温阳益心汤对慢性心力衰竭(阳气虚衰、血瘀水停型)心功能和炎症因子的影响

The Effect of Wenyang Yixin Decoction on Cardiac Function and Inflammatory Factorson in Chronic Heart Failure(Yang Qi Deficiency and Failure,Blood Stasis and Water Stagnation Type)

目的观察温阳益心汤对慢性心力衰竭(阳气虚衰、血瘀水停型)患者心功能和炎症因子的影响。方法将80例慢性心力衰竭患者随机分为治疗组和对照组,每组40例。对照组给螺内酯20 mg,日1次口服;单硝酸异山梨酯缓释片40 mg,日1次口服;倍他乐克片25 mg,日2次口服;贝那普利5 mg,日1次口服;安慰剂(由淀粉制成)10 g/袋,日2次口服。治疗组:在对照组的基础上加用温阳益心汤10 g/袋,日2次口服,疗程8周。对2组患者治疗前后的中医证候进行评分,判断疗效。用彩色超声测量LEVDd和LVEF;用ELASA法测量患者血清中NT-proBNP和IL-6、TNF-α含量。结果治疗后2组患者的中医证候评分均较治疗前下降(P<0.05),治疗组优于对照组(P<0.05);治疗组总有效率为92.5%,对照组总有效率为72.5%,2组之间差异有统计学意义(P<0.05);治疗后2组患者的LVEDd改变无统计学意义(P>0.05);治疗后2组患者LVEF均提高(P<0.05),其中治疗组优于对照组(P<0.05);治疗后2组患者血清中NT-proBNP和IL-6、TNF-α含量较治疗前降低,其中治疗组低于对照组(P<0.05)。结论温阳益心汤可能通过抑制心衰的炎症反应,改善心功能,临床疗效显著。

Objective To observe the effect of Wenyang Yixin decoction on cardiac function and inflammatory factorson in chronic heart failure(yang qi deficiency and failure,blood stasis and water stagnation type).Methods 80 patients with chronic heart failure were randomly divided into treatment group and control group,with 40 patients in each group.The control group was given spironolactone 20mg orally once a day,Isosorbide mononitrate sustained release tablets 40mg,oral once a day,Betaloc tablet 25mg,oral twice daily,Benazepril 5mg,oral daily,placebo(made of starch)10g/bag,oral twice daily.On the basis of the control group,the treatment group was given Wenyang Yixin decoction 10g/bag,oral twice a day,and the course of treatment was 8 weeks.The TCM syndromes of the two groups were scored before and after treatment to judge the curative effect.LEVDd and LVEF were measured by color ultrasound.ELASA method was used to measure the levels of NT-probNP,IL-6 and TNF-αin serum of patients.Results The TCM syndrome scores of patients in both groups decreased after treatment(P<0.05).The shortness of breath,fatigue,aversion to cold and dropsy of the treatment group was better than that of the control group(P<0.05).The total response rate was 92.5%in the treatment group and 72.5%in the control group,and there had significant differences between the two groups(P<0.05).After treatment,there was no significant change in LVEDd between the two groups(P>0.05).After treatment,LVEF was increased in both groups(P<0.05),in which the treatment group was better than the control group(P<0.05).After treatment,the content of NT-probNP,IL-6 and TNF-αin the serum of the two groups of patients was lower than that before treatment,and the treatment group was better than the control group(P<0.05).Conclusion Wenyang Yixin decoction can improve the clinical symptoms of patients,improve the systolic force of heart failure through suppress inflammatory reaction.