健心汤对慢性心力衰竭患者细胞炎症因子水平与心功能的影响

Effect of Jianxin Decoction on Levels of Inflammatory Cytokines and Cardiac Function of Patients with Chronic Heart Failure

【目的】观察具有益气温阳、健脾利水作用的健心汤对慢性心力衰竭(CHF)患者细胞炎症因子水平与心功能的影响。【方法】将62例CHF患者随机分为观察组和对照组,每组各31例。对照组单纯给予西药治疗,观察组患者在对照组治疗基础上加服健心汤,连续治疗4周后,采用酶联免疫吸附(ELISA)法检测血清中白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)和脑钠素(BNP)含量,利用超声心动图测定左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)并计算左室射血分数(LVEF)、心输出量(CO)和二尖瓣舒张早期血流速度峰值/二尖瓣舒张晚期血流速度峰值(E/A),同时评价2组患者的中医证候疗效、心功能疗效及不良反应。【结果】(1)治疗后,观察组患者的中医证候疗效和心功能分级疗效均明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者血清中IL-6、IL-10、TNF-α和BNP含量均较治疗前显著下降(P<0.05),且观察组患者血清中IL-6、IL-10、TNF-α和BNP含量的降低作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者LVSED、LVEDD较治疗前显著降低(P<0.05),而LVEF、E/A和CO较治疗前显著升高(P<0.05),且观察组患者LVSED、LVEDD较对照组明显降低,而LVEF、E/A和CO较对照组明显升高(P<0.05)。(4)治疗期间,2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】健心汤联合西药治疗能够有效降低患者机体细胞炎症因子和BNP含量,改善慢性心力衰竭患者的临床症状和心功能分级,其疗效明显优于单纯西药治疗,且安全性高。

Objective To observe the effect of Jianxin Decoction,a recipe with the actions of tonifying Qi and warming Yang,strengthening spleen and removing edema,on the levels of inflammatory cytokines and cardiac function in patients with chronic heart failure（CHF）. Methods Sixty-two CHF patients were randomly divided into observation group and control group, 31 cases in each group. The control group was treated with western medicine alone, and the observation group was given Jianxin Decoction combined with western medicine. After treatment for 4 weeks,the levels of serum interleukin-6（IL-6）, interleukin-10（IL-10）, tumor necrosis factor alpha（TNF-α） and brain natriuretic peptide（BNP） were detected by enzyme-linked immunosorbent assay（ELISA）. The left ventricular end systolic diameter（LVESD）,left ventricular end diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF）,cardiac output（CO） and ratio of mitral peak velocity of early filling to mitral late diastolic peak velocity（E/A）were determined with echocardiography. The effect on traditional Chinese medicine（TCM） syndromes, effect on cardiac function grading, and adverse reaction in the two groups were also observed. Results（1） After treatment, the effective rate on TCM syndromes and improvement of cardiac function in the observation group were superior to those in the control group,the difference being significant（P〈0.05）.（2）Levels of serum IL-6,IL-10,TNF-α and BNP of the two groups after treatment were decreased as compared with those before treatment（P〈0.05）,and the decrease in the observation group was superior to that in the control group（P〈0.05）.（3）After treatment, LVSED and LVEDD of the two groups were much decreased,and LVEF, E/A and CO were markedly increased（P〈0.05 compared with those before treatment）. The improvement of LVSED,LVEDD,LVEF,E/A and CO in observation group was significantly superior to that in the control group（P〈0.05）.（4） During the treatment, the incidence of adverse reaction showed no significant differences between the two groups（P〉0.05）. Conclusion Jianxin Decoction combined with western medicine can effectively reduce the levels of inflammatory cytokines and BNP, so as to relieve the clinical symptoms and improve cardiac function grading in patients with CHF. The combination has better effect and is safer than western medicine alone for CHF.