Treatment of Chronic Ischemic Heart Failure with <italic style="font-style: italic">Qi</italic> Deficiency and Blood Stasis Pattern by <italic style="font-style: italic">Xiefei Lishui Mixture</italic> （泻肺利水合剂） Combined with Western Medicine Routine Therapy： A Real-world Multicenter Cohort Study

Xiaolei LAI; Juju SHANG; Hongxu LIU; Tong TONG; Wenlong XING; Heng LI

doi:10.13288/j.11-2166/r.2022.06.010

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Treatment of Chronic Ischemic Heart Failure with Qi Deficiency and Blood Stasis Pattern by Xiefei Lishui Mixture （泻肺利水合剂） Combined with Western Medicine Routine Therapy： A Real-world Multicenter Cohort Study

更新时间：2022-04-12

- Treatment of Chronic Ischemic Heart Failure with Qi Deficiency and Blood Stasis Pattern by Xiefei Lishui Mixture （泻肺利水合剂） Combined with Western Medicine Routine Therapy： A Real-world Multicenter Cohort Study
- Journal of Traditional Chinese Medicine Vol. 63, Issue 6, Pages: 544-550(2022)
- 作者机构：
  
  首都医科大学附属北京中医医院，北京市东城区美术馆后街23号， 100010
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2022.06.010
  CLC：
- Received：20 July 2021，
  
  Revised：2021-11-25，
  
  Published：17 March 2022
- 稿件说明：
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来晓磊,尚菊菊,刘红旭等.泻肺利水合剂联合西医常规方法治疗慢性缺血性心力衰竭气虚血瘀证疗效的真实世界、多中心、队列研究[J].中医杂志,2022,63(06):544-550.

LAI Xiaolei,SHANG Juju,LIU Hongxu,et al.Treatment of Chronic Ischemic Heart Failure with Qi Deficiency and Blood Stasis Pattern by Xiefei Lishui Mixture （泻肺利水合剂） Combined with Western Medicine Routine Therapy： A Real-world Multicenter Cohort Study[J].Journal of Traditional Chinese Medicine,2022,63(06):544-550.
来晓磊,尚菊菊,刘红旭等.泻肺利水合剂联合西医常规方法治疗慢性缺血性心力衰竭气虚血瘀证疗效的真实世界、多中心、队列研究[J].中医杂志,2022,63(06):544-550. DOI： 10.13288/j.11-2166/r.2022.06.010.

LAI Xiaolei,SHANG Juju,LIU Hongxu,et al.Treatment of Chronic Ischemic Heart Failure with Qi Deficiency and Blood Stasis Pattern by Xiefei Lishui Mixture （泻肺利水合剂） Combined with Western Medicine Routine Therapy： A Real-world Multicenter Cohort Study[J].Journal of Traditional Chinese Medicine,2022,63(06):544-550. DOI： 10.13288/j.11-2166/r.2022.06.010.

摘要

目的

探讨泻肺利水合剂联合西医常规方法治疗慢性缺血性心力衰竭气虚血瘀证的临床疗效。

方法

纳入8家协作医院因慢性缺血性心力衰竭气虚血瘀证住院患者，依据患者意愿分为泻肺利水合剂组73例及辨证施治组72例。所有患者均给予西医规范化治疗，在此基础上泻肺利水合剂组给予泻肺利水合剂，辨证施治组由临床应诊医师根据个人经验依辨证施治原则处方。两组患者均每日1剂口服，疗程（14±3）天。治疗前后比较患者血清N端脑钠肽前体（NT-proBNP）水平、NT-proBNP下降幅度、临床症状积分（包括喘息、气短、神疲乏力、肢体浮肿、小便短少）、心功能［包括左室舒张末期内径（LVEDD）、左室射血分数（LVEF）］、6分钟步行距离，记录患者治疗期间不良反应；治疗结束30天及180天随访记录主要心血管不良事件（MACE）发生情况。

结果

两组治疗后NT-proBNP水平均较本组治疗前下降，治疗后泻肺利水合剂组NT-proBNP水平低于辨证施治组，泻肺利水合剂组NT-proBNP下降（1920±1115.49）pg/ml，大于辨证施治组的下降值（1273±120.81）pg/ml（

＜0.05）。治疗后泻肺利水合剂组LVEDD水平较治疗前下降，LVEF水平较治疗前上升（

＜0.05）。两组患者6分钟步行试验距离均较治疗前增加、各项临床症状积分均较治疗前下降，且泻肺利水合剂组6分钟步行距离大于辨证施治组，气短、肢体浮肿、小便短少症状积分低于辨证施治组（

＜0.05）。治疗后结束30天及180天随访时两组MACE发生情况差异无统计学意义（

＞0.05）。两组均未见明显不良反应。

结论

在联合西医常规疗法基础上，泻肺利水合剂较常规中药辨证治疗可以更好地降低慢性缺血性心力衰竭气虚血瘀证患者血清NT-proBNP水平、改善患者临床症状与心功能、延长6分钟步行距离，且安全性好。

Abstract

Objective

To analyze the clinical effect on chronic ischemic heart failure （CIHF） with

deficiency and blood stasis pattern treated by

Xiefei Lishui Mixture

（泻肺利水合剂， XLM） combined with western medicine routine therapy.

Methods

Hospitalized CIHF patients with

deficiency and blood stasis pattern in eight collaborative hospitals were included， and they were divided into XLM group and control group according to the patients' willingness. All the patients received routine western medicine. Additionally， patients in XLM group were administered with XLM， while those in the control group received syndrome-differentiated prescriptions based on clinicians' experience. The prescriptions in both groups were orally administered， one dose daily， and the course was 14±3 days. The N-terminal pro-brain natriuretic peptide （NT-proBNP） level in serum， the decline of NT-proBNP， scores of clinical symptoms including wheezing， shortness of breath， fatigue， limb edema and shortness of urine， cardiac function indicators left ventricular end-diastolic diameter （LVEDD） and left ventricular ejection fraction （LVEF）， and 6-minute walking distance （6WMD） were assessed before and after treatment， and the adverse reactions were recorded. The occurrence of major adverse cardiovascular events （MACE） were recorded 30 days and 180 days after treatment.

Results

The NT-proBNP level in both groups decreased after treatment， and it was lower in XLM group as more decrease was found in XLM group （1920±1115.49 pg/ml） than in the control group （1273±120.81 pg/ml，

＜0.05）. The LVEDD level in XLM group decreased， while the LVEF level increased after treatment （

＜0.05）. The 6MWD of the two groups were higher than those before treatment， and the clinical symptoms scores were lower. Moreover， more increase of 6MWD， as well as more decreases of clinical symptoms scores regarding shortness of breath， limb edema， and shortness of urine were found in XLM group than in the control group （

＜0.05）. There was no significant difference between groups in the occurrence of MACE at follow-up of 30 days and 180 days after treatment （

＞0.05）. There were no obvious adverse reactions in both groups.

Conclusion

XLM combined with routine western medicine can better reduce the NT-proBNP level， improve the clinical symptoms and cardiac function， and prolong the 6MWD in CIHF patients with

deficiency and blood stasis pattern when compared to the differentiated prescriptions combined with western medicine， and is safe.

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references

张健，张宇辉 . 中国心力衰竭诊断和治疗指南2014 ［J］. 中华心血管病杂志， 2014 ， 42 （ 2 ）： 98 - 122 .

胡盛寿，高润霖，刘力生，等 . 《中国心血管病报告2018》概要［J］. 中国循环杂志， 2019 ， 34 （ 3 ）： 209 - 220 .

ZHOU M ， WANG H ， ZHU J ， et al . Cause-specific mortality for 240 causes in China during 1990-2013： a systematic subnational analysis for the global burden of disease study 2013 ［J］. Lancet ， 2016 ， 387 （ 10015 ）： 251 - 272 .

JIANG L ， KRUMHOLZ HM ， LI X ， et al . Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system ［J］. Lancet ， 2015 ， 386 （ 10002 ）： 1493 - 1505 .

许心如，魏执真，许信国，等 . 心衰合剂治疗充血性心力衰竭30例临床观察［J］. 中医杂志， 1983 ， 24 （ 11 ）： 25 - 26 .

杨雪卿，王巍，周琦 . 心衰合剂对射血分数保留心力衰竭病人生存质量的影响［J］. 中西医结合心脑血管病杂志， 2019 ， 17 （ 4 ）： 581 - 583 .

仇盛蕾，戴梅，时莉晓，等 . 泻肺利水法对冠心病心力衰竭患者心衰超声指数的影响［J］. 世界中医药， 2018 ， 13 （ 8 ）： 1833 - 1836 .

顾晶，王巍，周琦 . 心衰合剂对慢性心力衰竭患者生活质量及用药安全性分析［J］. 河北医药， 2020 ， 42 （ 14 ）： 2195 - 2197 .

王巍，杨雪卿，周琦 . 泻肺利水合剂治疗气虚水饮内停型心衰患者疗效评价研究［J］. 北京中医药， 2019 ， 38 （ 2 ）： 157 - 160 .

尚菊菊，林谦，张冬梅，等 . 心衰合剂对慢性心力衰竭患者作用的临床观察［J］. 世界中西医结合杂志， 2012 ， 7 （ 9 ）： 768 - 771 .

仇盛蕾，金玫，刘红旭，等 . 心衰合剂对冠心病心力衰竭患者生活质量的影响［J］. 中国中医基础医学杂志， 2014 ， 20 （ 5 ）： 683 - 685 .

陆再英，钟南山 . 内科学［M］. 7 版. 北京：人民卫生出版社，2010： 169 - 170 .

中华医学会心血管病专业组 . 缺血性心脏病的命名及诊断标准［J］. 广东医学， 1982 ， 3 （ 9 ）： 33 - 34 .

中华人民共和国国家技术监督局 . 中医临床诊疗术语：证候部分［M］. 北京：中国标准出版社， 1997 ： 13 .

刘建平 . 临床试验样本含量的计算［J］. 中国中西医结合杂志， 2003 ， 23 （ 7 ）： 536 - 538 .

郑筱萸 . 中药新药临床研究指导原则（试行）［M］. 北京：中国医药科技出版社， 2002 ： 77 - 85 .

王新房 . 超声心动图学［M］. 4版 . 北京：人民卫生出版社， 2009 ： 228 - 231 .

GUYATT GH ， SULLIVAN MJ ， THOMPSON PJ ， et al . The 6-minute walk： a new measure of exercise capacity in patients with chronic heart failure ［J］. Can Med Assoc J ， 1985 ， 132 （ 8 ）： 919 - 923 .

KUCH M ， JANISZEWSKI M ， MAMCARZ A ， et al . Major adverse cardiac event predictors in survivors of myocardial infarction with asymptomatic left ventricular dysfunction or chronic heart failure ［J］. Med Sci Monit ， 2009 ， 15 （ 6 ）： PH40 - PH48 .

DI LORENZO E ， SAURO R ， CAPASSO M ， et al . Long-term results of the randomized comparison of everolimus-eluting stents and sirolimus-eluting stent in patients with ST elevation myocardial infarction （RACES-MI trial）［J］. Int J Cardiol ， 2016 ， 202 （ 1 ）： 177 - 182 .

佟彤，尚菊菊，陈嘉兴，等 . 泻肺利水法对心力衰竭患者血清中NT-proBNP及GDF-15水平的影响［J］. 现代中医临床， 2015 ， 22 （ 6 ）： 33 - 34 .

陈少军，张宁，孙久林，等 . 泻肺利水法治疗慢性心力衰竭袢利尿剂抵抗的临床研究［J］. 北京中医药， 2016 ， 35 （ 7 ）： 653 - 655，659 .

戴梅，温庆祥，何俊仁，等 . 心衰合剂对心肌梗死后心力衰竭大鼠的影响［J］. 中国中医药信息杂志， 2006 ， 13 （ 12 ）： 28 - 29 .

佟彤，尚菊菊，刘红旭，等 . 心衰合剂对大鼠心肌细胞肥大模型内质网应激因子Grp78、Caspase-12表达的影响［J］. 北京中医药， 2015 ， 34 （ 3 ）： 173 - 175 .

周明学，李悦，李思耐，等 . 泻肺利水方对维拉帕米诱导的心力衰竭模型斑马鱼心脏功能的影响［J］. 中医杂志， 2021 ， 62 （ 10 ）： 904 - 907 .

HUNT PJ ， RICHARDS AM ， NICHOLLS MG ， et al . Immunoreactive amino-terminal pro-brain natriuretic peptide （NT-PROBNP）： a new marker of cardiac impairment ［J］. Clin Endocrinol （Oxf）， 1997 ， 47 （ 3 ）： 287 - 296 .

HOBBS FD ， DAVIS RC ， ROALFE AK ， et al . Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure： cohort study in representative and high risk community populations ［J］. BMJ ， 2002 ， 324 （ 7352 ）： 1498 - 1502 .

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Treatment of Chronic Ischemic Heart Failure with Qi Deficiency and Blood Stasis Pattern by Xiefei Lishui Mixture （泻肺利水合剂） Combined with Western Medicine Routine Therapy： A Real-world Multicenter Cohort Study

DOI：10.13288/j.11-2166/r.2022.06.010

摘要

Abstract

关键词

Keywords

references