NYHA心功能Ⅱ级占比高于对照组（P<0.05）；LVEF、SV、6MWT、VEGF水平升高（P<0.05），且观察组高于对照组（P<0.05）；LVEDD、ET-1、NO水平及MLHFQ评分降低（P<0.05），且观察组低于对照组（P<0.05）。观察组总不良反应发生率（10.20%）与对照组（6.12%）比较，差异无统计学意义（P>0.05）。结论 葛丹生脉养心合剂可有效降低CHF气阴两虚兼痰瘀互阻证患者中医证候积分，提高临床疗效，改善心功能和运动耐量，促进血管内皮功能恢复，提高生活质量。 |
| 关键词: 慢性心力衰竭 气阴两虚兼痰瘀互阻证 葛丹生脉养心合剂 血管内皮功能 心脏功能 安全性 |
| DOI：10.3969/j.issn.1674-070X.2025.06.014 |
| 投稿时间：2025-01-08 |
| 基金项目:南京市医疗机构中药传统制剂备案研究项目（NJCC-ZJ-202417）。 |
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| Efficacy of Gedan Shengmai Yangxin Mixture in treating patients with chronic heart failure and its effects on vascular endothelial function |
| LI Min, JU Juan, XU Zhihong, ZHU Yunxian, WANG Jun, BO Guanggan, XING Junwu |
| (Department of Cardiology, Nanjing Hospital of Integrated Chinese and Western Medicine, Nanjing, Jiangsu 210018, China) |
| Abstract: |
| Objective To observe clinical efficacy of Gedan Shengmai Yangxin Mixture (GDSMYXM) in treating chronic heart failure (CHF) patients with qi and yin deficiency with inter-obstructed phlegm and blood stasis pattern and its effects on vascular endothelial function.Methods A total of 98 CHF patients with qi and yin deficiency with inter-obstructed phlegm and blood stasis pattern treated in our hospital from January 2023 to July 2024 were enrolled and randomly divided into an observation group and a control group, with 49 cases in each group. The control group was treated with routine western medicine, while the observation group was treated with GDSMYXM combined with routine western medicine. Both groups underwent treatment for 4 weeks. Clinical efficacy, TCM pattern scores, cardiac function [ultrasonic indicators: left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), stroke volume (SV); New York Heart Academy (NYHA) cardiac function classification], exercise tolerance [6-minute walk test (6MWT)], vascular endothelial function [serum vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), nitric oxide (NO)], and quality of life [Minnesota Living with Heart Failure Questionnaire (MLHFQ) score] were compared between the two groups. Treatment safety was also evaluated.Results The total response rate in observation group was higher than that in control group (93.88% vs 77.55%, P<0.05). After treatment, TCM pattern scores decreased in both groups (P<0.05), with lower scores in the observation group than that in the control group (P<0.05). The proportion of NYHA cardiac function class Ⅱ in the observation group was higher than that in the control group (P<0.05), while the proportion of class III was lower (P<0.05). LVEF, SV, 6MWT, and VEGF levels increased (P<0.05), with greater improvements in the observation group than those in the control group (P<0.05). LVEDD, ET-1, NO levels, and MLHFQ scores decreased (P<0.05), with greater reductions in the observation group than those in the control group (P<0.05). There was no statistically significant difference in total incidence of adverse reactions between observation group and control group (10.20% vs 6.12%, P>0.05).Conclusion GDSMYXM can effectively reduce TCM pattern scores in CHF patients with qi and yin deficiency with inter-obstructed phlegm and blood stasis pattern, improve clinical efficacy, enhance cardiac function and exercise tolerance, promote the recovery of vascular endothelial function, and improve quality of life. |
| Key words: chronic heart failure qi and yin deficiency with inter-obstructed phlegm and blood stasis pattern Gedan Shengmai Yangxin Mixture vascular endothelial function cardiac function safety |
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