1.天津中医药大学第一附属医院/中医国家临床医学研究中心,天津市西青区昌凌路88号,300381
2.天津中医药大学
通信作者:jymao@126. com
收稿:2025-08-31,
修回:2025-11-15,
纸质出版:2026-02-17
移动端阅览
王贤良,张静宜,葛昭等.优化新生脉散方对慢性心力衰竭气虚血瘀水饮证患者运动耐量的影响——随机、双盲、安慰剂对照试验[J].中医杂志,2026,67(04):425-431.
WANG Xianliang,ZHANG Jingyi,GE Zhao,et al.Effect of Optimized New Shengmai Powder (优化新生脉散方) on Exercise Tolerance in Patients with Chronic Heart Failure of Qi Deficiency,Blood Stasis and Fluid Retention Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(04):425-431.
王贤良,张静宜,葛昭等.优化新生脉散方对慢性心力衰竭气虚血瘀水饮证患者运动耐量的影响——随机、双盲、安慰剂对照试验[J].中医杂志,2026,67(04):425-431. DOI: 10.13288/j.11-2166/r.2026.04.014.
WANG Xianliang,ZHANG Jingyi,GE Zhao,et al.Effect of Optimized New Shengmai Powder (优化新生脉散方) on Exercise Tolerance in Patients with Chronic Heart Failure of Qi Deficiency,Blood Stasis and Fluid Retention Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(04):425-431. DOI: 10.13288/j.11-2166/r.2026.04.014.
目的
2
评价优化新生脉散方对慢性心力衰竭气虚血瘀水饮证患者运动耐量的影响和安全性。
方法
2
采用随机、双盲、安慰剂对照试验设计,将78例慢性心力衰竭气虚血瘀水饮证患者随机分为治疗组和对照组各39例。治疗组在原西医常规治疗基础上加用优化新生脉散方颗粒剂,对照组同时给予优化新生脉散方安慰剂口服,两组患者均每次服用30.6 g、每日2次,水冲服,共用药4周。主要疗效指标为6分钟步行距离(6MWD)和心肺运动试验峰值摄氧量(Peak VO
2
)。次要疗效指标为纽约心脏病协会(NYHA)心功能分级、血清B型利钠肽(BNP)水平、心功能指标[包括左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]、明尼苏达心力衰竭生活质量量表(MLHFQ)评分及中医四诊信息计分,分别于治疗前后各评价1次。进行安全性指标评价,记录试验期间不良事件发生情况。
结果
2
治疗组和对照组各39例患者符合全分析集(FAS)和安全性数据集(SS)。与本组治疗前比较,治疗组患者治疗后6MWD、心肺运动试验Peak VO
2
均升高,MLHFQ评分、血清BNP水平、中医四诊信息计分均降低,NYHA心功能分级改善(
P
<0.01)。治疗组治疗后6MWD、心肺运动试验Peak VO
2
及其与治疗前差值均高于对照组,MLHFQ评分、血清BNP水平、中医四诊信息计分均低于对照组,NYHA心功能分级改善程度优于对照组(
P
<0.01)。对照组治疗前后各指标比较差异均无统计学意义(
P
>0.05)。治疗组不良事件发生率为5.1%(2/39),对照组为2.6%(1/39),两组间不良事件发生率比较差异无统计学意义(
P
>0.05)。
结论
2
在西医常规治疗基础上加用优化新生脉散方,可进一步提高慢性心力衰竭气虚血瘀水饮证患者运动耐量,改善心功能及生活质量,且安全性良好。
Objective
2
To evaluate the effects and safety of the optimized new
Shengmai Powder
(优化新生脉散方) on exercise tolerance in patients with chronic hea
rt failure (CHF) of
qi
deficiency, blood stasis, and fluid retention syndrome.
Methods
2
A randomized, double-blind, placebo-controlled trial was conducted. A total of 78 CHF patients with
qi
deficiency, blood stasis, and fluid retention syndrome were recruited and randomly assigned to a treatment group (39 cases) and a control group (39 cases). On the basis of conventional western medical therapy, patients in the treatment group additionally received the optimized new
Shengmai Powder
granules, while the control group was given an oral placebo of optimized new
Shengmai Powder
granules. Patients in both groups took 30.6 g each time, twice a day, mixed with water for administration, with a total treatment course of 4 weeks. The primary outcomes were 6-minute walk distance (6MWD) and peak oxygen uptake (Peak VO
2
) measured by cardiopulmonary exercise testing. Secondary outcomes included New York Heart Association (NYHA) functional classification, B-type natriuretic peptide (BNP) levels, cardiac function indexes including left ventricular ejection fraction (LVEF), left ventri-cular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD), Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, and scores of four diagnostic information of traditional Chinese medicine (TCM). All indicators were assessed once before and after treatment respectively. Safety indicators were evaluated, and adverse events during the trial were recorded.
Results
2
All patients in both groups were included in the full ana-lysis set (FAS) and safety set (SS). Compared with baseline, the 6MWD and Peak VO₂ of cardiopulmonary exercise test in the treatment group significantly increased after treatment, while the MLHFQ scores, serum BNP levels and scores of TCM four diagnostic information significantly decreased, and the NYHA cardiac function grade significantly improved (
P
<0.01). After treatment, the 6MWD and Peak VO₂ of cardiopulmonary exercise test, as well as their changes from baseline in the treatment group were higher than those in the control group; the MLHFQ scores, serum BNP levels and scores of TCM four diagnostic information in the treatment group were lower than those in the control group; and the improvement of NYHA cardiac function grade in the treatment group was superior to that in the control group (
P
<0.01). There was no statistically significant differences in all indicators after treatment in the control group (
P
>0.05). The incidence of adverse events was 5.1% (2/39) in the treatment group and 2.6% (1/39) in the control group, with no statistically significant difference between groups (
P
>0.05).
Conclusion
2
On the basis of conventional western medicine treatment, the addition of the optimized new
Shengmai Powder
can further improve exercise tolerance, cardiac function and quality of life in patients with CHF of
qi
deficiency, blood stasis and fluid retention syndrome, and show good safety.
中华医学会心血管病学分会 , 中国医师协会心血管内科医师分会 , 中国医师协会心力衰竭专业委员会 , 等 . 中国心力衰竭诊断和治疗指南2024 [J]. 中华心血管病杂志 , 2024 , 52 ( 3 ): 235 - 275 .
兰晨 , 苏文斌 , 颜霄迪 , 等 . 慢性心力衰竭药物治疗临床研究进展 [J]. 中国医院药学杂志 , 2024 , 44 ( 12 ): 1467 - 1471 .
中国中西医结合学会心血管疾病专业委员会 , 中国医师协会中西医结合医师分会心血管病学专家委员会 . 慢性心力衰竭中西医结合诊疗专家共识 [J]. 中国中西医结合杂志 , 2016 , 36 ( 2 ): 133 - 141 .
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 .
王贤良 , 袁杨 , 毛静远 , 等 . 优化新生脉散方联合西药治疗慢性心力衰竭单病例交叉随机对照研究 [J]. 中医杂志 , 2015 , 56 ( 21 ): 1849 - 1853 .
李中珂 . 优化新生脉散方联合西药治疗慢性心力衰竭的临床效果观察 [J]. 中医临床研究 , 2016 , 8 ( 28 ): 20 - 22 .
吴志贵 . 优化新生脉散方和新生脉散原方在治疗慢性心力衰竭气虚血瘀水饮证中的效果对比 [J]. 现代诊断与治疗 , 2017 , 28 ( 22 ): 4136 - 4137 .
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 , 中华心血管病杂志编辑委员会 , 等 . 中国心力衰竭诊断和治疗指南2018 [J]. 中华心血管病杂志 , 2018 , 46 ( 10 ): 804 - 809 .
The Criteria Committee of the New York Heart Association . Nomenclature and criteria for diagnosis of diseases of the heart and great vessels [M]. 9th ed . Boston : Little, Brown and Company , 1994 : 253 - 256 .
王帅 , 赵志强 , 王贤良 , 等 . 芪参益气滴丸治疗缺血性心力衰竭的多中心、前瞻性队列研究 [J]. 中医杂志 , 2022 , 63 ( 7 ): 635 - 643 .
DOS SANTOS MR , ALVES MNN , JORDÃO CP , et al . Sacubitril/valsartan versus enalapril on exercise capacity in patients with heart failure with reduced ejection fraction: a randomized, double-blind, active-controlled study [J]. Am Heart J , 2021 , 239 : 1 - 10 . doi: 10.1016/j.ahj. 2021.05.005 http://dx.doi.org/10.1016/j.ahj.2021.05.005 .
中华医学会心血管病学分会 , 中国康复医学会心肺预防与康复专业委员会 , 中华心血管病杂志编辑委员会 . 六分钟步行试验临床规范应用中国专家共识 [J]. 中华心血管病杂志 , 2022 , 50 ( 5 ): 432 - 442 .
中华医学会心血管病学分会 , 中国康复医学会心肺预防与康复专业委员会 , 中华心血管病杂志编辑委员会 . 心肺运动试验临床规范应用中国专家共识 [J]. 中华心血管病杂志 , 2022 , 50 ( 10 ): 973 - 986 .
王贤良 , 刘洪伟 , 毛静远 , 等 . 基于中国文化改良明尼苏达心力衰竭生存质量量表的条目筛选 [J]. 中医杂志 , 2016 , 57 ( 1 ): 22 - 24, 31 .
GONG X , HU M , LI M . Relationship of arterial tonometry and exercise in patients with chronic heart failure: a systematic review with meta-analysis and trial sequential analysis [J]. BMC Cardiovasc Disord , 2022 , 22 ( 1 ): 345 .
SHI B , HUANG Y , NI J , et al . Qi Dan Li Xin pill improves chronic heart failure by regulating mTOR/p70S6k-mediated autophagy and inhibiting apoptosis [J]. Sci Rep , 2020 , 10 ( 1 ): 6105 .
PATTI A , MERLO L , AMBROSETTI M , et al . Exercise-based cardiac rehabilitation programs in heart failure patients [J]. Heart Fail Clin , 2021 , 17 ( 2 ): 263 - 271 .
SCRUTINIO D , GUIDA P , PASSANTINO A . Prognostic value of 6-minute walk test in advanced heart failure with reduced ejection fraction [J]. Ame J Cardiol , 2023 , 199 : 37 - 43 . doi: 10.1016/j.amjcard.2023.04.041 http://dx.doi.org/10.1016/j.amjcard.2023.04.041 .
0
浏览量
1
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号