四逆加人参方配合西药对慢性心力衰竭患者临床疗效及血清NT-proBNP水平的影响

Clinical Effect of Sini Plus Renshen Recipe(四逆加人参方)Combined with Western Medicine on Patients with Chronic Heart Failure and Its Effect of Serum NT-proBNP Level

目的研究四逆加人参方配合西药对慢性心力衰竭患者临床疗效及血清N末端脑钠肽前体(NT-proBNP)水平的影响。方法选取河北省邯郸明仁医院2017年8月—2019年4月收治的诊及住院患者100例,采用随机数字法分为两组。对照组给予常规西药对症治疗,治疗组患者在对照组基础上给予四逆加人参方配合治疗,30 d为1个疗程,分析两组患者疗程结束后的临床效果。结果治疗组心衰和中医证候总有效率分别为92.00%和90.00%,高于对照组的76.00%和70.00%,差异具有统计学意义(P<0.05)。两组治疗前相关细胞因子、左室射血分数(LVEF)、6 min步行距离(6MWT)、肱动脉内皮依赖性舒张功能(FMD)水平组间比较,差异不具有统计学意义(P>0.05)。治疗组治疗后NT-proBNP、核转录因子-κB(NF-κB)、神经肽Y(NPY)、白细胞介素-18(IL-18)水平低于对照组,LVEF、6MWT、FMD水平高于对照组(P<0.05)。治疗组患者总不良反应率(10.00%)与对照组(60.00%)比较,差异不具有统计学意义(P>0.05)。结论四逆加人参方配合西药对慢性心力衰竭可调节NT-proBNP、NF-κB、NPY、IL-18的表达水平,改善心功能和内皮功能。

Objective To study the clinical effect of Sini Plus Renshen Recipe(四逆加人参方) combined with western medicine on patients with chronic heart failure and the effect of serum N-terminal brain natriuretic peptide precursor(NT-proBNP).Methods A total of 100 inpatients admitted to Akihito Hospital in Handan,Hebei Province(August 2017 to April 2019) were randomly divided into two groups.The control group was treated with routine western medicine,and the patients in the treatment group were treated with Sini Plus Renshen Recipe on the basis of the control group,30 days as a course of treatment.The clinical effects of the two groups after the course of treatment were analyzed.Results The total effective rates of heart failure and TCM syndrome in the treatment group were 92.00% and 90.00%,respectively,which were significantly higher than those in the control group(76.00% and 70.00%,P<0.05).There was no significant difference in levels of related cytokines,left ventricular ejection fraction(LVEF),6 min walking distance(6 MWT) or brachial artery endothelial diastolic function(FMD) between the two groups before treatment(P>0.05).After treatment,NT-proBNP,nuclear factor-kappa B(NF-kappa B) and neuropeptide Y(NPY) and IL-18 in the treatment group were lower than those of the control group,and the levels of LVEF,6 MWT and FMD were higher than those of the control group(P<0.05).There was no significant difference in the total adverse reaction rate between the treatment group(10.00%) and the control group(60.00%)(P>0.05).Conclusion Sini Plus Renshen Recipe combined with western medicine can regulate the levels of NT-proBNP,NF-κ B,NPY and IL-18 and improve cardiac function and endothelial function in patients with chronic heart failure.