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益气化浊利水方联合别嘌醇治疗慢性心力衰竭合并高尿酸血症的临床效果研究OACSTPCD

Clinical Effect of Yiqi Huazhuo Lishui Formula Combined with Allopurinol in the Treatment of Chronic Heart Failure Complicated with Hyperurice-mia

中文摘要英文摘要

目的 探讨益气化浊利水方联合别嘌醇治疗慢性心力衰竭(CHF)合并高尿酸血症的效果.方法 以随机数字表法将2021 年8 月—2023 年8 月就诊的105 例CHF合并高尿酸血症分为 3 组,每组 35 例.3 组均给予常规治疗,在此基础上,中药组给予益气化浊利水方治疗,别嘌醇组给予别嘌醇治疗,联合组给予益气化浊利水方联合别嘌醇治疗,均治疗 3 个月.比较 3 组临床疗效、血清尿酸、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、血栓素B2(TXB2)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-proBNP)、6 min步行距离、一氧化氮(NO)、内皮素(ET)、降钙素基因相关肽(CGRP)及不良反应.结果 联合组总有效率 94.29%(33/35)高于中药组 74.29%(26/35)、别嘌醇组 71.43%(25/35)(P<0.05),但中药组与别嘌醇组比较,无显著差异(P>0.05).治疗后联合组LVESD、LVEDD、NT-proBNP、hs-CRP、TXB2、TNF-α、ET、IL-6 低于中药组、别嘌醇组,6 min步行距离大于中药组、别嘌醇组,LVEF、NO、CGRP高于中药组、别嘌醇组(P<0.05),但中药组与别嘌醇组比较,无显著差异(P>0.05);治疗后血清尿酸联合组低于别嘌醇组低于中药组(P<0.05);3 组不良反应总发生率比较,无显著差异(P>0.05).结论 益气化浊利水方联合别嘌醇对CHF合并高尿酸血症患者疗效可靠,可调节血清尿酸、炎性因子及NT-proBNP水平,改善血管内皮功能,促进心功能恢复,增强运动能力,且安全性高.

Objective To investigate the effect of Yiqi Huazhuo Lishui formula combined with Allopurinol in the treatment of chronic heart failure(CHF)complicated with hyperuricemia.Methods A total of 105 patients with CHF and hyperuricemia who were treated from August 2021 to August 2023 were divided into three groups using the random number ta-ble method,with 35 patients in each group.All three groups received conventional treatment,and on this basis,the tradition-al Chinese medicine(TCM)group was treated with Yiqi Huazhuo Lishui formula,the Allopurinol group was treated with Allo-purinol,and the combination group was treated with Yiqi Huazhuo Lishui formula combined with Allopurinol.All groups were treated for 3 months.The clinical efficacy,serum uric acid,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),thromboxane B2(TXB2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),N-terminal pro-brain natriuretic pep-tide(NT-proBNP),6-minute walking distance,nitric oxide(NO),endothelin(ET),calcitonin gene-related peptide(CGRP),and adverse reactions were compared among the three groups.Results The total effective rate of the combination group was94.29%(33/35),which was higher than that of the TCM group(74.29%,26/35)and the Allopurinol group(71.43%,25/35)(P<0.05),but there was no significant difference between the TCM group and the Allopurinol group(P>0.05).After treatment,the combination group had lower LVESD,LVEDD,NT-proBNP,hs-CRP,TXB2,TNF-α,ET,and IL-6 than the TCM group and the Allopurinol group,and a longer 6-minute walking distance than the TCM group and the Allopurinol group,and the LVEF,NO,and CGRP were higher than those of the TCM group and the Allopurinol group(P<0.05);however,there was no significant difference between the TCM group and the Allopurinol group(P>0.05).After treatment,the serum uric acid level was the lowest in the combination group,followed by the Allopurinol group and the TCM group(P<0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion The efficacy of the Yiqi Huazhuo Lishui formula combined with Allopurinol in the treatment of CHF pa-tients with hyperuricemia is reliable.It can regulate serum uric acid,inflammatory factors,and NT-proBNP levels,improve vascular endothelial function,promote cardiac function recovery,enhance exercise ability,and is highly safe.

陈启玲;孙恺;庹婧

641000 四川 内江,内江市中医医院心血液病科

临床医学

慢性心力衰竭高尿酸血症别嘌醇益气化浊利水方肿瘤坏死因子-α一氧化氮内皮素左心室射血分数

Chronic heart failureHyperuricemiaAllopurinolYiqi Huazhuo Lishui formulaTumor necrosis fac-tor-αNitric oxideEndothelinLeft ventricular ejection fraction

《临床误诊误治》 2024 (008)

81-87,94 / 8

四川省中医药管理局科学技术研究专项课题(2020LC0155)

10.3969/j.issn.1002-3429.2024.08.016

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