加味柴葶丹参饮治疗冠心病心力衰竭(气滞血瘀水停证)的疗效及对24h尿量、AVP的影响

Curative Effect of Using Modified Chaiting Danshen Decoction in the Treatment of Coronary Heart Disease Combined with Heart Failure (Qi-stagnation Blood-stasis Syndrome) and Its Influences on 24h Urine Output and AVP

目的:探讨加味柴葶丹参饮治疗冠心病(CHD)心力衰竭(气滞血瘀水停证)的疗效及对24h尿量、AVP的影响。方法:选取2019年9月~2020年9月本院收治的112例CHD合并慢性心力衰竭(CHF)患者,随机数值表法分为观察组、对照组各56例。对照组予常规西医治疗,观察组在对照组的基础上加予加味柴葶丹参饮治疗,两组均连续治疗6周。治疗结束后,评估两组疾病疗效、中医症候疗效;于治疗前后,检测两组血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血管加压素(AVP),尿液水通道蛋白2(AQP2)水平,统计24h尿量,并检测左室射血分数(LVEF)、左室舒张末径(LVEDD)及心脏每搏量(SV),观察治疗期间不良反应。结果:观察组疾病疗效、中医症候疗效的总有效率为89.29%、87.50%,明显高于对照组的75.00%、71.43%(P<0.05)。观察组治疗后的LVEF、SV水平较本组治疗前明显上升(P<0.05),且显著高于对照组同期(P<0.05);而LVEDD水平较本组治疗前明显下降(P<0.05),且显著低于对照组同期(P<0.05)。观察组治疗后的血清CRP、IL-6及NT-proBNP水平较本组治疗前明显下降(P<0.05),且显著低于对照组同期(P<0.05)。观察组治疗后的24h尿量较本组治疗前明显上升(P<0.05),且显著高于对照组同期(P<0.05);而AVP及AQP2水平较本组治疗前明显下降(P<0.05),且显著低于对照组同期(P<0.05)。两组治疗期间,均未出现严重不良反应。结论:加味柴葶丹参饮治疗CHD合并CHF(气滞血瘀水停证)患者的疗效显著,有助于提升心功能,降低机体炎症反应,改善水平衡代谢情况。

Objective: To explore the curative effect of Modified Chaiting Danshen Decoction on coronary heart disease(CHD) combined with heart failure(Qi-stagnation blood-stasis syndrome) and its influences on 24 h urine output and arginine vasopressin(AVP). Methods: A total of 112 CHD patients with chronic heart failure(CHF) who were admitted to the hospital from September 2019 to September 2020 were enrolled and divided into an observation group and a controlled group by the random number table method, 56 cases in each group. The controlled group was treated with routine western medicine, while the observation group was treated with modified Chaiting Danshen Decoction on the basis of the controlled group. Both groups were continuously treated for 6 weeks. At end of the treatment, the curative effect on diseases and TCM symptoms in both groups was evaluated. Before and after treatment, levels of serum high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),AVP and urine aquaporin 2(AQP2) in both groups were detected. The 24 h urine output was statistically analyzed. The left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD) and stroke volume(SV) were detected. And adverse reactions during treatment were observed. Results: The total response rates of diseases and TCM symptoms in the observation group were 89.29% and 87.50%,significantly higher than 75.00% and 71.43% in the controlled group(P<0.05). After treatment, levels of LVEF and SV in the observation group were significantly increased(P<0.05),which were significantly higher than those in the controlled group(P<0.05). After treatment, LVEDD level in the observation group was significantly decreased(P<0.05),which was significantly lower than that in the controlled group(P<0.05). After treatment, levels of serum CRP,IL-6 and NT-proBNP in the observation group were significantly decreased(P<0.05),which were significantly lower than those in the controlled group(P<0.05). After treatment, 24 h urine output in the observation group was significantly increased(P<0.05),which was significantly higher than that in the controlled group(P<0.05). After treatment, levels of AVP and AQP2 in the observation group were significantly decreased(P<0.05),which were significantly lower than those in the controlled group(P<0.05). During treatment, there were no severe adverse reactions in either group. Conclusion: The curative effect of Modified Chaiting Danshen Decoction is significant in patients with CHD and CHF(Qi-stagnation blood-stasis syndrome),which is beneficial to improve cardiac function, reduce inflammatory response, and improve water balance metabolism.