术附汤对慢性心力衰竭标志物及心室重构相关新型生物标志物的影响

Effect of Zhufu Decoction on New Biomarkers Related to Ventricular Remodeling and Heart Failure Markers in Patients with Chronic Heart Failure

目的探讨慢性心衰患者采用术附汤辅助西药治疗的效果及对血清指标的影响。方法于2018年10月至2020年6月选取许昌市人民医院106例慢性心力衰竭患者,随机数字表法分组,两组各53例。对照组给予伊伐布雷定+左西孟旦治疗,研究组在对照组基础上加服术附汤。统计两组治疗效果,治疗前后中医证候积分,心室重构指标[半乳糖凝集素-3(Gal-3)、可溶性人基质裂解素2(sST2)、生长分化因子-15(GDF-15)],心功能指标[左心室射血分数(LVEF)、心搏出量(SV)、心排出量(CO)],血管内皮和血液流变学指标[内皮素-1(ET-1)、红细胞聚集指数(EAI)、血浆黏度(PSV)、一氧化氮(NO)],心衰标志物[B型钠尿肽(BNP)、N末端B型钠尿肽前体(NT-proBNP)]及不良反应。结果研究组治疗总有效率高于对照组(94.34%vs 81.13%)(P<0.05);治疗2周后研究组中医症候积分低于对照组(P<0.05),治疗2周后研究组LVEF、SV、CO较对照组高(P<0.05);治疗2周后两组血清Gal-3、sST2、GDF-15、ET-1、PSV、EAI较治疗前降低,NO较治疗前升高,且研究组优于对照组(P<0.05);治疗2周后研究组血浆BNP、NT-proBNP水平低于对照组(P<0.05);研究组不良反应发生率与对照组间差异无统计学意义(7.55%vs 3.77%,P>0.05)。结论术附汤辅助西药治疗能进一步改善慢性心衰患者心功能及血液流变学,下调心室重构相关新型生物标志物血清水平,抑制心室重构,利于提升整体治疗效果及血管内皮功能。

Objective To investigate the effect of zhufu decoction on patients with chronic heart failure and its influence on serum indexes.Methods From October 2018 to June 2020,106 patients with chronic heart failure in Xuchang People's Hospital were selected and randomly divided into two groups,53 patients in each group.The control group was treated with ivabradine+levosimendan,and the study group was treated with zhufu decoction on the basis of the control group.The therapeutic effect,Traditional Chinese medicine(TCM)syndrome score,ventricular remodeling index[galactoagglutinin 3(Gal-3),soluble human matrix lysin 2(sST2),growth differentiation factor-15(GDF-15)],cardiac function index[left ventricular ejection fraction(LVEF),cardiac output(SV),cardiac output(CO)],vascular endothelium and hemorheology indexes[endothelin-1(ET-1),red cell assembling index(EAI),Plasma viscosity(PSV),nitric oxide(NO)],heart failure markers[B-type natriuretic peptide(BNP),N-terminal B-type natriuretic peptide precursor(NT proBNP)]and adverse reactions of the two groups before and after treatment were counted.Results The total effective rate of the study group was higher than that of the control group(94.34%vs 81.13%)(P<0.05);after 2 weeks of treatment,the TCM symptom score of the study group was lower than that of the control group(P<0.05).After 2 weeks of treatment,LVEF,SV and CO of the study group were higher than those of the control group(P<0.05);after 2 weeks of treatment,the levels of serum Gal-3,sST2,GDF-15,ET-1,PSV and EAI in the two groups were lower than those before treatment,and the levels of NO in the study group were higher than that in the control group(P<0.05);after 2 weeks of treatment,the plasma BNP and NT proBNP levels in the study group were lower than those in the control group(P<0.05);there was no significant difference in the incidence of adverse reactions between the study group and the control group(7.55%vs 3.77%,P>0.05).Conclusion Zhufu decoction assisted with western medicine can further improve the cardiac function and hemorheology of patients with chronic heart failure,lower the serum level of new biomarkers related to ventricular remodeling,inhibit ventricular remodeling,and promote the overall therapeutic effect and vascular endothelial function.