“十一味益心汤”颗粒剂治疗气阴两虚、心血瘀阻型慢性心力衰竭的临床研究

Clinical Observation on Shiyiwei Yixintang Particles in the Treatment of Chronic Heart Failure with Qi and Yin Deficiency and Blood Stasis Syndrome

目的观察"十一味益心汤"颗粒剂的临床疗效及对血浆N端B型脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)及左室射血分数(LVEF)的影响。方法将68例慢性心力衰竭病人随机分为治疗组和对照组,每组34例。对照组单纯使用西药治疗;治疗组在使用西药的基础上加服"十一味益心汤"颗粒剂,疗程4周。检测治疗前后血浆NT-proBNP、Hcy及LVEF,记录治疗前后中医症状体征量化积分。结果两组治疗后血浆NT-proBNP水平均较治疗前显著降低(P<0.05),且治疗后治疗组较对照组明显降低(P<0.05)。两组治疗后Hcy水平均较治疗前明显降低(P<0.05),但治疗后治疗组与对照组比较差异无统计学意义(P>0.05)。两组治疗后LVEF较治疗前均有提高(P<0.05),治疗后治疗组提高左室射血分数更显著(P<0.05)。两组治疗后症状体征量化积分均有明显改善(P<0.05),治疗后治疗组症状量化积分优于对照组(P<0.05)。治疗组临床疗效总有效率优于对照组(P<0.05)。结论 "十一味益心汤"可以降低慢性心力衰竭病人血浆N端B型脑钠肽前体、同型半胱氨酸水平,改善症状体征量化积分,提高左室射血分数,改善心功能,是治疗慢性心力衰竭的有效方剂。

Objective To observe the clinical efficacy of Shiyiwei Yixintang particles(SYP)in the treatment of chronic heart failure (CHF) and its effects on the levels of plasma N terminal pro brain natriuretic peptide (NT proBNP),homocysteine (Hcy)and left ventricular ejection fraction (LVEF)in patients with CHF. Methods Sixty eight patients with CHF were randomly divided into two groups:control group (n =34)treated with routine western treatment,and treatment group(n =34)treated with SYP in the ba- sis of western routine treatment for four weeks.The LVEF as well as the levels of plasma NT proBNP and Hcy were observed.The TCM integral of quantized symptom and signs were recorded before and after the treatment.Results After treatment,the level of plasma NT proBNP decreased significantly in two groups(P <0.05),which was lower in treatment group than that in control group (P <0.05).The levels of Hcy significantly decreased in two groups(P <0.05),but there was no significant difference between two groups(P >0.05).The LVEF were increased after treatment in two groups (P <0.05),which was higher in treatment group than that in control group (P <0.05).The TCM integral of quantized symptom and signs were improved in two groups after treatment(P <0.05), which was better in treatment group than that in control group(P <0.05).The total efficiency of treatment group was higher than that of control group (P <0.05).Conclusion SYP can decrease the levels of plasma NT proBNP and Hcy,improve the TCM integral of quantized symptom and signs,increase the LVEF,and improve the cardiac function in patients with CHF.