Abstract:

Objective　To explore the efficacy of the Huangqi Zongqi Formula in treating patients with coronary heart disease combined with heart failure and its impact on vascular endothelial function. Methods　A total of 98 patients with coronary heart disease and heart failure who were admitted to the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from October 2021 to October 2024 were selected as the research subjects. The patients were divided into the traditional Chinese medicine group and the conventional group using the random number table method, with 49 cases in each group. There were 27 males and 22 females in the traditional Chinese medicine group, aged 45-81 (62.10±8.05) years, course of coronary heart disease 4-13(8.43±2.09) years, course of heart failure 1-5 (2.61±0.70) years, New York Heart Association (NYHA) classification: 13 cases at grade Ⅱ, 25 cases at grade Ⅲ, and 11 cases at grade Ⅳ. There were 25 males and 24 females in the conventional group, aged 44-82 (63.20±8.78) years, course of coronary heart disease 3-12 (8.08±1.96) years, course of heart failure 1-5 (2.67±0.66) years, NYHA classification: 15 cases at grade Ⅱ, 24 cases at grade Ⅲ, and 10 cases at grade Ⅳ. The conventional group received conventional Western medical treatment, while the traditional Chinese medicine group was treated with the Huangqi Zongqi Formula in addition to the treatment provided by the conventional group. Both groups were treated continuously for 8 weeks. Compare the clinical efficacy of the two groups; vascular endothelial function (endothelin-1, nitric oxide), cardiac function [left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), B-type natriuretic peptide (BNP)], heart failure symptoms (Lee's heart failure score), and quality of life [Minnesota heart failure quality of life questionnaire (MLHFQ)] before and after treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total effective rate of the traditional Chinese medicine group was higher than that of the conventional group [91.84% (45/49) vs. 73.47% (36/49)] (P<0.05). After treatment, the level of endothelin-1 in the traditional Chinese medicine group was lower than that in the conventional group [(43.98±3.30) ng/L vs. (51.31±3.88) ng/L], and the level of nitric oxide was higher than that in the conventional group [(39.33±2.99) μmol/L vs. (35.15±1.37) μmol/L] (both P<0.05); the LVEF of the traditional Chinese medicine group was higher than that of the conventional group [(58.14±3.57)% vs. (55.06±4.43)%], while the LVESD, LVEDD and BNP levels were all lower in the traditional Chinese medicine group [(46.41±3.96) mm vs. (49.57±2.32) mm, (46.61±3.03) mm vs. (52.92±3.25) mm, (454.36±90.21) ng/L vs. (506.58±76.30) ng/L] (all P<0.05); the Lee's heart failure score and the MLHFQ score in the traditional Chinese medicine group were both lower than those in the conventional group [(7.47±1.60) points vs. (9.29±1.44) points, (38.12±4.60) points vs. (45.27±4.71) points] (both P<0.05). Conclusion　The Huangqi Zongqi Formula combined with other treatments for coronary heart disease complicated with heart failure has a better therapeutic effect. It can improve vascular endothelial function, cardiac function and symptoms of heart failure, and enhance the quality of life.

Key words: Coronary heart disease,  Heart failure,  Huangqi ZongqiFormula,  Vascular endothelial function,  Quality of life

摘要：

目的　探讨黄芪宗气方治疗冠心病合并心力衰竭患者的效果及对血管内皮功能影响。方法　选取2021年10月至2024年10月陕西中医药大学第二附属医院收治的98例冠心病合并心力衰竭患者作为研究对象。采用随机数字表法，将患者分为中医组和常规组，每组49例。中医组男27例，女22例；年龄45～81（62.10±8.05）岁；冠心病病程4～13（8.43±2.09）年；心力衰竭病程1～5（2.61±0.70）年；纽约心脏病协会（NYHA）分级：Ⅱ级13例，Ⅲ级25例，Ⅳ级11例。常规组男25例，女24例；年龄44～82（63.20±8.78）岁；冠心病病程3～12（8.08±1.96）年；心力衰竭病程1～5（2.67±0.66）年；NYHA分级：Ⅱ级15例，Ⅲ级24例，Ⅳ级10例。常规组采用常规西医治疗，中医组在常规组基础上联合黄芪宗气方治疗。两组均连续治疗8周。比较两组临床疗效，治疗前后血管内皮功能（内皮素-1、一氧化氮）、心功能［左心室射血分数（LVEF）、左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、B型利钠肽（BNP）］、心力衰竭症状（Lee氏心力衰竭评分）及生活质量［明尼苏达心力衰竭生活质量问卷（MLHFQ）］。采用独立样本t检验、配对t检验和χ²检验进行统计学分析。结果　中医组治疗总有效率高于常规组［91.84%（45/49）比73.47%（36/49）］（P<0.05）。治疗后，中医组内皮素-1水平低于常规组［（43.98±3.30）ng/L比（51.31±3.88）ng/L］，一氧化氮水平高于常规组［（39.33±2.99）μmol/L比（35.15±1.37）μmol/L］（均P<0.05）；中医组LVEF高于常规组［（58.14±3.57）%比（55.06±4.43）%］，LVESD、LVEDD、BNP水平均低于常规组［（46.41±3.96）mm比（49.57±2.32）mm、（46.61±3.03）mm比（52.92±3.25）mm、（454.36±90.21）ng/L比（506.58±76.30）ng/L］（均P<0.05）；中医组Lee氏心力衰竭评分、MLHFQ评分均低于常规组［（7.47±1.60）分比（9.29±1.44）分、（38.12±4.60）分比（45.27±4.71）分］（均P<0.05）。结论　黄芪宗气方联合治疗冠心病合并心力衰竭效果较好，可改善血管内皮功能、心功能和心力衰竭症状，提高生活质量。

关键词:

冠心病, 心力衰竭, 黄芪宗气方, 血管内皮功能, 生活质量