加味苓桂术甘汤对阳虚水停证慢性心力衰竭患者TGF-β1、TNF-α、NT-proBNP及心室重构的影响

Effects of Modified Linggui Zhugan Decoction on TGF-β1,TNF-α,NT-proBNP and Ventricular Remodeling in Patients with Chronic Heart Failure of Yang Deficiency and Water Stagnation Syndrome

目的探究加味苓桂术甘汤对阳虚水停证慢性心力衰竭患者TGF-β1、TNF-α、NT-proBNP及心室重构的影响。方法将2017年12月至2020年11月六安市中医院收治的98例阳虚水停证慢性心力衰竭患者纳入本研究,随机分为两组,各49例。对照组行西医常规治疗,观察组在此基础上行加味苓桂术甘汤口服治疗,治疗6个月后检测心功能,血清肿瘤坏死因子(tumor necrosis factor,TNF)-α、转化生长因子(transforming growth factor,TGF)-β1、同型半胱氨酸(homocysteine,Hcy)、氨基末端脑钠素原(amminoterminal brain sodium minogen,NT-proBNP)水平并比较临床疗效。结果两组患者治疗后各项指标均较治疗前明显改善(P<0.05)。其中观察组患者治疗后血清TNF-α、TGF-β1、Hcy、NT-proBNP、左室舒张末期内径、左室收缩末期内径和中医证候总积分低于对照组,左室射血分数、6 min步行距离和临床疗效高于对照组(P<0.05)。结论加味苓桂术甘汤治疗阳虚水停证慢性心力衰竭可减轻患者炎症反应,预防心室重构,提高临床疗效。

Objective To investigate the clinical efficacy of modified Linggui Zhugan decoction on TGF-β1,TNF-α,NT-proBNP and ventricular remodeling in patients with chronic heart failure of Yang deficiency and water stagnation syndrome.Methods Ninety-eight patients with chronic heart failure with Yang deficiency and water stagnation admitted to the Lu'an Hospital of traditional Chinese medicine from December 2017 to November 2020 were included in this study and randomly divided into two groups of 49 cases each.The patients from the control group were conventionally treated with western medicine,and the patients from the observation group were treated combined with modified Linggui Zhugan decoction on the basis of the control group(P<0.05).Cardiac function,tumor necrosis factor-α(TNF-α)and transforming growth factor-β1(TGF-β1)were measured after 6 months of treatment.TGF-β1,homocysteine(Hcy),amino-terminal brain sodium minogen(NT-proBNP)levels,and the clinical efficacy were compared.Results After treatment,all the indexes of the two groups were improved compared with those before treatment(P<0.05).The serum TNF-α,TGF-β1,Hcy,NT-proBNP levels,left ventricular end diastolic diameter,internal diameter of late left ventricular contraction and total TCM symptom score in observation group after treatment were lower than those in the control group(P<0.05).The left ventricular ejection fraction,6-minute walk distance and total effective rate of the observation group were higher than those of the control group(P<0.05).Conclusion Modified Linggui Zhugan decoction is known to attenuate inflammatory response,prevent ventricular remodeling,and improve clinical efficacy in chronic heart failure patients with Yang deficiency and water stagnation syndrome.