血府逐瘀汤联合西药治疗慢性心力衰竭合并抑郁症血行郁滞证

Xuefu Zhuyu Decoction combined with Western Medicine in Treating Chronic Heart Failure combined with Depression with Syndrome of Blood Stasis

目的观察血府逐瘀汤加味联合氟哌噻吨美利曲辛片治疗慢性心力衰竭合并抑郁症血行郁滞证的疗效以及对血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-8、IL-2水平的影响。方法筛选2018年2月-2019年2月沧州市中心医院收治的慢性心力衰竭合并抑郁症患者共120例作为研究对象,按随机数字表法将120例患者分为对照组和观察组,每组60例。2组根据指南采取常规治疗措施;对照组给予氟哌噻吨美利曲辛片;观察组在对照组治疗基础上给予血府逐瘀汤加味治疗,每日1剂,2次/d。2组连续治疗2个月后,比较2组心功能指标、汉密尔顿抑郁量表(HAMD)-17量表和抑郁自评量表(SDS)评分、临床疗效以及血清TNF-α、IL-8、IL-2水平。结果与对照组比较,观察组患者治疗后左心室收缩末期内径(LVSD)、HAMD、SDS评分降低更明显,左心室射血分数(LVEF)、心输出量(CO)增加更显著(P<0.01);观察组和对照组的临床总有效率分别为93.33%和76.27%,差异有统计学意义(P<0.05);与对照组比较,观察组患者治疗后血清TNF-α、IL-8、IL-2水平降低更明显(P<0.01)。结论血府逐瘀汤加味联合氟哌噻吨美利曲辛片治疗慢性心力衰竭合并抑郁症血行郁滞证的疗效明显,可能与下调血清TNF-α、IL-8、IL-2水平有关。

Objective To investigate the efficacy of Xuefu Zhuyu decoction combined with fluperthiazi meili trixin tablets in treating chronic heart failure combined with depression with syndrome of blood stasis,and its effect on serum levels of tumor necrosis factor(TNF)-a,interleukin(IL)-8,and IL-2.Methods 120 chronic heart failure patients with depression admitted by the hospital were selected as research objects,who were divided into control group and observation group according to the random number table method,and each group had 60 cases.The two groups were given with routine treatment according to the guidelines.The control group was given with fluperazide tonmetrixine tablets.The observation group was treated with Xuefu Zhuyu decoction(1 dose and bid)on the basis of the control group.After continuous treatment for 2 months,cardiac function indicators,scores of Hamilton depression scale(HAMD)-17 scale and self-rating depression scale(SDS),the efficacy,and serum levels of TNF-α,IL-8,IL-2 were compared between the two groups.Results Compared with the control group,left ventricular systolic dimension(LVSD)and scores of HAMD and SDS the observation group were significantly decreased,and left ventricular ejection fraction(LVEF),and cardiac output(CO)were significantly increased after treatment(P<0.01).The total clinical effective rate of observation group and control group was 93.33%and 76.27%,respectively,and the difference was statistically significant(P<0.05).Compared with the control group,serum levels of TNF-α,IL-8,IL-2 in the observation group were significantly reduced after treatment(P<0.01).Conclusion The efficacy of Xuefu Zhuyu decoction combined with fluperthiazi meili trixin tablets in treating chronic heart failure combined with depression with syndrome of blood stasis is significant,and down-regulation of serum levels of TNF-α,IL-8,and IL-2 may be related with the efficacy.