| 摘要: |
| 目的：观察抗纤益心方治疗气虚血瘀型扩张型心肌病（DCM） 合并心力衰竭患者的临床疗效，并分析其对患者心肌及神经内分泌因子水平的影响。方法：选取112 例气虚血瘀型DCM 合并心衰患者，按照随机数字表法将患者分为2 组各56 例。对照组采用西医综合治疗，观察组在对照组治疗方案的基础上联合抗纤益心方治疗，2 组均连续治疗6 个月。比较2 组治疗前后血浆中醛固酮（ALD）、N 末端B 型钠尿肽原（NT-proBNP）、肾素活性（PRA）、血管紧张素Ⅱ （AngⅡ）、内皮素-1 （ET-1）、血栓素B2 （TXB2） 水平、左心室舒张期内径（LVEDd），左室射血分数（LVEF）、左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）、6 min 步行距离（6-MWT）、中医证候积分、不良事件，并评价中西医临床疗效。结果：观察组中医、西医临床疗效总有效率均高于对照组，差异均有统计学意义（P＜0.05）；治疗后，观察组心肌功能指标LVEF、6-MWT 均高于对照组，LVEDd、LVESV 及LVEDV 低于对照组，差异均有统计学意义（P＜0.05）；观察组神经内分泌因子水平NT-proBNP、ALD、PRA、ET-1、AngⅡ及TXB2 均低于对照组，差异均有统计学意义（P＜0.05）；观察组中医证候积分低于对照组，差异均有统计学意义（P＜0.05）；2 组不良事件发生率比较，差异无统计学意义（P＞0.05）。结论：采用抗纤益心方治疗气虚血瘀型DCM 合并心衰患者，中西医疗效显著，能够降低神经内分泌因子表达，改善心肌功能，安全性高。 |
| 关键词: 扩张型心肌病 心力衰竭 气虚血瘀型 抗纤益心方 神经内分泌因子 心肌功能 |
| DOI： |
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| 基金项目:河南省中医药科学研究专项计划（2018YD10224） |
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| Effect of Kangxian Yixin Prescription on Myocardial Function and NeuroendocrineFactors in Patients with Dilated Cardiomyopathy of Qi Deficiency and Blood StasisType Complicated with Heart Failure |
| LI Bin |
| (单篇PDF全文查阅请上中国知网下载阅读（中国知网电子版刊出时间：纸刊刊出日期一个月左右）) |
| Abstract: |
| Abstract：Objective：To observe the clinical effect of Kangxian Yixin prescription for patients with dilated cardiomyopathy
(DCM) of qi deficiency and blood stasis type complicated with the heart failure， and to analyse its effect on myocardial
function and the level of neuroendocrine factors. Methods：A total of 112 cases of DCM patients of qi deficiency and blood
stasis type complicated with the heart failure were divided into two groups according to the random number table method，56
cases in each group. The control group was given comprehensive treatment of western medicine，and the observation group
was additionally given Kangxian Yixin prescription based on the treatment of the control group. Both groups were continuously
treated for six months. The levels of aldosterone(ALD)，N- terminal pro- B- type natriuretic peptidec(NT- proBNP)，plasma
renin activity(PRA)，angiotensinⅡ(AngⅡ)，endothelin- 1(ET- 1)，and thromboxane B2 in the plasma(TXB2) before and after
treatment were compared between the two groups. Left ventricular internal dimension diastole(LVEDd)， left ventricular
ejection fraction(LVEF)，left ventricular end systolic volume(LVESV)，left ventricular end diastolic volume(LVEDV)，6-minute
walking distance(6- MWT)， Chinese medicine syndrome scores， and adverse events before and after treatment were compared between the two groups. The clinical effect of integrated Chinese and western medicine was evaluated. Results：
The total clinical effective rate of Chinese medicine and western medicine in the observation group were higher than those in
the control group，differences being significant(P＜0.05). After treatment，the myocardial function indexes such as LVEF and
6- MWT in the observation group were higher than those in the control group， and LVEDd， LVESV and LVEDV lower，
differences being significant(P＜0.05)；the levels of neuroendocrine factors including NT-proBNP，ALD，PRA，ET-1，AngⅡ
and TXB2 in the observation group were lower than those in the control group， differences being significant(P＜0.05)；
Chinese medicine syndrome scores in the observation group were lower than those in the control group，differences being
significant(P＜0.05)； there was no significant difference being found in the comparison of the incidence of adverse events
between the two groups(P＞0.05). Conclusion： Kangxian Yixin prescription has significant curative effect of integrated
Chinese and western medicine in treating DCM patients of qi deficiency and blood stasis type complicated with the heart
failure，which can reduce the expression of neuroendocrine factors，and improve myocardial function，with high safety. |
| Key words: Keywords： Dilated cardiomyopathy Heart failure Qi deficiency and blood stasis type Kangxian Yixin prescription Neuroendocrine factors Myocardial function |
