芪苈大黄泻肺汤联合福辛普利治疗慢性肺源性心脏病合并心力衰竭的临床研究

Clinical Research of Qili Dahuang Xiefei Decoction Combined with Fosinopril in the Treatment of Chronic Pulmonary Heart Disease with Heart Failure

目的观察芪苈大黄泻肺汤联合福辛普利治疗慢性肺源性心脏病(CPHD)合并心力衰竭(HF)的临床疗效及对血清白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)的影响。方法选取2017年1月—2018年12月在周口市中医院和河南省人民医院就诊的CPHD合并心力衰竭病人126例,以完全随机化法将其分为对照组与联合组,各63例。对照组在常规治疗基础上应用福辛普利,联合组在对照组基础上联合芪苈大黄泻肺汤治疗。比较两组临床疗效,观察两组治疗前后心功能指标及血清IL-8、IL-10、TNF-α水平变化,记录不良反应发生情况。结果联合组临床总有效率高于对照组(93.65%与80.95%,P<0.05)。治疗后两组左心室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)均较治疗前降低(P<0.05),左心室射血分数(LVEF)均较治疗前增加(P<0.05);联合组治疗后LVESD、LVEDD均低于对照组(P<0.05),LVEF高于对照组(P<0.05)。治疗后两组血清IL-8、TNF-α水平均较治疗前下降(P<0.05),IL-10水平均较治疗前升高(P<0.05);联合组治疗后IL-8、TNF-α水平均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。联合组与对照组不良反应发生率比较差异无统计学意义(14.29%与17.46%,P>0.05)。结论芪苈大黄泻肺汤联合福辛普利治疗CPHD合并心力衰竭病人,可促进病人心功能的恢复,降低炎性因子水平,且具有良好的安全性。

Objective To observe the effect of Qili Dahuang Xiefei decoction combined with Fosinopril on serum interleukin-8(IL-8),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)in patients with chronic pulmonary heart disease(CPHD)complicated with heart failure(HF)and its clinical efficacy.Methods One hundred and twenty-six patients with CPHD and HF were randomly divided into control group(63 cases)and combined group(63 cases).The patients in control group were treated with Fosinopril on the basis of routine treatment,while the combined group was treated with Qili Dahuang Xiefei decoction on the basis of the control group.The clinical effects,cardiac function,serum IL-8,IL-10,TNF-αlevels and adverse reactions were compared.Results The clinical efficiency of combined group was higher than that of control group(93.65%vs 80.95%,P<0.05).Compared with data before treatment,the left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)were decreased,while the left ventricular ejection fraction(LVEF)was increased after treatment(P<0.05).After treatment,LVESD and LVEDD in combined group were lower than those in control group(P<0.05),and LVEF in combined group was higher than that in control group(P<0.05).Compared with data before treatment,the levels of serum IL-8 and TNF-αwere decreased,and IL-10 level was increased after treatment(P<0.05).After treatment,the levels of IL-8 and TNF-αin combined group were lower than those in control group(P<0.05),and the level of IL-10 in combined group was higher than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(14.29%vs 17.46%,P>0.05).Conclusion Qili Dahuang Xiefei decoction combined with Fosinopril can promote the recovery of heart function,reduce the level of inflammatory factors,with better safety in the treatment of CPHD with HF.