世界中医药

目的：研究益气通脉汤对冠心病心力衰竭患者左心室射血分数（LVEF）、用力肺活量（FVC）、第1秒钟用力呼气容积（FEV1）及N端脑钠肽前体（Nt-proBNP）水平的影响。方法:选取2015年2月至2017年2月接受治疗的冠心病心力衰竭患者84例进行回顾性分析。根据就诊时间前后顺序分为观察组与对照组，每组42例。对照组予以常规西药治疗，观察组则在对照组的基础上予以益气通脉汤治疗。分别比较2组临床疗效，治疗前后LVEF、FVC、FEV1以及6 min步行距离，治疗前后血浆Nt-proBNP水平，治疗前后IL-6、TNF-α水平变化情况。结果：观察组治疗总有效率为95.24%（40/42），明显高于对照组的80.95%（34/42），差异有统计学意义（P<0.05）。治疗后观察组LVEF、FVC、FEV1以及6 min步行距离分别为（52.9±7.5）%、（2.6±0.5）L、（1.7±0.3）L、（413.1±67.2）m，均明显高于对照组的（45.3±9.6）%、（2.2±0.3）L、（1.4±0.1）L、（365.4±73.2）m，差异有统计学意义（P<0.05）。治疗后观察组与对照组血浆NT-proBNP水平分别为（478.7±211.4）pg/mL、（783.5±281.5）pg/mL，均明显低于治疗前，而观察组又明显低于对照组，差异均有统计学意义（均P<0.05）。治疗后血清IL-6、TNF-α水平分别为（10.4±2.5）ng/L、（4.5±0.9）mg/L，均明显低于对照组的（17.2±3.3）ng/L、（7.5±1.2）mg/L，差异有统计学意义（P<0.05）。结论：益气通脉汤可有效改善冠心病心力衰竭患者心肺功能，同时有利于降低炎性反应。

English Summary:

To study the effect of Yiqi Tongmai Decoction on left ventricular ejection fraction (LVEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and N terminal pro brain natriuretic peptide (Nt-proBNP) of patients with coronary heart disease. Methods:A retrospective analysis was conducted for 84 cases of patients with coronary heart disease and heart failure from February 2015 to February 2017 in our hospital. According to the time of diagnosis, they were divided into study group and control group, with 42 cases in each group. The control group received conventional western medicine treatment, and the study group was given Yiqi Tongmai Decoction on the basis of that. The clinical curative effect of two groups was compared respectively. LVEF, FVC, FEV1 and 6 min walking distance, plasma levels of Nt-proBNP, IL-6, and the changes of TNF-α level of two groups before and after treatment were compared. Results:The total effective rate of study group was 95.24% (40/42), which was significantly higher than the control group 80.95% (34/42). The difference was statistically significant (P<0.05). LVEF, FVC , FEV1 and 6 min walking distance of the study group of after treatment respectively was (52.9±7.5)% and (2.6±0.5)L, (1.7±0.3)L, (413.1±67.2)m, which were significantly higher than those in control group of (45.3±9.6)% and (2.2±0.3)L, (1.4±0.1)L, (365.4±73.2)m. The differences were statistically significant (P<0.05). After treatment, the plasma levels of NT-proBNP of the study group and the control group were (478.7±211.4) pg/mL, (783.5±281.5) pg/mL respectively, which was significantly lower than before treatment. The study group was significantly lower than the control group. The differences were statistically significant (P<0.05). After treatment, the serum IL-6, TNF-α was (10.4±2.5) ng/L, (4.5±0.9) mg/L, which were significantly lower than the control group (17.2±3.3) ng/L, (7.5±1.2) mg/L. The differences were statistically significant (P<0.05). Conclusion:Yiqi Tongmai Decoction can effectively improve the heart and lung function in patients with coronary heart disease and heart failure, and reduce the inflammatory reaction at the same time.

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