真武汤加减对阳虚水泛型冠心病慢性心力衰竭的治疗作用及对BNP、sST2、VEGF水平的影响

Effect of Zhenwu Decoction(真武汤)on Chronic Heart Failure Due to Yang Deficiency and Water Flooding and Its Influence on Levels of IL-1 and TNF-α

目的探讨真武汤加减对阳虚水泛型冠心病慢性心力衰竭的治疗作用及对脑钠肽(BNP)、可溶性生长刺激表达基因2蛋白(sST2)、血管内皮生长因子(VEGF)水平的影响。方法选择2017年2月—2019年2月医院心内科门诊及住院患者收治的慢性心力衰竭患者62例,依据治疗方法不同分为实验组(30例)和参照组(32例)。参照组采用西药常规治疗,实验组在对照组治疗的基础上配合真武汤加减治疗。两周均以8周为1个治疗周期。比较两组治疗前后的中医证候积分和治疗疗效,比较两组治疗前后心功能指标:N末端脑钠肽前体(NT-proBNP)水平、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD),比较两组治疗前后BNP、sST2、VEGF水平。结果实验组治疗总有效率90.00%(27/30)高于对照组治疗总有效率的(68.75%,22/32)(P<0.05),实验组治疗后心悸、气短喘息、胸闷、浮肿和肢寒体冷等中医证候积分低于参照组(P<0.05);实验组治疗后心功能指标NT-proBNP、LVESD和LVEDD水平低于参照组,LVEF水平高于参照组(P<0.05);实验组治疗后BNP、sST2水平低于参照组,VEGF高于参照组(P<0.05)。结论真武汤加减可有效的改善冠心病慢性心力衰竭的临床症状,减轻心力衰竭程度,提升心脏功能,增强心肌功能,控制病情进展,提高治疗疗效,值得临床进一步研究探讨。

Objective To explore the therapeutic effect of Zhenwu Decoction(真武汤) on chronic heart failure of coronary heart disease with Yang deficiency and water flooding and the influence on levels of BNP, ST2 and VEGF. Methods A total of 62 patients with chronic heart failure in outpatient and in-patient department of cardiology in our hospital were selected from February 2017 to February 2019. According to the treatment method, they were divided into experimental group(30 cases) and control group(32 cases). The control group was treated with western medicine, and the experimental group was treated with Zhenwu Decoction on the basis of the treatment of the control group. The treatment cycle was 8 weeks in both weeks. The two groups’ TCM symptom score and curative effect were compared. The indexes of cardiac function(NT-proBNP,LVEF,LVESD and LVEDD) and levels of NP,sST2 and VEGF before and after treatment were compared. Conclusion Zhenwu Decoction can effectively improve the clinical symptoms of chronic heart failure of coronary heart disease, reduce the degree of heart failure, improve the heart function, enhance the myocardial function, control the progress of the disease, and improve the therapeutic effect, which is worthy of further clinical study.