加减天麻钩藤饮合芪苈强心胶囊联合呋塞米治疗高血压合并慢性心力衰竭患者疗效及对神经内分泌因子与心室重构的影响

The therapeutic effect of Modified Tianma Gouteng Yin combined with Qili Qiangxin Capsules and furosemide on hypertensive patients with chronic heart failure and its impact on neuroendocrine factors and ventricular remodelling

关键词:  加减天麻钩藤饮  芪苈强心胶囊  呋塞米  高血压合并慢性心力衰竭  神经内分泌因子  心室重构

Key words:  Modified Tianma Gouteng Yin  Qipli Qiangxin Capsules  furosemide  hypertension combined with chronic heart failure  neuroendocrine factors  ventricular remodeling

摘要:

[目的] 探究加减天麻钩藤饮合芪苈强心胶囊联合呋塞米治疗高血压合并慢性心力衰竭患者疗效及对神经内分泌因子与心室重构的影响。[方法] 前瞻性选取2022年1月—2024年1月在陕西中医药大学附属医院治疗的高血压合并慢性心力衰竭患者120例，随机数字表法分为对照组和试验组各60 例。对照组使用呋塞米治疗，试验组使用加减天麻钩藤饮合芪苈强心胶囊联合呋塞米治疗。观察两组疗效及不良反应发生情况，比较两组患者的中医症状评分、6 min步行距离（6MWT）、肌钙蛋白I（cTnI）、血压、心率、神经内分泌因子[血管紧张素Ⅱ（AngⅡ）、N末端脑钠肽前体（NT-proBNP）、醛固酮（ALD）]、心功能[左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）]水平变化。[结果] 治疗后，两组患者的中医症状评分、血压、心率、cTnI、LVEDD、LVESD、AngⅡ、NT-proBNP、ALD水平均降低，而6MWT、LVEF水平增加（P<0.05）。试验组的中医症状评分、血压、心率、cTnI、LVEDD、LVESD、AngⅡ、NT-proBNP、ALD水平低于对照组，而6MWT、LVEF水平高于对照组，两组比较，差异有统计学意义（P<0.05）。试验组的总有效率高于对照组（P<0.05），而两组不良反应比较，差异无统计学意义（P>0.05）。[结论] 加减天麻钩藤饮合芪苈强心胶囊联合呋塞米治疗高血压合并慢性心力衰竭患者疗效显著，或可通过调节患者神经内分泌功能，改善血压心率，缓解心室重构。

Abstract:

[Objective] To investigate the therapeutic effect of Modified Tianma Gouteng Yin combined with Qiqiangxin Capsules and furosemide on patients with hypertension and chronic heart failure，and its impact on neuroendocrine factors and ventricular remodeling. [Methods] A total of 120 patients with hypertension and chronic heart failure treated in the Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2022 to January 2024 were prospectively selected and the random number table method was divided into a control group and an experimental group，with 60 patients in each group. The control group was treated with furosemide，while the experimental group was treated with Modified Tianma Gouteng Yin combined with Qili Qiangxin Capsules and furosemide. Observe the efficacy and incidence of adverse reactions between two groups of patients，and compare the changes in traditional Chinese medicine symptom scores，6-minute walking distance（6MWT），cardiac troponin I（cTnI），blood pressure，heart rate，neuroendocrine factors [angiotensin Ⅱ（Ang Ⅱ），N-terminal pro brain natriuretic peptide（NT-proBNP），aldosterone（ALD）]，and cardiac function [left ventricular ejection fraction（LVEF），left ventricular end diastolic diameter（LVEDD），and left ventricular end systolic diameter（LVESD）] levels between the two groups of patients. [Results] After treatment，the traditional Chinese medicine symptom scores，blood pressure，heart rate，cTnI，LVEDD，LVESD，Ang Ⅱ，NT-proBNP，and ALD levels of both groups of patients decreased，while 6MWT and LVEF levels increased（P<0.05）. The traditional Chinese medicine symptom scores，blood pressure，heart rate，cTnI，LVEDD，LVESD，Ang Ⅱ，NT-proBNP，and ALD levels in the experimental group were lower than those in the control group，while the 6MWT and LVEF levels were higher than those in the control group，with significant differences between the two groups（P<0.05）. The total effective rate of the experimental group was higher than that of the control group（P<0.05），while there was no statistically significant difference in adverse reactions between the two groups（P>0.05）. [Conclusion] The combination of Modified Tianma Gouteng Yin and Qili Qiangxin Capsules with furosemide has significant therapeutic effects on patients with hypertension and chronic heart failure. It may be possible to improve blood pressure and heart rate，and alleviate ventricular remodeling by regulating the patient’s neuroendocrine function.