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益气活血方与运动康复训练结合西医常规疗法治疗慢性心力衰竭临床研究

Clinical effect of Yiqi-Huoxue decoctions combined with exercise rehabilitation training for the patients with chronic heart failure

摘要:

目的 评价益气活血方与运动康复训练结合西医常规疗法治疗慢性心力衰竭(chronic heart failure,CHF)的疗效.方法 将符合入选标准的120例CHF患者,采用随机数字表法分为2组,每组60例.对照组给予西医常规疗法治疗,治疗组在对照组基础上给予运动康复训练联合益气活血方治疗.2组均连续治疗30 d.采用彩色多普勒超声诊断仪检测左室收缩末期内径(left ventricular end systolic diameter,LVESD)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)及左室射血分数(left ventricular ejection fraction,LVEF);采用ELISA法检测血清基质金属蛋白酶-1(matrix metalloproteinase-1,MMP-1)和基质金属蛋白酶组织抑制剂-1(tissue inhibitor of metalloproteinase 1,TIMP-1);测量收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP),评价临床疗效.结果 治疗组总有效率为93.3%(56/60)、对照组为73.3%(44/60),2组比较差异有统计学意义(χ2=8.640,P=0.003).治疗后,治疗组SBP[(125.17±13.51)mmHg比(140.82±14.63)mmHg,t=6.087]、DBP[(74.36±10.31)mmHg比(86.29±11.17)mmHg,t=6.079]、LVESD[(41.11±3.23)mm比(49.69±4.99)mm,t=11.181]、LVEDD[(57.36±3.28)mm比(64.16±4.05)mm,t=10.107]低于对照组(P<0.01),LVEF[(69.82±5.05)%比(51.40±4.11)%,t=21.913]高于对照组(P<0.01);血清MMP-1水平[(141.52±15.22)μg/L比(164.10±16.18)μg/L,t=7.874]低于对照组(P<0.01),TIMP-1水平[(3.98±0.22)μg/L比(3.51±0.16)μg/L,t=13.383]高于对照组(P<0.01).结论 益气活血方与运动康复训练结合西医常规疗法可明显改善CHF患者的心功能,提高临床疗效.

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abstracts:

Objective To study the clinical effect of Yiqi-Huoxue decoctions combined with exercise rehabilitation training for patients with chronic heart failure and its effect on serum MMP-1, TIMP-1. Methods A total of 120 patients with chronic heart failure in our hospital from February 2016 to January 2017 were enrolled in this study. The subjects were randomly divided into the control group (n=60) and the treatment group (n=60). The control group were treated with conventional treatment, and the treatment group were treated with Yiqi-Huoxue decoctions combined with exercise training. The two groups were treated for 30 days. The clinical effects of the two groups after treatment were compared. The SBP, DBP, LVESD, LVEDD and LVEF of the two groups before and after treatment were compared. The serum MMP-1, TIMP-1 of the two groups before and after treatment were compared. The adverse reaction rates of the two groups during treatment were compared. Results The total effect rate of the treatment group was 93.3% (56/60), significantly higher than 73.3% (44/60)of the control group (χ2=8.640, P=0.003). After treatment, the SBP (125.17 ± 13.51 mmHg vs. 140.82 ± 14.63 mmHg, t=6.087), DBP (74.36 ± 10.31 mmHg vs. 86.29 ± 11.17 mmHg, t=6.079), LVESD (41.11 ± 3.23 mm vs. 49.69 ± 4.99 mm, t=11.181) and LVEDD (57.36 ± 3.28 mm vs. 64.16 ± 4.05 mm, t=10.107) of the treatment group were significantly lower than those of the control group (P<0.05). The LVEF (69.82% ± 5.05% vs. 51.40% ± 4.11%, t=21.913) of the treatment group was significantly higher than the control group (P<0.05). After treatment, the serum MMP-1 (141.52 ± 15.22 μg/L vs. 164.10 ± 16.18 μg/L, t=7.874) of the treatment group were significantly lower than those of the control group (P<0.05), and the serum TIMP-1 (3.98 ± 0.22 μg/L vs. 3.51 ± 0.16 μg/L, t=13.383) of the treatment group were significantly higher than those of the control group (P<0.05). There was no significant differences of the adverse reaction rates of the two groups during treatment (χ2=0.152, P=0.697). Conclusions The Yiqi-Huoxue decoctions combined with exercise rehabilitation training for patients with chronic heart failure showed good efficacy and low incidence of adverse reactions, can significantly improve cardiac function and the cardiac remodeling.

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