参麦注射液对充血性心力衰竭患者甲状腺激素的影响

The Influence of “SHEN MAI” Injection on Thyroid Hormone in Patients with Congestive Heart Failure

目的 观察充血性心力衰竭 (CHF)患者甲状腺激素改变及参麦注射液对CHF的疗效及对甲状腺激素的影响。方法 将 86例患者分为常规治疗组和参麦注射液组 ,参麦注射液组在常规治疗的基础上加用参麦注射液治疗 ,疗程均 2周 ,治疗前后采用放射免疫法检测三碘甲状腺原氨酸 (T3)、甲状腺素 (T4 )、反三碘甲状腺原氨酸(rT3)及促甲状腺素 (TSH)。应用彩色多普勒超声心动图测定左室射血分数、左室短轴缩短率、每搏出量、心输出量及心脏指数。 35例健康者作为对照。结果 参麦注射液组总有效率显著高于常规治疗组 (P <0 .0 1)。与健康对照组相比 ,充血性心力衰竭患者T3、T4明显降低 (P <0 . 0 1) ,rT3升高 ,且T3、T4与心功能分级负相关 ,rT3与心功能分级正相关。经 2周治疗后 ,常规治疗组和参麦注射液组的T3、T4由治疗前较低水平显著升高 ,rT3由治疗前的较高水平显著降低 (P <0. 0 5 ,P <0 . 0 1) ,而参麦注射液组治疗后这 3项指标与常规治疗组比较有显著性差异 (P<0 .0 5 ,P<0. 0 1)。结论 CHF患者存在“正常甲状腺功能病态综合征” ,甲状腺激素分泌异常 ;且甲状腺激素异常程度与心脏病变程度相关。参麦注射液治疗CHF ,可提高疗效 ,纠正CHF患者异常的甲状腺激素。

Objective: To observe the changes of thyroid hormone in patients with congestive heart failure after the intervension by “SHEN MAI” injection. Methods: 86 cases with CHF were divided randomly into two groups: normal treatment group which were given conventional treatment (digitalis+diuretics+ACEI et al ) and “SHEN MAI” injection group which were given “SHEN MAI” injection besides conventional treatment. Before and two weeks after the treatment , The plasma level of T3, T4, rT3 and TSH were determined by radioimmunoassay. The ejection fraction of left ventricle (LVEF), fractional shortening of left ventricle (FS), stroke volume (SV), cardiac output (CO), and cardiac index (CI) were determined by colour doppler ultrasonic cardiaography. 35 healthy persons were taken as the comparison. Results: It showed that the effective rate in “SHEN MAI”injection group was higher than that in normal treament group(P<0.01). Compared with healthy group, T3、T4 in patients with CHF decreased signifcantly(P<0.01), rT3 increased signifcantly. The plasma level of T3、T4 correlated negatively to heart function grades, rT3 positively. The plasma level of T3、T4 increased and rT3 decreased signifcantly in two groups 2 weeks after treatment, but there were significant differences:T3、T4 in “SHEN MAI” injection group were higher and rT3 lower than normal treatment group signifcantly after treatment(P<0.05,P<0.01). Conclusion: The patients with CHF had sick syndrome of normal thyroid function. Thyroid hormone secreted abnormaly. The abnormal degree of thyroid hormone was correlated to the grade of heart function. “SHEN MAI” injection may improve heart function and rectify abnormal thyriod hormone.