葶苈大枣泻肺汤加减对慢性心力衰竭患者尿液白蛋白/肌酐比值及炎症因子的影响

Chronic Heart Failure:Effects of TingLiDaZao Decoction on Urine Albumin/Creatinine Ratio and Inflammatory Cytokines in Patients

目的：探索葶苈大枣汤对慢性心力衰竭患者微量尿白蛋白及血浆炎症因子IL-6,C反应蛋白的影响。方法：70例诊断为慢性心力衰竭的患者（心功能Ⅱ~Ⅳ级）按心功能分级并随机分为中药＋心衰基础治疗组（治疗组）和心衰基础治疗对照组（对照组）,每组35例;在进行积极控制感染,改善心功能的基础上,对照组患者给予心衰的基础治疗（利尿剂＋β受体阻断剂＋ARB或ACEI）;治疗组在心衰基础治疗的基础上给予葶苈大枣汤加减进行治疗,每2周随访1次,观察周期为3月。治疗前后观察患者的心功能变化,尿微量白蛋白的变化,炎症因子IL-6,CRP的变化。结果：基线资料比较,两组患者无显著性差异;经3月的治疗后,治疗组患者心功能改善情况要好于对照组患者,P〈0.05;与对照组比较,葶苈大枣汤加减可显著降低慢性心力衰竭患者血浆IL-6,CRP水平,降低尿微量白蛋白水平,P均〈0.05,且与对照组比较,不良反应事件未见显著增加,P〉0.05。结论：对于慢性心力衰竭患者,在心衰基础治疗的基础上结合葶苈大枣汤加减治疗可显著提高对慢性心力衰竭患者的临床疗效,且安全性良好,值得临床推广。

Objective： To explore the effects of TingLiDaZao decoction to the levels of UCRA, IL-6, CRP and the heart function in chronic heart disease patients. Methods： A total of 70 cases of chronic heart disease ,in accordance with the classification of cardiac function, were randomly divided into two groups, the Chinese medicine plus heart failure foundation treatment group （treatment group, n=35）; heart failure foundation treatment group （control group,n=35）.On the basis of active infection control and improvement of cardiac function, the control group was given heart failure foundation treatment （diuretic agent ＋ β blocker＋ ACEI or ARB ）, and treatment group, heart failure foundation treatment plus Chinese medicine treatment （TingLiDaZao decoction）. They were followed up every two weeks; 3 months of observation period. Before and after treatment, the levels of UCRA, IL-6, CRP and heart fimction were observed. Results： After 3 months of treatment, the heart function level of treatment group was improved better than that of control group（P〈0.05）; Compared with control group, TingLiDaZao decoction decreased the levels of UCRA, IL-6 and CRP in treatment group （P〈0.05）. Adverse events didn＇t significantly increase （P〉0.05）. Conclusions： Heart failure foundation treatment plus Chinese medicine treatment （TingLiDaZao decoction） can significantly improve the clinical efficacy in patients with chronic heart failure, which has good safety and is worthy of promotion in clinical practice.