参附养心汤对老年慢性心力衰竭阳虚水泛型病人血管内皮功能及心功能的影响

Effects of Shenfu Yangxin Decoction on Vascular Endothelial Function and Cardiac Function in Elderly Patients with Chronic Heart Failure and Water Overflowing Due to Yang Insufficiency Syndrome

目的观察参附养心汤对老年慢性心力衰竭阳虚水泛型病人血管内皮功能及心功能的影响。方法将96例辨证为阳虚水泛证的老年慢性心力衰竭病人随机分为观察组和对照组,各48例。观察组给予参附养心汤治疗,对照组给予常规治疗,治疗4周后,比较两组临床疗效,观察治疗前后主要症状、心功能指标及血管内皮功能指标变化情况。结果观察组总有效率为91.7%,对照组为72.9%,两组总体疗效比较差异有统计学意义(P<0.05);两组治疗前心悸、气短、乏力、水肿评分,左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室射血分数(LVEF)、血清内皮素(ET)、降钙素基因相关肽(CGRP)、一氧化氮(NO)水平比较,差异均无统计学意义(P>0.05);治疗后,两组心悸、气短、乏力、水肿评分,LVEDd、LAESd指标及血清ET水平均较治疗前降低(P<0.05),LVEF及血清NO、CGRP水平均较治疗前升高(P<0.05),且观察组较对照组改善更显著(P<0.05)。结论参附养心汤治疗老年慢性心力衰竭阳虚水泛证,能够改善病人血管内皮功能,提高心功能,缓解临床症状。

Objective To observe the effect of Shenfu Yangxin decoction(SYD)on vascular endothelial function and cardiac function in elderly patients with chronic heart failure(CHF)and water overflowing due to yang insufficiency syndrome.Methods Ninety-six elderly patients with CHF and water overflowing due to yang insufficiency syndrome were randomly divided into two groups:the control group(n=48)treated with routine treatment,and the observation group(n=48)treated with SYD for 4 weeks.After 4 weeks of treatment,the clinical curative effects,the main symptoms,cardiac function indexes,and the changes of vascular endothelial function indexes were compared between two groups before and after treatment.Results The total effective rate was 91.7%in the observation group,and 72.9%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the palpitations,shortness of breath,fatigue,and edema scores,the left ventricular end-diastolic volume(LVEDd),end-systolic volume(LVESd),left ventricular ejection fraction(LVEF),and the levels of serum endothelin(ET),calcitonin gene-related peptide(CGRP)and nitric oxide(NO)between two groups before treatment(P>0.05).After treatment,the palpitations,shortness of breath,fatigue,and edema scores,LVEDd,LVESd,and serum ET level were lower than that before treatment in two groups(P<0.05),while LVEF,serum NO,and CGRP levels were higher than that before treatment in two groups(P<0.05).The improvement in the observation group was more significant than that in the control group(P<0.05).Conclusion SYD can improve vascular endothelial function and heart function,and relieve clinical symptoms in elderly patients with CHF and water overflowing due to yang insufficiency syndrome.