益气活血方联合沙库巴曲缬沙坦对慢性心衰患者的疗效观察

Effect of Yiqi Huoxue Recipe and Sacubitril Valsartan on Cardiac Related Indicators in Chronic Heart Failure Patients

关键词:  益气活血方  心衰  沙库巴曲缬沙坦  心率变异性  NT-proBNP  MMP-9

Key words:  Yiqi Huoxue recipe  heart failure  sacubitril valsartan  heart rate variability  NT-proBNP  MMP-9

摘要:

目的 观察中药益气活血方配合沙库巴曲缬沙坦在慢性心衰治疗中的疗效及对患者心率变异性指标、血清NT-proBNP、MMP-9水平的影响。方法 将2017年7月-2018年8月期间收治的126例慢性心衰患者随机分为沙库巴曲组（61例）和益气沙库组（65例），沙库巴曲组均给予常规抗慢性心衰基本治疗和沙库巴曲缬沙坦治疗，益气沙库组在沙库巴曲组基础上加以益气活血方治疗，观察2组治疗6个月后的临床疗效、心率变异性指标、血清NT-proBNP、MMP-9及不良反应情况。结果 益气沙库组的临床总有效率显著优于沙库巴曲组（89.23%vs 72.13%）（χ²=5.979，P=0.031）；治疗后，2组心率变异性指标（SDNN、SDANN、pNN50）及NT-proBNP、MMP-9比较均较治疗前改善和降低。益气沙库组治疗后心率变异性指标SDNN、SDANN、pNN50显著高于沙库巴曲组[（129.53±34.26 vs 114.28±31.84）ms、（112.31±36.02 vs 101.44±29.59）ms、（8.71±7.64 vs 6.37±5.80）%]（P<0.05）；益气沙库组治疗后血清NT-proBNP、MMP-9显著低于沙库巴曲组[（207.45±51.71 vs 268.62±74.15）pg·mL^-1、（561.79±64.03 vs 688.19±87.94）pg·mL^-1]（P<0.05）。结论 中药益气活血方配合沙库巴曲缬沙坦在慢性心衰治疗中的疗效显著，该治疗方案可改善患者心率变异性指标、NT-proBNP、MMP-9指标的异常情况。

Abstract:

OBJECTIVE To observe the effect of Chinese herbal medicine Yiqi Huoxue recipe combined with sacubitril valsartan in the treatment of chronic heart failure and its influence on heart rate variability index, serum NT-proBNP and MMP-9 levels. METHODS One hundred and twenty-six patients with chronic heart failure admitted to July 2017 to August 2018 were randomly divided into the Shakuba group(61 cases) and the Yiqishaku group(65 cases). Basic treatment of anti-chronic heart failure and sacubitril valsartan treatment, Yiqishaku group on the basis of Shakuba group on the treatment of Yiqi Huoxue recipe, observed the clinical efficacy of the two groups after 6 months of treatment, heart rate variability index, serum NT-proBNP, MMP-9 and adverse reactions. RESULTS The total effective rate of the Yiqishaku group was significantly better than that of the Shakuba group(89.23% vs 72.13%)(χ²=5.979, P=0.031). After treatment, the two groups of heart rate variability indicators(SDNN, SDANN, pNN50) and NT-proBNP, MMP-9 were better than before treatment. The heart rate variability indicators SDNN, SDANN, and pNN50 were significantly higher in the Yiqishaku group than in the Shakuba group[129.53±34.26 vs 114.28±31.84)ms, (112.31±36.02 vs 101.44±29.59)ms, (8.71±7.64 vs 6.37±5.80)%](P<0.05); Serum NT-proBNP and MMP-9 were significantly lower in the Yiqishaku group than in the Shakuba group[(207.45±51.71 vs 268.62±74.15)pg·mL^-1, (561.79±64.03 vs 688.19±87.94)pg·mL^-1](P<0.05). CONCLUSION The traditional Chinese medicine Yiqi Huoxue recipe combined with sacubitril valsartan has a significant effect in the treatment of chronic heart failure. This treatment can improve the abnormality of heart rate variability index, NT-proBNP and MMP-9.