摘要
目的:观察芪参益气滴丸对不宜进行血运重建的气虚血瘀型冠状动脉粥样硬化性心脏病(简称“冠心病”)患者的心功能、运动耐量和生活质量的影响。方法:将符合诊断标准和病例纳入、排除标准的114例冠心病患者,随机分为试验组62例和对照组52例。对照组给予冠心病二级预防的规范药物治疗,试验组在对照组治疗方案的基础上加用芪参益气滴丸,连续治疗3个月。结果:两组患者的心肺运动试验(cardio pulmonary exercise testing,CPET)相关指标、左室舒张末期内径(left ventricular end diastolic dimension,LVEDD)、左室射血分数(left ventricular ejection fraction,LVEF)、红细胞分布宽度变异系数(red blood cell distribution width coefficient of variation,RDW-CV)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)较治疗前均得到显著改善(P<0.05),试验组患者的最大公斤摄氧量(VO_(2)/kg max)、无氧阈时摄氧量(AT-VO_(2)/kg)、无氧阈时代谢当量(AT-METs)、最大代谢当量(METs max)、二氧化碳通气当量斜率(VE/VCO_(2)-slope)、最大摄氧量占预计值的百分比(VO_(2) max%pred)、LVEF改善程度显著优于对照组(P<0.05)。两组患者的健康状况调查问卷(MOS item short from health survey,SF-36)各项评分均较治疗前显著提高(P<0.05),而试验组在生理机能、生理职能、一般健康状况、精力、社会功能以及健康变化方面显著优于对照组(P<0.05);两组西雅图心绞痛量表(Seattle angina questionnaire,SAQ)各项评分均较治疗前显著改善(P<0.05),试验组在躯体活动受限程度、治疗满意程度和疾病认知程度方面的改善程度显著优于对照组(P<0.05)。结论:芪参益气滴丸联合常规西药治疗,可改善不宜进行血运重建的气虚血瘀型冠心病患者的CPET相关指标,提高患者的心功能、运动耐量和生活质量水平。
Objective:To observe the effect of Qishen Yiqi Drip Pill on cardiac function,exercise tolerance and quality of life in patients with qi deficiency and blood stasis coronary atherosclerotic heart disease(hereinafter referred to as"coronary heart disease")who are not suitable for revascularization.Methods:A total of 114 patients with coronary heart disease who met the diagnostic criteria and case inclusion and exclusion criteria were randomly divided into the experimental group(62 cases)and the control group(52 cases).The control group was given standardized drug treatment for the secondary prevention of coronary heart disease,and the experimental group was treated with Qishen Yiqi Drip Pill based on the treatment plan of the control group for 3 months.Results:The two groups had cardiopulmonary exercise testing(CPET)related indexes,left ventricular end diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF),The red blood cell distribution width coefficient of variation(RDW-CV)and low density lipoprotein cholesterol(LDL-C)were significantly improved compared with those before treatment(P<0.05),and the maximum kilogram oxygen uptake(VO_(2)/kg max)of patients in the experimental group was significantly improve,and the maximum kilogram oxygen uptake(VO_(2)/kg max)and The improvement of oxygen uptake(AT-VO_(2)/kg),metabolic equivalents at anaerobic threshold(AT-METs),maximum metabolic equivalents(METs max),carbon dioxide ventilation equivalent slope(VE/VCO_(2)-slope),and LVEF at the anaerobic threshold was significantly better than that in the control group(P<0.05).The scores of the MOS item short from health survey(SF-36)were significantly higher than those before treatment(P<0.05),while those in the experimental group were significantly better than those in the control group(P<0.05)in terms of physiological function,physiological function,general health status,energy,social function,and health changes.SAQ was significantly improved compared with that before treatment(P<0.05),the control group had significant improvement in physical activity limitation,treatment satisfaction,and disease cognition(P<0.05),and the experimental group had significantly better improvement in physical activity limitation,treatment satisfaction,and disease cognition than the control group(P<0.05).Conclusion:Qishen Yiqi Drip Pill combined with conventional Western medicine can improve the CPET-related indexes of patients with qi deficiency and blood stasis coronary heart disease who are not suitable for revascularization,and improve the cardiac function,exercise tolerance and quality of life of patients.
作者
高建凯
冯娟
马会华
闫奎坡
吴雷
唐聚花
GAO Jiankai;FENG Juan;MA Huihua;YAN Kuipo;WU Lei;TANG Juhua(The Fifth Clinical Medical College of Henan University of Chinese Medicine/The People′s Hospital of Zhengzhou,Zhengzhou Henan China 450003;Shuqing Medical College of Zhengzhou,Zhengzhou Henan China 450064;Heart Center of The First Affiliated Hospital to Henan University of Chinese Medicine/National Regional(Traditional Chinese Medicine)Cardiovascular Diagnosis and Treatment Center,Zhengzhou Henan China 450000)
出处
《中医学报》
CAS
2024年第7期1551-1560,共10页
Acta Chinese Medicine
基金
河南省中医药临床建设基地专项项目(2022JDZX106)
河南省自然科学基金青年项目(232300421308)
河南省中医药科学研究专项课题项目(2021JDZX2006,20-21ZY1015,2022JDZX128)。
关键词
冠状动脉粥样硬化性心脏病
气虚血瘀证
芪参益气滴丸
心功能
运动耐量
生活质量
coronary atherosclerotic heart disease
Qi deficiency and blood stasis syndrome
Qishen Yiqi Drip Pill
cardiac function
exercise tolerance
quality of life
