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目的：观察苓桂术甘汤加减联合托拉塞米治疗心力衰竭的临床疗效及其对患者胰岛素样生长因子Ⅰ（IGF-Ⅰ）、黏结蛋白聚糖4(syndecan-4)、半乳糖凝集素-3(Gal-3)水平的影响。方法：选取心力衰竭患者152例，依据随机数字表法分为对照组和观察组各76例。对照组给予托拉塞米治疗，观察组在对照组基础上给予苓桂术甘汤加减治疗，两组均治疗4周。治疗前及治疗2周、4周后检测两组血清IGF-Ⅰ、syndecan-4、Gal-3、氨基末端脑钠肽前体（NTpro-BNP）、肌酸激酶同工酶（CK-MB）及超声心动图心功能水平，评估生活质量、生活能力及中医证候积分，评价临床疗效。结果：与治疗前比较，治疗2周、4周后两组血清syndecan-4、Gal-3、NTpro-BNP、CK-MB水平及左心房前后径（LAD）、日常生活活动（ADL）评分、明尼苏达心力衰竭生活质量（MLHFQ）评分、中医证候积分均降低（P<0.05），且观察组均低于对照组（P<0.05）；血清IGF-Ⅰ水平、每搏输出量、左室射血分数（LVEF）均升高（P<0.05），且观察组均高于对照组（P<0.05）；两组以上各观察指标治疗2周后与4周后组内比较，差异均有统计学意义（P<0.05）；治疗结束后观察组总有效率96.05%，对照组85.53%，两组疗效比较，差异有统计学意义（P<0.05）。结论：苓桂术甘汤加减联合托拉塞米能够改善心力衰竭患者IGF-Ⅰ、syndecan-4、Gal-3水平，有效缓解临床症状，提高心功能。
Abstract：Objective:To explore the clinical effect of Linggui Zhugan Decoction（苓桂术甘汤） combined with torasemide on the levels of insulin-like growth factor-I(IGF-I),syndecan-4,and galactose lectin-3(Gal-3) in patients with heart failure. Methods:One hundred and fifty two patients with heart failure were included and randomly divided into control group and observation group,76 patients in each group. The control group was treated with torasemide,and the observation group was treated with modified Linggui Zhugan Decoction besides torasemide. Both groups were treated for 4 weeks. The serum levels of IGF-Ⅰ,syndecan-4,Gal-3,N-terminal pro-brain natriuretic peptid(NTpro-BNP)and creatine kinase-MB(CK-MB) were detected,echocardiography was conducted to evaluate cardiac function,and quality of life,activities of daily living(ADL) score,traditional Chinese medicine(TCM) syndrome score were evaluated before treatment and 2 and 4 weeks after treatment to determine the clinical effectiveness.Results:After 2 and 4 weeks of treatment,the serum levels of syndecan-4,Gal-3,NTpro-BNP,CK-MB,left artrial diameter(LAD),ADL score,TCM syndrome score and Minnesota living with heart failure questionnaire(MLHFQ) score decreased compared with before treatment,and they were lower in the observation group than those in the control group(P<0.05). The serum levels of IGF-I,stroke volume and left ventricular ejection fraction(LVEF) increased compared with before treatment,and they were higher in the observation group than those in the control group(P<0.05). The differences between 2 weeks after treatment and 4 weeks after treatment in both groups on the observed indexes were statistically significant(P<0.05). The total effective rate in observation group was 96.05% and that in the control group was 85.53% after the treatment.The difference between both groups on the curative effect was statistically significant(P<0.05). Conclusion:Modified Linggui Zhugan Decoction combined with torasemide could improve the levels of IGF-I,syndecan-4 and Gal-3 in patients with heart failure,effectively relieve the clinical symptoms and improve the cardiac function.
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基本信息:
DOI：10.16295/j.cnki.0257-358x.2022.03.006
中图分类号:R541.6
引用信息:
[1]任欣,申思,易琼,等.苓桂术甘汤加减联合托拉塞米治疗心力衰竭临床研究[J],2022,41(03):270-275.DOI:10.16295/j.cnki.0257-358x.2022.03.006.
基金信息:
湖南省中医药科研计划项目（编号：2019378