柴胡加龙骨牡蛎汤联合冻干重组人脑利钠肽治疗应激性心肌病的临床疗效及对焦虑、抑郁、心功能、血清炎症因子的影响

Clinical efficacy of bupleurum plus dragon bone oyster decoction combined with lvophilized recombinant human brain natriuretic peptide in treating stress cardiomyopathy and effects on anxiety, depression, cardiac functions and serum inflammatory cytokines

目的观察柴胡加龙骨牡蛎汤联合冻干重组人脑利钠肽治疗应激性心肌病(SCM)的临床疗效及对焦虑、抑郁、心功能、血清炎症因子的影响。方法将62例SCM患者按照随机数字表法分为2组。对照组31例予冻干重组人脑利钠肽治疗,治疗组31例在对照组治疗基础上联合柴胡加龙骨牡蛎汤治疗。2组均治疗1周。比较2组疗效;观察2组治疗前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、明尼苏达心力衰竭生活质量问卷调查量表(MLHFQ)评分及中医证候评分变化;观察2组治疗前后心功能指标变化;观察2组治疗前后血清炎症因子水平变化。结果治疗组总有效率93.5%(29/31),对照组总有效率74.2%(23/31),治疗组疗效优于对照组(P<0.05)。2组治疗后SAS、SDS、MLHFQ及中医证候评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)均较本组治疗前降低(P<0.05),左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)均较本组治疗前升高(P<0.05);治疗后治疗组LVEDD、LVESD均低于对照组(P<0.05),LVEF、LVFS均高于对照组(P<0.05)。2组治疗后心肌肌钙蛋白T(cTnT)、N末端脑利钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)及白细胞介素6(IL-6)均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论柴胡加龙骨牡蛎汤联合冻干重组人脑利钠肽治疗SCM,能明显改善患者临床疗效及心功能指标,改善患者焦虑、抑郁状态,且安全性好。

Objective To observe the clinical efficacy of Bupleurum plus dragon bone oyster decoction combined with lyophilizedrecombinant human brain natriuretic peptide(rh-BNP)on treating the stress cardiomyopathy(SCM)on effects on anxiety,depression,cardiac functions and serum inflammatory cytokines.Methods Sixty two patients with SCM were divided into two groups with random number table,31 patients in the control group were treated with lyophilized recombinant human brain natriuretic peptide,31 cases in the treatment group on the basis of the control group treated by combining bupleurum plus dragon bone oyster decoction,and the patients in the both groups were treated for one week,and the efficacy on patients in two group was compared.The changes in self-rating anxiety scale(SAS),self-rating depression scale(SDS),Minnesota living with heart failure questionnaire(MLHFQ)scale of patients and changes of TCM Syndrome Score in two groups before and after treatment were observed,and the changes in cardiac function index and levels of serum inflammatory cytokines of patients in two groups before and after treatment were observed.Results The total response rate of patients in the treatment group and control group was 93.5%(29/31)and 74.2%(23/31)respectively,the efficacy on patients in the treatment group was better than that on patients in the control group(P<0.05).SAS,SDS,MLHFQ and TCM Syndrome Score Scale(TCMSSS)of patients in two groups after treatment were lower than such indexes before treatment(P<0.05),and the decrease in any index of patients in the treatment group was more evident(P<0.05).The left ventricular end diastolic diameter(LVEDD)and left ventricular end-systolic dimension(LVDS)of patients in two groups after treatment were lower than such indexes of patients in respective groups before treatment(P<0.05),left ventricular ejection fraction(LVEF)and left ventricular short axis shortening rate(LVFS)of patients in two group were higher than such indexes of patients in respective groups before treatment(P<0.05);LVEF and LVFS of patients in the treatment group were lower than those indexes of patients in the control group(P<0.05),LVEFand LVFSof patients in the treatment group were higher than those of the control group(P<0.05).The cardiac troponin T(cTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)of patient in two groups after treatment were lower than such indexes of patients before treatment(P<0.05),and the decreases in such indexes of patients in the treatment group was more evident(P<0.05).Conclusion Bupleurum plus dragon bone oyster decoction combined with lyophilized withlyophilized recombinant human brain natriuretic peptide(rh-BNP)treating the stress cardiomyopathy(SCM)can significant improve clinical efficacy and cardiac function index,and improve the anxiety and depression of patients with great safety.