苓桂术甘汤加减联合曲美他嗪治疗阳虚证慢性心力衰竭的效果及对氧化应激指标、HSP27、ApoE表达的影响

Effect of modified Linggui Zhugan decoction combined with trimetazidine in the treatment of chronic heart failure with Yang deficiency syndrome and its influences on oxidative stress indexes,HSP27,ApoE expression

目的探讨苓桂术甘汤加减联合曲美他嗪治疗阳虚证慢性心力衰竭的效果及对氧化应激指标、热休克蛋白27(HSP27)、载脂蛋白E(ApoE)表达的影响。方法选取70例阳虚证慢性心力衰竭患者,以抽签法将其随机分为对照组(曲美他嗪)和观察组(苓桂术甘汤加减联合曲美他嗪),各35例。比较两组的治疗效果。结果观察组的临床治疗总有效率高于对照组(P<0.05)。治疗后,观察组的谷胱甘肽-过氧化物酶(GSH-Px)、过氧化氢酶(CAT)及超氧化物歧化酶(SOD)水平均高于对照组,HSP27、ApoE、醛固酮(ALD)、去甲肾上腺素(NE)及血管紧张素Ⅱ(AngⅡ)、层粘连蛋白(LN)、透明质酸(HA)、尿Ⅲ型前胶原(PCⅢ)水平均低于对照组(P<0.05)。结论苓桂术甘汤加减联合曲美他嗪治疗阳虚证慢性心力衰竭有助于提高治疗效果,减轻患者氧化应激反应,有效下调HSP27、ApoE表达水平。

Objective To explore the effect of modified Linggui Zhugan decoction combined with trimetazidine in the treatment of chronic heart failure with Yang deficiency syndrome and its influences on oxidative stress indexes,heat shock protein 27(HSP27),apolipoprotein E(ApoE)expression.Methods A total of 70 patients with chronic heart failure with Yang deficiency syndrome were selected and randomly divided into control group(trimetazidine)and observation group(modified Linggui Zhugan decoction combined with trimetazidine)by lottery method,with 35 cases in each group.The treatment effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that of the control group(P<0.05).After treatment,the levels of glutathione peroxidase(GSH-Px),catalase(CAT)and superoxide dismutase(SOD)in the observation group were higher than those in the control group,the levels of HSP27,ApoE,aldosterone(ALD),norepinephrine(NE),angiotensinⅡ(AngⅡ),laminin(LN),hyaluronic acid(HA)and procollagenⅢ(PCⅢ)were lower than those in the control group(P<0.05).Conclusion Modified Linggui Zhugan decoction combined with trimetazidine in the treatment of chronic heart failure with Yang deficiency syndrome can improve the therapeutic effect,reduce the oxidative stress response of patients,and effectively down-regulate the expression levels of HSP27 and ApoE.