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目的观察加味心喘方治疗糖尿病心肌病(DC)心功能不全的临床疗效及其作用机制。方法将79例糖尿病心肌病心功能不全患者随机分为对照组(39例)和治疗组(40例);两组均予西医常规治疗,治疗组加服加味心喘方治疗,疗程4周。结果治疗后,对照组和治疗组的总有效率分别为71.79%和90.00%;两组临床疗效有显著性差异(P<0.05)。心脏每分钟输出量(CO)、射血分数(EF)、舒张早晚期最大充盈速度比值(E/A)有明显改善(P<0.05,P<0.01),且治疗组改善优于对照组(P<0.05);治疗后两组血浆脑利钠肽(BNP)、C反应蛋白(CRP)水平均明显降低(P<0.01),且治疗组血浆BNP、CRP水平低于对照组(P<0.05,P<0.01)。治疗后治疗组ET、NO均明显改善(P<0.01),对照组仅ET改善明显(P<0.01);治疗后两组ET、NO有统计学差异(P<0.05)。结论加味心喘方可提高糖尿病心肌病心功能不全的临床疗效,其作用机制可能与改善心功能、降低血浆BNP、减轻炎症和调节内皮功能有关。
Objective To observe the clinical effect and mechanism of Jiawei Xinchuan Recipe in treating cardiac dysfunction of diabetic cardiomyopathy (DC). Methods 79 cases of diabetic cardiomyopathy patients with heart failure were randomly divided into control group (39 cases) and treatment group (40 cases). Both groups were treated routinely with Western medicine. The treatment group received Jiawei Xinchuan Decoction for 4 weeks. Results After treatment, the total effective rates of the control group and the treatment group were 71.79% and 90.00%, respectively. The clinical effects of the two groups were significantly different (P <0.05). Cardiac output (CO), ejection fraction (EF) and maximum filling velocity ratio (E / A) in early and late diastole were significantly improved (P <0.05, P <0.01), and the improvement in the treatment group was better than that in the control group (P <0.05). After treatment, the level of BNP and CRP in the two groups were significantly decreased (P <0.01), and the levels of plasma BNP and CRP in the treatment group were lower than those in the control group , P <0.01). After treatment, the ET and NO in the treatment group were significantly improved (P <0.01), while the control group only improved ET (P <0.01). After treatment, the ET and NO levels were significantly different between the two groups (P <0.05). Conclusion Jiawei Xinchuan can improve the clinical efficacy of cardiac dysfunction in diabetic cardiomyopathy. The mechanism may be related to improving cardiac function, decreasing plasma BNP, reducing inflammation and regulating endothelial function.