脐灸治疗阳虚血瘀水停证慢性心力衰竭的疗效

doi:10.3969/j.issn.1006-5725.2024.14.020

Abstract

Abstract:

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.

Key words: moxibustion, umbilical moxibustion, Yang deficiency and blood stasis, heart failure, quality of life, cardiac function

CLC Number:

R541.6⁺1

Xiaojing CAI,Yonglian HUANG,Fei ZHOU,Xianwen. TANG. Clinical observation of umbilical moxibustion in treating chronic heart failure with Yang deficiency syndrome of blood stasis and water withdrawal[J]. The Journal of Practical Medicine, 2024, 40(14): 2021-2026.

Figures/Tables 8

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Tab.6

Tab.7

Tab.8

References 30

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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 doi: 10.3969/j.issn.1674-4055.2022.11.12

组别	例数	性别（例）		年龄（x ± s，岁）	病程（x ± s，年）	心功能分级(NYHA分级)（例）
组别	例数	男	女	年龄（x ± s，岁）	病程（x ± s，年）	Ⅲ级	Ⅳ级
对照组	40	23	17	66.03 ± 11.87	4.09 ± 1.70	28	12
观察组	40	21	19	65.65 ± 9. 60	4.01 ± 1.60	24	16
χ²/t值		0.202		3.416	0.426	0.879
P值		0.653		0.877	0.840	0.348

组别	例数	显效	有效	无效	总有效率(%)
对照组	40	19	15	6	85.0
观察组	40	31	8	1	97.5
χ²值					3.865
P值					0.049

组别	例数	NT-proBNP		t值	P值
组别	例数	治疗前	治疗后	t值	P值
对照组	40	7 490.1 ± 1 643.9	2 963.0 ± 2 269.4	-5.471	0.000
观察组	40	7 536.2 ± 1 302.7	1 540.8 ± 1 409.4	-5.511	0.000
t值		-0.077	-3.363
P值		0.939	0.001

组别	LVEF(%)		t值	P值	LVEDD (mm)		t值	P值	LVESD (mm)		t值	P值
组别	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	41.88 ± 4.99	49.63 ± 7.39	-5.40	0.000	61.13 ± 4.03	54.50 ± 4.88	-5.50	0.000	48.20 ± 3.62	41.60 ± 6.26	-5.248	0.000
观察组	41.75 ± 5.39	54.05 ± 6.08	-5.51	0.000	60.23 ± 3.97	51.00 ± 4.90	-5.54	0.000	47.03 ± 4.59	37.10 ± 3.80	-5.522	0.000
t值	-0.290	-2.726			-1.453	-2.723			-1.446	-3.130
P值	0.772	0.006			0.146	0.006			0.148	0.002

组别	生活质量评分（分）		t值	P值	6MWT(m)		t值	P值
组别	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	65.18 ± 7.82	38.10 ± 12.37	-5.51	0.000	184.10 ± 101.20	374.30 ± 168.20	-5.51	0.000
观察组	66.47 ± 7.48	27.18 ± 9.84	-5.52	0.000	182.30 ± 97.54	467.25 ± 102.24	-5.51	0.000
t值	-0.636	-3.998			-0.183	-2.290
P值	0.525	0.000			0.855	0.022

Clinical observation of umbilical moxibustion in treating chronic heart failure with Yang deficiency syndrome of blood stasis and water withdrawal

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 8

References 30

Related Articles 15

Recommended Articles

Metrics

Comments

组别	例数	低血压	恶心	腹泻	腹痛	皮肤过敏	合计
对照组	40	1（2.5）	1（2.5）	1（2.5）	1（2.5）	0	4（10.0）
观察组	40	1（2.5）	0（0）	1（2.5）	0（0）	1（2.5）	3（7.5）
χ²值							0.157
P值							0.692

组别	例数	急性冠脉综合征	心衰再发	心源性死亡	合计
对照组	40	5（12.5）	8（20.0）	2（5.0）	15（37.5）
观察组	40	2（5.0）	4（10.0）	1（2.5）	7（17.5）
χ²值					4.013
P值					0.045

[1]	Ting XU,Wei HUANG,Li YANG,Hao. YU. Tumor endothelial markers1 mediate endothelial cell angiogenesis and heart failure myocardial remodeling via MAPKs pathway [J]. The Journal of Practical Medicine, 2024, 40(6): 780-786.
[2]	Cui JI,Qinying WANG,Lei WANG,Yuan. WANG. Effect of cognitive⁃behavioral intervention under the family⁃based care model on continuing care of patients after aortic dissection surgery [J]. The Journal of Practical Medicine, 2024, 40(4): 566-570.
[3]	Xian WEN,Xianfeng ZENG,Ruiya SU. Efficacy of ivabradine combined with levosimendan in patients with acute myocardial infarction complicated with heart failure [J]. The Journal of Practical Medicine, 2024, 40(2): 242-247.
[4]	Rui WANG,Duo LI,Zhao PENG,Lijun CUI,Xiang ZHANG,Kaili FAN,Wenyan. WU. Effect of endoscopic tumor resection by submucosal tunnel on recurrence in patients with submucosal tumors around cardia [J]. The Journal of Practical Medicine, 2024, 40(18): 2555-2560.
[5]	Yalin YANG,Yang HU,Yunhong WEI,Jie DENG,Yu. WANG. Application value and progress of heart rate recovery in indication of cardiovascular diseases [J]. The Journal of Practical Medicine, 2024, 40(18): 2660-2664.
[6]	Yihuan CHEN,Zhenya SHEN,Yunsheng YU,Haoyue HUANG,Wenxue YE,Fei HUA,Yanqiu. HU. Observation on the effects and complications of mitral valve membrane replacement surgery with preservation of mitral valve subvalvular structure on cardiac function and valve function [J]. The Journal of Practical Medicine, 2024, 40(15): 2092-2097.
[7]	Wenjuan TANG,Huanhuan JIA,Yaonan DU,Meirong WU. Analysis of the functional improvement effect of acupuncture with the three yang meridians of the hand as the main acupuncture， governor vessel moxibustion， and translucent medicine moxibustion therapy on cervical spondylosis of wind⁃cold obstruction type [J]. The Journal of Practical Medicine, 2024, 40(12): 1744-1748.
[8]	Yanqing MAO,Ya′nan WANG,Jie. LI. The clinical symptoms， quality of life and laboratory indexes of newly diagnosed chronic obstructive pulmonary disease with hypertension [J]. The Journal of Practical Medicine, 2024, 40(11): 1549-1553.
[9]	AIZEZI Zu⁃ lifeiye, APAER Shadike, CAO Xinling, WANG Ying, TUXUN Tuerhongjiang, LI Tao, YANG Yuanyuan.. Effects of laparoscopic sleeve gastrectomy on weight loss and quality of life in obese patients [J]. The Journal of Practical Medicine, 2023, 39(7): 875-874.
[10]	Bin WANG,Dan HU,Fangfang. WANG. Relationships of serum uric acid and brain natriuretic peptide levels with structural remodeling of atrial fibrillation in patients with heart failure with preserved ejection fraction [J]. The Journal of Practical Medicine, 2023, 39(20): 2633-2637.
[11]	Jing LIU,Hong FU,Hui JIN,Zhongming WANG,Hui ZENG,Fengjie HAN,Xiaoyang HANG,Qingqing ZHOU,Yanxia ZHU,Haijun. ZHENG. Clinical effect of sacubatrol valsartan combined with ivabradine in the treatment of elderly patients with chronic heart failure and the impact on cardiac remodeling [J]. The Journal of Practical Medicine, 2023, 39(20): 2651-2658.
[12]	WANG Xiaolu, YIN Zongsheng, LIU Yiming, MA Li, YU Xianshun.. Analysis of the curative effect and changes of spinopelvic parameters after multilevel lumbosacral fusion [J]. The Journal of Practical Medicine, 2023, 39(2): 224-229.
[13]	Hua PAN,Minshang ZHANG,Xu WANG,Dandan. JIANG. Effect of Qi Chang Xue Xing Tang retention enema combined with heat sensitive moxibustion on gastrointestinal function and immune function of patients after radical gastrectomy [J]. The Journal of Practical Medicine, 2023, 39(16): 2130-2135.
[14]	ZHANG Kaitai, DING Minggang, ZHOU Jingxiang, FANG Chongtao, ZHANG Tingting. . A clinical observation on modified Sijunzi decoction for heart failure with reduced ejection fraction of Qi deficiency and blood stasis syndrome [J]. The Journal of Practical Medicine, 2023, 39(15): 1982-1986.
[15]	WU Jun, CUI Weiyan, LI Ping, ZHANG Qingfeng, OU Yuezhen. . Life′s Simple 7 intervention to alleviate chemotherapy⁃related cardiovascular system damage in HER2 posi⁃ tive patients with breast cancer [J]. The Journal of Practical Medicine, 2023, 39(13): 1647-1651.