心衰合剂对慢性心力衰竭患者作用的临床观察

Clinical Observation of Xinshuai Mixture in the Treatment of Chronic Heart Failure

目的观察心衰合剂对慢性心力衰竭(CHF)患者心功能及心肌细胞凋亡相关因子的影响。方法将诊断为CHF的70例患者随机分为两组,各35例。对照组按西医常规进行治疗;治疗组在对照组基础上,根据辨证应用心衰合剂方加减进行治疗。观察治疗前后患者临床症状、脑钠肽水平、左室射血分数及左室舒张末径值、细胞凋亡相关因子sFas/Apo-1、sFasL。结果治疗后治疗组症状、体征积分低于对照组,差异有统计学意义(P<0.05);治疗组与对照组治疗后BNP下降、LVEF上升、LVED下降,治疗组BNP下调与LVEF升高较对照组明显(P<0.05);两组治疗后血清中sFas/Apo-1、sFasL含量较治疗前均显著降低(P<0.01);治疗组sFas/Apo-1及sFasL水平较对照组明显降低(P<0.05)。结论心衰合剂能够有效改善心衰患者的临床症状,降低患者脑钠肽水平,改善患者心功能,抑制心肌细胞的凋亡。

Objective To observe the impacts of xinshuai mixture on heart function and the relevant factors of myocardial apoptosis for the patients with chronic heart failure（CHF）. Methods 70 cases with the diagnosis as CHF were randomized into two groups,35 cases in each. In a control group, the conventional western medicine was provided. In a treatment group,on the basis of the conventional western medicine treat- ment, the modified xinshuai mixture was prescribed according to pattern/syndrome differentiation. Before and after treatment,the clinical symptoms,brain natriuretic peptide（BNP） level, the left ventrieular ejection frac- tion（LVEF） ,the left ventrieular end diastolic diameter（LVEDD） , and the relevant factors of apoptosis such as sFas/Apo - 1 and sFasL were observed. Results After the treatment,the scores of symptoms and physical signs in the treatment group were lower than those in the control group, presenting the significant difference in comparison（P 〈 0.05 ）. After treatment, in the treatment group and the control group, BNP was reduced, LVEF was increased and LVEDD was decreased. In the treatment group, the down - regulation of BNP and the increasing of LVEF were obvious as compared with the control group （ P 〈 0. 05 ）. In both groups, after treatment, the contents of serum sFas/Apo - 1 and sFasL were reduced significantly as compared with those before treatment（ P 〈 0. 01 ）. The levels of sFas/Apo - 1 and sFasL in the treatment group were lower appar- ently than those in the control group （ P 〈 0.05 ）. Conclusion Xinshuai mixture effectively relieves the clini- cal symptoms for the patients with heart failure, reduces BNP level,improves the heart functions of the pa- tients and inhibits myocardial apoptosis.