加味五苓散联合西药治疗慢性心力衰竭疗效及对患者心功能、纤维化指标、炎性因子水平的影响

Effects of modified Wuling powder combined with western medicine on levels of cardiac function,fibrosis indicators and inflammatory factors in patients with chronic heart failure

目的:探讨加味五苓散在慢性心力衰竭(阳虚水泛型)患者治疗中的应用价值,观察其对心功能、炎性因子及纤维化指标的影响,旨在为本病提供有效的治疗手段。方法:将慢性心力衰竭且中医证型属于阳虚水泛型的92例患者纳入研究,纳入研究前均用随机数字表法对患者进行分组,每组46例。对照组采用单纯西药治疗,观察组加用加味五苓散,比较4周后疗效。结果:治疗后观察组血浆肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)水平、基质金属蛋白酶-9(MMP-9)水平、症状积分水平、血浆转化生长因子-β1(TGF-β1)、成纤维细胞生长因子-23(FGF-23)等纤维化指标、氨基末端脑钠肽前体(NT-ProBNP)低于对照组,基质金属蛋白酶组织抑制剂(TIMP)-1、左心室射血分数(LVEF)高于对照组,差异具有统计学意义(均P<0.05);观察组总有效率93.48%(43/46),高于对照组的73.91%(34/46);观察组皮疹、肾功能损伤、肝功能异常等不良反应总发生率17.39%(8/46),对照组19.56%(9/46),差异无统计学意义(P>0.05)。结论:对于慢性心力衰竭(阳虚水泛型)患者联合加味五苓散疗效较好,可减轻炎症反应,预防纤维化,改善预后。

Objective:To investigate the application value of Wuling powder in the treatment of chronic heart failure patients,and to observe its effect on cardiac function,inflammatory factors and fibrosis indicators,in order to provide effective treatment for this disease.Methods:A total of 92 patients with chronic heart failure and TCM syndrome type was yang-deficient type were included in the study.Before the study,the patients were grouped by random number table method,with 46 patients in each group.The control group was treated with pure western medicine,the observation group was treated with modified Wuling powder,and the curative effect was compared after 4 weeks.Results:After treatment,the plasma levels of Tumor Necrosis Factor-α(TNF-α),Homocysteine(Hcy),Matrix metalloproteinase-9(MMP-9),symptom integration,and plasma transforming growth factor were all in the observation group.TGF-1,FGF-23,amino terminal brain natriuretic peptide precursor(NT-ProBNP)were significantly lower than those of the control group,and Tissue inhibitor of matrix metalloprotease.TIMP-1,left ventricular ejection fraction(LVEF)was higher than that of the control group,with statistically significant difference(P<0.05).The total effective rate in the observation group was 93.48%(43/46),higher than 73.91%(34/46)in the control group.The total incidence of adverse reactions,such as rash,renal injury and abnormal liver function,was 17.39%(8/46)in the observation group and 19.56%(9/46)in the control group,with no statistically significant difference(P>0.05).Conclusion:For patients with chronic heart failure(Yang-deficient type),the combination of modified Wuling powder is of great significance,which can reduce inflammation,prevent fibrosis and improve prognosis.