芪参益气滴丸联合阿托伐他汀对慢性心力衰竭患者心功能和BNP、TNF-α和IL-6的影响

Effect of the Qishenyiqi Diwan combined with atorvastatin treatment on cardiac function,serum levels of BNP, TNF-α and IL-6 in patients with chronic heart failure

目的探讨芪参益气滴丸联合阿托伐他汀对慢性心力衰竭患者心功能和B型脑钠肽(BNP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)的影响,以期能为临床治疗慢性心力衰竭提供参考。方法选取100例中医辨证为阳气虚乏、血淤水停的慢性心力衰竭患者,以数字表格法分为治疗组与对照组,各50例,对照组给予常规利尿、强心、扩血管等治疗,治疗组在以上治疗基础上加用芪参益气滴丸餐后0.5 h服用,1袋/次,3次/d,阿托伐他汀睡前服用20 mg,疗程3个月,检测治疗前后左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、收缩末期内径(LVDs)、左心室射血分数(LVEF)、BNP、TNF-α和IL-6变化。结果两组患者治疗后LVESD、LVEDD、LVEF均较治疗前明显改善(均P<0.05);治疗后LVESD、LVEDD、LVEF治疗组较对照组改善更为明显(均P<0.05);两组患者治疗后TNF-α、IL-6、BNP均较治疗前明显改善(均P<0.05);治疗后TNF-α、IL-6、BNP治疗组较对照组改善更为明显(均P<0.05);治疗组患者治疗疗效(51.06%)明显优于对照组(26.67%)(P<0.05)。结论中医辨证为阳气虚乏、血淤水停的慢性心力衰竭患者在常规治疗基础上加用芪参益气滴丸联合阿托伐他汀有助于进一步改善患者心功能,降低血浆BNP及血清TNF-α、IL-6水平,改善改善心室重构。

Objective To explore the effect of the Qishenyiqi Diwan combined with atorvastatin treatment on cardiac function, and serum levels of B-type brain natriuretic peptide （BNP）, tumor necrosis factor alpha （TNF-α） and interleukin 6 （IL-6） in patients with chronic heart failure （CHF）.MethodsA total of 100 patients diagnosed as CHF and characterized by Yang asthenia and blood stasis in traditional Chinese medicine （TCM） syndrome differentiation were randomly divided into 2 groups（control group and treatment group）. The patients in the control group were administrated with conventional CHF treatment including diuretics, digitalis and vasodilators, while the patients in the treatment group were treated with conventional CHF agents plus Qishenyiqi Diwan （1 bag half an hour after a meal, t.i.d. for 3 months） and atorvastatin （20 mg before bedtime for 3 months）. Left ventricular end-systolic diameter （LVESD）, left ventricular end-diastolic diameter （LVEDD）, left ventricular diameter （LVDs）, left ventricular ejection factor （LVEF）, serum level of TNF-α and IL-6 and BNP were detected in pre-and post-treatment. ResultsLVESD, LVEDD and LVEF were significantly improved in both groups（post-treatmentvs. pre-treatment, allP〈0.05）;？LVESD, ？LVEDD and ？LVEF in treatment group were significantly higher than that in control group （allP〈0.05）; The levels of TNF-α, IL-6 and BNP were significantly declined in both groups （post-treatmentvs.pre-treatment, allP〈0.05）; The levels of？TNF-α, ？IL-6 and？BNP in treatment group were significantly higher than that in control group （allP〈0.05）; The therapeutic effect in treatment group （51.06%） was significantly higher than that in control group （26.67%）（P〈0.05）. ConclusionConventional treatment combined with Qishenyiqi Diwan and atorvastatin can help improve cardiac function and lower serum TNF-α, IL-6 and BNP level in patients diagnosed as Yang asthenia, blood stasis by TCM syndrome differentiation.