暖心胶囊对心力衰竭病人神经内分泌-细胞因子系统的影响

Effect of Nuanxin Capsule on Neuroendocrine-cytokine System in Patients with Heart Failure

目的观察暖心胶囊对心力衰竭病人神经内分泌-细胞因子系统的影响。方法采用随机双盲安慰剂对照试验设计方法,选择60例心力衰竭病人,随机分为治疗组和对照组,每组30例,两组均采用西医治疗方案,在此基础治疗上治疗组与对照组分别加用暖心胶囊和安慰剂胶囊,疗程2周。测定两组血浆肾素活性(PRA)、血浆血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、血浆肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)水平,并观察中医证候和心功能的分级。结果两组治疗后PRA水平、AngⅡ水平均有下降,两组间比较,治疗组能更有效地降低血中PRA水平、AngⅡ水平(P<0.05),两组治疗后ALD比较无统计学意义(P>0.05)。两组治疗后IL-6水平均有下降,且两组组间比较差异有统计学意义(P<0.05),治疗组能更有效地降低血中IL-6水平,治疗后组间比较TNF-α、CRP差异无统计学意义(P>0.05)。中医证候疗效,治疗组和对照组总有效率分别为86.7%和60.0%,两组比较差异有统计学意义(P<0.05)。心功能疗效治疗组和对照组总有效率分别为76.6%和63.3%,两组比较差异无统计学意义(P>0.05)。结论暖心胶囊能抑制心力衰竭病人神经内分泌-细胞因子激活,改善中医证候积分。

Objective To observe the effects of Nuanxin capsule（ NXC） on neuroendocrine-cytokine system in patients with heart failure（ HF）.Methods Sixty patients with HF were randomly divided into two groups： control group（ n = 30） treated with routine treatment plus placebo,and treatment group（ n = 30） treated with NXC in the basis of routine treatment for 2 weeks. The levels of plasma renin activity（ PRA）,angiotensin Ⅱ（ Ang Ⅱ）,aldosterone（ ALD）,plasma tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6）,C-reactive protein（ CRP） were measured.Traditional Chinese medi cine（ TCM） syndrome and cardiac function were observed.Results The levels of PRA and Ang Ⅱ decreased after treatment in two groups,which as lower in treatment group than that in control group（ all P〈0.05）. IL-6 levels decreased after treatment in two groups（ P 0. 05）,which were lower in treatment group than that in control group. There was no significant difference in the TNF-α and CRP levels between two groups（ P〈0.05）. The total clinical effective rate of TCM syndrome was significantly higher in treatment group than that in control group（ 86.7% vs 60.0%,P〈0.05）.There was no significant difference in the total clinical effective rate of cardiac function between two groups（ 76.6% vs 63.3%,P〈0.05）.Conclusion NXC can inhibit the activation of neuroendocrine-cytokine and improve TCM syndrome scores in patients with HF.