中药心力神对心气(阳)虚型心力衰竭患者内皮素及其受体基因表达的影响

Effect of Xinlisheng on endothelin/endothelin receptor gene expression in patients with heart qi(yang) deficiency type of chronic heart failure

目的:观察中药心力神对心气(阳)虚型充血性心力衰竭(CHF)患者内皮素(ET-1)及受体基因(ETAR、ETBR)表达的影响。方法:将心功能Ⅲ-Ⅳ级,中医辨证属心气(阳)虚证患者60例随机分为治疗组和对照组各30例,对照组采用CHF标准治疗,治疗组在标准治疗的基础上加用心力神,治疗2个月。对比两组治疗后左室射血分数(LVEF)、脑利钠肽(BNP)、ET-1、ETAR、ETBR表达水平的差异。结果:两组治疗后LVEF、BNP较治疗前明显改善,有显著性差异(P<0.05);治疗后治疗组LVEF、BNP较对照组改善更明显,有显著性差异(P<0.05)。两组治疗后ET-1、ETAR均较治疗前下降,有显著性差异(P<0.05);治疗后治疗组ET-1、ETAR较对照组下降明显,具有显著性差异(P<0.05)。结论:提示心力神与标准治疗结合应用能进一步改善左室收缩功能,可能是影响了内皮素及其受体基因的表达。

Objective： To investigate the effect of Xinlisheng on endothelin（ET-1） and endothelin receptor gene（ETAR,ETBR） expression in patients with heart qi（yang） deficiency type of chronic heart failure（CHF）.Methods： 60 heart qi（yang） deficiency type of CHF with severe cardiac dysfunction（NYHA class Ⅲ-Ⅳ） were devided into two groups.The patients in therapy group（group T） were given both the routine treatment and Xinlisheng,however,the patients in control group（group C） were given only the routine treatment.All cases were followed up for 2 months.Plasma ET-1,ETAR,ETBR,brain natriuretic peptide（BNP）,left ventricular ejective fraction（LVEF） were measured at the beginning,and all the indices were measured again after 2 months.Results： All indices included LVEF,BNP,ET-1,ETAR and ETBR in two groups after treatment were significantly lower than that in two groups before treatment（all P0.05）.Similarly,the indices of LVEF,BNP,ETAR and ETBR in group T after treatment were significantly decreased,compared with the group C after treatment（all P0.05）.Conclusion： For patients with CHF,longtime treatment with Xinlisheng in combination with routine therapy can significantly improve the left cardiac function.Maybe the low levels of plasm ETAR and ETBR gene expression regulated by Xinlisheng played an important role in the process.