收稿日期: 2023-12-12
网络出版日期: 2024-07-15
基金资助
深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(LGKCYLWS2020083)
Clinical observation of umbilical moxibustion in treating chronic heart failure with Yang deficiency syndrome of blood stasis and water withdrawal
Received date: 2023-12-12
Online published: 2024-07-15
目的 探讨脐灸治疗阳虚血瘀水停证慢性心力衰竭的临床疗效。 方法 选取2021年1月1日至2022年12月31日在北京中医药大学深圳医院(龙岗)心病科住院的80例辨证为阳虚血瘀水停证的慢性心力衰竭患者作为研究对象,随机分为对照组(40例,完成治疗40例)和观察组(40例,完成治疗40例)。对照组接受标准的药物治疗,而观察组则在药物治疗的基础上增加脐灸治疗。治疗10 d后,对比两组患者治疗前后NT-proBNP、NYHA心功能分级、心脏彩超指标(包括LVEF、LVEDD、LVESD)、明尼苏达生活质量评分、6分钟步行距离、中医证候积分,监测并记录不良反应发生情况。 结果 观察组患者的治疗总有效率高于对照组(χ2 = 3.865,P = 0.049)。两组患者的NYHA心功能分级、NT-proBNP、LVEF、LVEDD、LVESD、6分钟步行距离均较治疗前明显改善,且观察组患者以上指标的改善更显著(P < 0.05)。两组患者的明尼苏达生活质量评分及中医证候积分较治疗前都有所下降,且观察组患者的下降幅度超过了对照组(P < 0.05)。在治疗过程中,两组出现不良反应(如胃肠道反应、低血压、皮肤过敏等),组间比较差异无统计学意义(P > 0.05)。 结论 在药物治疗基础上,加用脐灸治疗阳虚血瘀水停证慢性心力衰竭的疗效优于单纯药物治疗,可改善慢性心力衰竭患者的心功能及生存质量。
蔡小静 , 黄永莲 , 周菲 , 汤献文 . 脐灸治疗阳虚血瘀水停证慢性心力衰竭的疗效[J]. 实用医学杂志, 2024 , 40(14) : 2021 -2026 . DOI: 10.3969/j.issn.1006-5725.2024.14.020
Objective To explore the clinical effect of umbilical moxibustion on chronic heart failure with yang deficiency and blood stasis and water retention syndrome. Methods 80 patients with chronic heart failure who were hospitalized in the Department of Cardiology, Shenzhen Hospital (Longgang), Beijing University of Chinese Medicine from January 1, 2021 to December 31, 2022 were selected as research samples and randomly divided into control group (40 cases, 40 cases completed) and observation group (40 cases, 40 cases completed). The control group received standard drug treatment, while the observation group received umbilical moxibustion treatment on the basis of drug treatment. Ten days after treatment, NT-proBNP, NYHA cardiac function classification, cardiac color Doppler indexes (including LVEF, LVEDD, LVSD), Minnesota quality of life score, 6-minute walking distance and TCM syndrome score were compared between the two groups before and after treatment, and the occurrence of adverse reactions was monitored and recorded. Results The total effective rate in the observation group was higher than that in the control group (χ2 = 3.865, P = 0.049). NYHA cardiac function classification, NT-proBNP, LVEF, LVEDD, LVESD and 6-minute walking distance in both groups were significantly improved compared with those before treatment, and the improvement of the above indexes in the observation group was more significant (P < 0.05). The Minnesota quality of life score and TCM syndrome score of the two groups decreased compared with those before treatment, and the decline of the patients in the observation group exceeded that of the control group (P < 0.05). During the treatment, the two groups had adverse reactions (such as gastrointestinal reaction, hypotension, skin allergy, etc.), and there was no difference between the two groups (P > 0.05). Conclusion On the basis of drug therapy, umbilical moxibustion is better than simple drug therapy in treating chronic heart failure with yang deficiency, blood stasis and water stagnation, which can improve the cardiac function and quality of life of patients with chronic heart failure.
| 1 | 骆骏骞, 邓志文, 黎土娣, 等. 心力衰竭的治疗进展[J]. 实用医学杂志, 2022,38(10):1181-1186. doi:10.3969/j.issn.1006-5725.2022.10.002 |
| 2 | 刘静, 付红, 晋辉, 等. 沙库巴曲缬沙坦联合伊伐布雷定治疗老年左室射血分数降低型心力衰竭的疗效及对左心室重构的影响[J]. 实用医学杂志, 2023,39(20):2651-2657. doi:10.3969/j.issn.1006-5725.2023.20.017 |
| 3 | 鲍如意, 胡铭, 刘建巍, 等. 血管紧张素受体拮抗剂脑啡肽酶抑制剂对心力衰竭患者肾功能的影响[J]. 临床心血管病杂志, 2021,37(8):700-705. |
| 4 | 中华中医药学会慢性心力衰竭中医诊疗指南项目组. 慢性心力衰竭中医诊疗指南(2022年)[J]. 中医杂志, 2023,64(7):743-756. |
| 5 | 徐改萍, 暴银素, 董新刚, 等. 隔药脐灸疗法研究进展[J]. 河南医学研究, 2018,27(3):436-437. doi:10.3969/j.issn.1004-437X.2018.03.023 |
| 6 | 中华心血管病杂志编辑委员会, 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心力衰竭和心肌病杂志, 2018,2(4):196-225. |
| 7 | 郑筱萸. 中药新药临床研究指导原则[M]. 北京:中国医药科技出版社, 2002. |
| 8 | 马丽媛, 王增武, 樊静, 等. 《中国心血管健康与疾病报告2022》要点解读[J]. 中国全科医学, 2023,26(32):3975-3994. doi:10.12114/j.issn.1007-9572.2023.0408 |
| 9 | 蔡美莲, 钟国强. 慢性心力衰竭治疗进展[J]. 中国实用内科杂志, 2023,43(11):944-949. |
| 10 | 何勇强. 中医辨证治疗慢性心力衰竭的研究进展[J]. 邵阳学院学报(自然科学版), 2023,20(4):105-110. |
| 11 | 孟超,杨丹丹. 真武汤联合脐灸疗法对慢性心力衰竭阳虚水泛型患者炎症及氧化应激的影响[J]. 世界中西医结合杂志,2022,17(12):2469-2474. |
| 12 | 邵晓飞. 脐灸疗法联合心宝丸治疗慢性心力衰竭阳虚水泛型效果观察[J]. 实用中医药杂志, 2023,39(10):1938-1940. |
| 13 | 朱静华, 吕洋, 梁明, 等. 芪苈强心胶囊治疗慢性心力衰竭研究进展[J]. 临床军医杂志, 2019,47(10):1137-1138. |
| 14 | ASADI M, TAGHIZADEH S, KAVIANI E, et al. Caspase‐3: Structure, function, and biotechnological aspects [J]. Int J Appl Biotechnol Biochem, 2022, 69(4): 1633-1645. doi:10.1002/bab.2233 |
| 15 | WANG Y Y, CHEN Y H, YANG M, et al. Effects of ginsenoside Rb1 on serum brain natriuretic peptide level and caspase-3 protein expression in cardiomyocytes of rats with chronic heart failure [J]. Pharmacogn Mag, 2021, 17(74): 282. doi:10.4103/pm.pm_561_19 |
| 16 | OBRADOVIC D, ROMMEL K P, BLAZEK S, et al. The potential role of plasma miR‐155 and miR‐206 as circulatory biomarkers in inflammatory cardiomyopathy [J]. Eur J Heart Fail, 2021, 8(3): 1850-1860. doi:10.1002/ehf2.13304 |
| 17 | YANG X, WU Y, ZHANG C,et al. Extraction,structural characterization, and immunoregulatory effect of a polysaccharide fraction from Radix Aconiti Lateralis Preparata (Fuzi)[J]. Int J Biol Macromol, 2020,143: 314-324. doi:10.1016/j.ijbiomac.2019.11.208 |
| 18 | XU X, XIE X F, ZHANG H Q,et al. Water-soluble alkaloids extracted from Aconiti Radix lateralis praeparata protect against chronic heart failure in rats via a calcium signaling pathway[J].Biomed Pharmacother, 2021,135: 111-184. doi:10.1016/j.biopha.2020.111184 |
| 19 | WANG M, HU W J, ZHOU X, et al. Ethnopharmacological use, pharmacology, toxicology, phytochemistry, and progress in Chinese crude drug processing of the lateral root of Aconitum carmichaelii Debeaux. (Fuzi): a review [J]. J Ethnopharmacol, 2023, 301: 115838. doi:10.1016/j.jep.2022.115838 |
| 20 | ZHANG Y R, CHEN S Y, FAN F F, et al. Neurotoxicity mechanism of aconitine in HT22 cells studied by microfluidic chip-mass spectrometry [J]. J Anal Pharm Res, 2023, 13(1):88-98. doi:10.1016/j.jpha.2022.11.007 |
| 21 | LIU J, LI Y, BIAN X,et al. Astragaloside IV alleviates heart failure by regulating SUMO-specific protease 1[J]. Exp Ther Med,2021,22(4): 1076. doi:10.3892/etm.2021.10510 |
| 22 | SHI H, ZHOU P, GAO G,et al. Astragaloside IV prevents acute myocardial infarction by inhibiting the TLR4 /MyD88/NF-kappaB signaling pathway[J]. J Food Biochem, 2021,45(7): e13757. doi:10.1111/jfbc.13757 |
| 23 | ZHANG W, WANG X, LI J,et al. Astragaloside IVReduces OxLDL-Induced BNP Overexpression byRegulating HDAC[J].J Healthc Eng, 2021, 2021: 3433615. doi:10.1155/2021/3433615 |
| 24 | WU Y T, XIE L P, HUA Y, et al. Tanshinone I Inhibits Oxidative Stress-Induced Cardiomyocyte Injury by Modulating NrF2 Signaling [J]. Front Pharmacol, 2021,12:644116. doi:10.3389/fphar.2021.644116 |
| 25 | WANG G, MA L, WANG B, et al. Tanshinone IIA Accomplished Protection against Radiation-Induced Cardiomyocyte Injury by Regulating the p38/p53 Pathway [J]. Mediators Inflamm, 2022,2022:1478181. doi:10.1155/2022/1478181 |
| 26 | XU L, HE D, WU Y, et al. Tanshinone IIA inhibits cardiomyocyte apoptosis and rescues cardiac function during doxorubicin-induced cardiotoxicity by activating the DAXX/MEK/ERK1/2 pathway [J]. Phytomedicine, 2022(107):154471. doi:10.1016/j.phymed.2022.154471 |
| 27 | ZHOU Z Y, SHI W T, ZHANG J,et al. Sodium tanshinone IIA sulfonate protects against hyperhomocysteine-induced vascular endothelial injury via activation of NNMT/SIRT1-mediated NRF2/HO-1 and AKT/MAPKs signaling in human umbilical vascular endothelial cells[J]. Biomed Pharmacother, 2023,158:114137. doi:10.1016/j.biopha.2022.114137 |
| 28 | ZHANG B, YU P, SU E, et al. Sodium Tanshinone IIA Sulfonate Improves Adverse Ventricular Remodeling Post-Mlby Reducin g Myocardial Necrosis, Modulating Inflammation, and Promoting Angiogenesis [J]. Curr Pharm Des, 2022,28(9):751-759. doi:10.2174/1381612828666211224152440 |
| 29 | 李志章, 马俊, 王皓光. 黄芪、葶苈子、防己“强心利水三味”治疗慢性心力衰竭的应用[J]. 中医临床研究, 2023,15(21):65-68. |
| 30 | 李雨濛,吴华芹,张并璇,等. 左室舒张末期内径对慢性心力衰竭患者远期预后的预测价值[J]. 中国循证心血管医学杂志,2022,14(11):1341-1344,1348. doi:10.3969/j.issn.1674-4055.2022.11.12 |
/
| 〈 |
|
〉 |