益气温阳活血利水法联合西药治疗慢性心力衰竭的疗效及对循环miRNAs表达的影响

Efficacy of Benefiting Qi for Warming Yang and Activating Blood Circulation with Western Medicine for Inducing Diuresis in the Patients with Chronic Heart Failure and its Effect on the Expression of Circulating miRNAs

目的:观察益气温阳活血利水法对慢性心力衰竭(CHF)患者临床疗效及循环miRNAs(miR-423-5p、miR-210-3p)的影响。方法:80例CHF患者随机分为观察组和对照组各40例,对照组予常规西药抗心衰治疗,观察组在对照组用药基础上加服益气温阳活血利水方煎剂,疗程均为2周。评估患者治疗前后的临床疗效及中医证候积分,超声心动图检查左室射血分数(LVEF)及左室舒张末期内径(LVEDD),实时荧光定量PCR检测患者治疗前后血浆循环miRNAs的表达水平,观察药品不良反应发生情况,评价益气温阳活血利水法对CHF的治疗作用。结果:观察组临床疗效总有效率优于对照组(87.50%vs.65.00%,P<0.05);治疗后两组患者的中医症候积分、LVEF及LVEDD指标、循环miRNAs表达水平均较前明显改善(P<0.05),且观察组均优于对照组(P<0.05)。两组药品不良反应比较差异无统计学意义(P>0.05)。结论:在常规治疗基础上联合益气温阳活血利水法可提高慢性心力衰竭的临床疗效,改善循环miR-423-5p表达水平。

Objective： To observe the efficacy of benefiting Qi for warming Yang and activating blood circulation for inducing diu- resis method in the treatment of patients with chronic heart failure（CHF） and its effect on the expression of circulating miRNAS （ miR- 423-5p, miR-210-3p）. Methods： Totally 80 CHF patients were randomly divided into two groups,the control group with 40 patients was treated with the conventional anti-heart failure therapy, and the treatment group with 40 patients was treated with benefiting Qi for warming Yang and activating blood circulation for inducing diuresis decoction on the basis of the control group, and the treatment course was 2 weeks. The clinical efficacy and syndrome integral of traditional Chinese medicine （TCM） were evaluated. Left ventricular ejection fraction （LVEF） and left ventricular end diastolic diameter（LVEDD） were measured by echocardiography; the plasma expression levels of circulating miRNAs（ miR-423-Sp, miR-210-3p） were measured by real-time PCR in the two groups before and after the treatment. The adverse drug reactions were observed as well. Results ： The total clinical effective rate of the treatment group was significantly higher than that of the control group （ 87.50% vs 65.00%, P 〈 0.05 ） ; the syndrome integral of TCM, indices of LVEF and LVEDD and the expression of circulating miRNAs were improved in both groups（ P 〈 0.05 ） ; the total clinical effective rate, syndrome integral of TCM, indices of LVEF and LVEDD and the expression of circulating miR-423-Sp of the treatment group were better than those of the control group（ P 〈0.05 ） ; there was no significant difference in adverse drug reactions between the groups （P 〉 0.05 ）. Conclusion： The benefiting Qi for warming Yang and activating blood circulation for inducing diuresis method can improve the clinical effects in the treatment of CHF, and improve the expression of circulating miRNAs.