真武汤合桃红四物汤对阳虚血瘀型慢性收缩性心力衰竭心肌重构的影响

The Influence of True Warrior Decoction Combined with Four Substances Decoction on Myocardial Remodeling of Chronic Congestive Heart Failure with Syndrome of Yang Deficiency and Blood Stasis

目的:观察真武汤合桃红四物汤对阳虚血瘀型慢性心力衰竭(chronic congestive heart failure,CHF)患者心肌重构的影响。方法:将80例CHF患者随机分为治疗组和对照组,每组各40例。对照组给予西药常规抗心力衰竭药物治疗,治疗组在对照组的基础上服用真武汤合桃红四物汤。观察两组患者的临床疗效,彩超下测量两组患者治疗前后左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(Left ventricular end systolic diameter,LVESD)及左室射血分数(left ventricular ejection fraction,LVEF)。检测两组患者治疗前后肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、脑钠肽(brain natriuretic peptide,BNP)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和金属蛋白酶组织抑制剂-1(tissue inhibitor of metalloproteinase-1,TIMP-1)值。结果:治疗后,两组患者LVEDD、LVESD低于治疗前,LVEF高于治疗前,差异具有统计学意义(P<0.05),治疗组与对照组比较,差异无统计学意义(P>0.05)。治疗后,两组患者BNP值、MMP-9低于治疗前,且治疗组低于对照组;TIMP-1高于治疗前,且治疗组高于对照组,差异均有统计学意义(P<0.05)。治疗组有效率为92.31%,对照组有效率为79.48%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。结论:真武汤合桃红四物汤治疗阳虚血瘀型慢性收缩性心力衰竭患者,可改善患者临床症状及体征,对提高LVEF、TIMP-1值,降低LVEDD、LVESD、BNP值、MMP-9值具有一定的疗效。

Objective： To observe the influence of True Warrior Decoction Combined with Four Substances Decoction on myocardial remodeling of chronic congestive heart failure（ CHF） with syndrome of yang deficiency and blood stasis. Methods： Eighty patients with CHF were randomly divided into the treatment group and the control group,with 40 cases in each group. The ones in the control group were treated with routine anti heart failure drug treatment,while the ones in the treatment group were added True Warrior Decoction Combined with Four Substances Decoction based on the treatment of the control group. Then the clinical curative effects of the two groups were observed. Their left ventricular end diastolic diameter（ LVEDD）,left ventricular end systolic diameter（ LVESD） and left ventricular ejection fraction（ LVEF） under color Doppler ultrasound before and after the treatment were measured. Their creatine kinase isoenzyme（ CK-MB）,brain natriuretic peptide（ BNP）,matrix metalloproteinase-9（ MMP-9） and tissue inhibitor of metalloproteinase-1,TIMP-1 before and after the treatment were detected. Results： After the treatment,the two groups＇ LVEDD and LVESD were lower than those before the treatment; LVEF was higher than that before the treatment,and all the differences were statistically significant（ P〈0. 05）; The difference between the treatment group and the control group was not statistically significant（ P〉0. 05）. After the treatment,the two groups BNP and MMP-9 were lower than those before the treatment,and the treatment group was lower than the control group; TIMP-1 was higher than that before the treatment,and the treatment group was higher than that of the control group,the difference was statistically significant（ P〈0. 05）. The effective rate of the treatment group was 92. 31%,while that of the control group was 79. 48%,and the difference was statistically significant（ P〈0. 05）. Conclusion： True Warrior Decoction Combined with Four Substances Decoction has a remarkable clinical curative effect CHF with syndrome of yang deficiency and blood stasis,can improve the clinical symptoms and signs of patients,and improve the LVEF and TIMP-1 values,and reduce the LVEDD,LVESD,BNP and MMP-9 values.