益气温阳活血法对慢性充血性心力衰竭患者神经内分泌的影响

The Effect of Profiting Qi and Warming Yang,Promoting Blood Circulationon on Neuroendocrine of Patients with Chronic Congestive Heart Failure

目的观察益气温阳活血法联用西医常规治疗对慢性充血性心力衰竭患者神经内分泌的影响。方法将63例住院患者随机分为两组,对照组31例采用西医常规治疗(洋地黄、利尿剂、血管扩张药、血管紧张素转换酶抑制剂等),治疗组32例在此基础上加用益气温阳活血中药,2周为1个疗程。用放射免疫法测定治疗前后血浆血管紧张素Ⅱ(AngⅡ)、内皮素(ET)及醛固酮(ALD)值的变化,并与健康人22例对比;同时治疗前后观察左室射血分数(EF)及血液流变学指标。结果充血性心力衰竭患者血浆AngⅡ、ET和ALD水平明显高于健康人,治疗组治疗后上述三项指标均显著降低;同时治疗组治疗后EF值和血液流变学指标有明显改善,与治疗前比较差异显著;治疗组心功能改善总有效率(93.75%)明显高于对照组(77.42%),其差异有显著性。结论益气温阳活血法可抑制神经内分泌系统过度激活,改善充血性心力衰竭患者心功能及血液流变学指标。

Objective：To observe the effect of Profiting Qi, Warming Yang and Promoting Blood Circulationon on neuroendocrine of patients with chronic congestive heart failure（CHF）, and the changes on neuroendocrine of patients. Methods 63 patients were randomly divided into two groups. Those in the control group （31 cases） was treated by complex treatment（digitora, diuretic, vessel dilator, angiotensin convertin genzyme inhibitor）, and in the thera- peutic group（32 cases） received Profiting Qi, Warming Yang and Promoting Blood Circulationon Decotion in addition. The course was 2 weeks. Plasma concentrations of atrial natriuretic polypeptide endothelin（Ang Ⅱ）, endothelin （ET）, aldosterone （ALD） were determined by immunoradiometric assay before and after the treatment, and contrasted with healthy controls（22 cases） . Meanwhile, the left ventricle ejection fraction（EF） and henorheology indexes were observed before and after the treatment. Results：The levels of Ang Ⅱ, ET and ALD of CHF patients were significantly higher than of the healthy, and in the therapeutic these were significantly decreased after the treatment, and EF and henorheology indexes in the therapeutic were obviously improved after the treatment. Conelusion： Profiting Qi, Warming Yang and Promoting Blood Circulation can improve the cardiac function CHF, the mechanisms may be related to the influence of neuroendocrine.