逍遥散对慢性心力衰竭合并抑郁患者心功能、炎症介质和血清5-HT、NE、CORT的影响

Effects of Xiaoyaosan on Cardiac Function, Inflammatory Mediators and Serum 5-HT, NE, CORT in Patients with Chronic Heart Failure and Depression

目的:探讨逍遥散对慢性心力衰竭(CHF)合并抑郁患者心功能、炎症介质和血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、皮质醇(CORT)的影响。方法:选择我院于2017年10月至2018年12月收治的94例CHF合并抑郁患者,随机分为对照组、观察组,每组47例,对照组给予常规CHF治疗及盐酸帕罗西汀治疗,研究组给予常规CHF治疗及逍遥散治疗,比较两组疗效、心功能、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、5-HT、NE、CORT、明尼苏达心衰生活质量调查表(MLHFQ)、汉密尔顿抑郁量表(HAMD)及不良反应。结果:观察组治疗8周后的CHF总有效率、抑郁总有效率为82.98%、87.23%,高于对照组的63.83%、61.70%(P<0.05)。治疗8周后,两组MLHFQ、HAMD评分均较治疗前下降,且观察组低于对照组(P<0.05)。与治疗前相比,治疗8周后,两组CORT、IL-6、TNF-α下降,且观察组低于对照组(P<0.05), 5-HT、NE升高,且观察组高于对照组(P<0.05)。两组与治疗前相比,治疗8周后,两组LVSD、LVED下降,且观察组低于对照组(P<0.05),LVEF升高,且观察组高于对照组(P<0.05)。治疗期间,两组未出现严重不良反应。结论:逍遥散治疗CHF合并抑郁患者,疗效肯定,可有效改善患者心功能,减轻炎性反应,并调节血清5-HT、NE、CORT水平。

Objective: To investigate the effects of Xiaoyaosan on cardiac function, inflammatory mediators and serum5-hydroxytryptamine(5-HT), norepinephrine(NE), cortisol(CORT) in patients with chronic heart failure(CHF) and depression.Methods: 94 patients with CHF and depression who were admitted in our hospital from October 2017 to December 2018 were selected,patients were divided into control group, observation group randomly, 47 cases per group, the control group was given conventional CHF treatment and paroxetine hydrochloride treatment, the observation group was given conventional CHF treatment and Xiaoyaosan treatment, the efficacy, cardiac function, interleukin-6(IL-6), tumor necrosis factor-α (TNF-α), 5-HT, NE, CORT, minnesota heart failure quality of life questionnaire(MLHFQ), hamilton depression scale(HAMD) and adverse reactions of the two groups were compared. Results: The total effective rates of CHF, depression in the observation group were 82.98%, 87.23%, which were higher than63.83%, 61.70% of the control group after 8 weeks of treatment(P < 0.05). After 8 weeks of treatment, the scores of MLHFQ, HAMD in the two groups decreased compared with those of before treatment, observation group were lower than control group(P < 0.05).Compared with before treatment, after 8 weeks of treatment, the levels of CORT, IL-6, TNF-α decreased in the two groups, observation group were lower than control group(P < 0.05), the levels of 5-HT, NE increased, observation group were higher than control group(P <0.05). Compared with before treatment, after 8 weeks of treatment, LVSD, LVED of the two groups decreased, observation group was lower than control group(P < 0.05), LVEF increased, observation group was higher than control group(P < 0.05). During the treatment,no serious adverse reactions occurred in the two groups. Conclusion: Xiaoyaosan treat the patients with CHF and depression, its efficacy is certain, which can effectively improve the cardiac function, reduce the inflammatory reaction, and regulate the serum levels of 5-HT,NE, CORT.