黄芪真武汤对心衰患者神经-—体液指标的影响

Effect of Huangqi Zhenwu Decoction on Neurohumoral Indexes in Patients with Heart Failure

目的:探讨黄芪真武汤对慢性心力衰竭(Chronic Heart Failure,CHF)患者心功能及RAAS指标、精氨酸加压素的影响。方法:70例CHF患者随机分为对照组和研究组各35例。对照组予以常规西药治疗,研究组在西药治疗基础上加服黄芪真武汤,200ml/次,2次/d,2组疗程均为8周。记录治疗前后中医证候学积分、6min步行实验(6MWT),超声心动图测定左室舒张末期内径(LVED)、左室射血分数(EF值),检测精氨酸加压素(AVP)、脑利钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)水平,治疗前后各评定1次。结果:2组治疗后中医证候学积分均比治疗前下降,且研究组低于对照组;2组治疗后6min步行实验(6MWT)均比治疗前有所改善,且研究组改善更为显著;2组治疗后左室舒张末期内径(LVED)、射血分数(EF值)均比治疗前有所改善,且研究组改善更显著。治疗后研究组血清精氨酸加压素(AVP)、脑利钠肽(BNP)、血管紧张素II(AngII)和醛固酮(ALD)水平均低于对照组,差异均有统计学意义。结论:在西医常规治疗的基础上加服黄芪真武汤能进一步改善CHF患者心功能,并能抑制RAAS系统,调节AVP和BNP,逆转心室重塑,这可能是其重要的作用机制。

Objective:to determine the effects of Huangqi Shenwu Decoction on cardiac function and the RAAS index,arginine vasopressin,in patients with chronic heart failure(CHF).Methods:Seventy CHF patients were randomly divided into control and study groups with 35 patients each.The control group was treated with conventional western medicine,and the study group received Huangqi Shenwu decoction,200 ml/time,twice/D,on the basis of Western medicine,for 8 weeks in both groups.The TCM syndrome scores,6min walk test(6MWT)before and after treatment were recorded,the left ventricular end diastolic diameter(LVED),left ventricular ejection fraction(EF value)were measured by echocardiography,arginine vasopressin(AVP),brain natriuretic peptide(BNP),angiotensin II(ANG II)and aldosterone(ALD)levels were detected,and 1 assessment was performed before and after treatment.Results:the TCM syndrome scores of the 2 groups decreased more after treatment than before,and were lower in the study group than in the control group;The 6min walk test(6MWT)improved more in the 2 groups after treatment than before,and the improvement was more significant in the study group;Left ventricular end diastolic diameter(LVED)and ejection fraction(EF)were improved after treatment in the 2 groups compared with before treatment,and the improvement was more significant in the study group.After treatment,serum arginine vasopressin(AVP),brain natriuretic peptide(BNP),angiotensin II(AngII),and aldosterone(ALD)levels in the study group were lower than those in the control group,with statistically significant differences.Conclusions:the addition of Huangqi Shenwu Decoction to the conventional treatment of Western medicine further improves cardiac function in CHF patients,and can inhibit the RAAS system,regulate AVP and BNP,and reverse ventricular remodeling,which may be an important mechanism.