鹿红方对慢性心力衰竭伴心肌纤维化影响的临床研究

Clinical research of Luhong Formula on myocardial fibrosis in chronic heart failure

目的观察鹿红方联合安体舒通治疗慢性心力衰竭伴心肌纤维化的临床疗效。方法将70例慢性心力衰竭伴心肌纤维化患者随机分为治疗组与对照组,每组35例。对照组采用心衰基础治疗和安体舒通,治疗组在对照组治疗措施基础上加用鹿红方。两组疗程均为6个月,观察中医证候疗效,比较明尼苏达心力衰竭生活质量表评分(MLHFQ)及血清心肌纤维化相关指标,其指标包括血清转化生长因子(TGF-β1)、结缔组织生长因子(CTGF)、Ⅰ型前胶原(PCⅠ)、Ⅲ型前胶原(PCⅢ)。结果 (1)试验期间,治疗组随访中脱落1例,对照组脱落2例;最终完成试验者67例,治疗组34例、对照组33例。(2)组间治疗后比较,TGF-β1、CTGF、PCⅠ、PCⅢ以及PCⅠ/PCⅢ水平差异有统计学意义(P<0.05)。(3)治疗组、对照组中医证候总有效率分别为85.23%和51.52%;组间中医证候疗效比较,差异有统计学意义(P<0.05)。(4)组间治疗后比较,MLHFQ评分差异有统计学意义,治疗组明显低于对照组(P<0.05)。结论鹿红方联合安体舒通治疗慢性心力衰竭伴心肌纤维化,可显著抑制患者心肌纤维化进展,减轻患者症状,改善其生活质量。

Objective To observe the clinical efficacy of Luhong formula combined with spironolactone on myocardial fibrosis in patients with chronic cardiac failure( CHF). Methods 70 CHF patients with myocardial fibrosis were randomly divided into the treatment group and control group,35 cases in each group. The control group was treated with basic treatment of heart failure and spironolactone. The treatment group was treated with Luhong Formula based on the treatment for the control group. The treatment course of both groups was six months. The efficacy of TCM syndrome was observed,and the Minnesota living with heart failure questionnaire( MLHFQ) score and serum markers of myocardial fibrosis were compared,including transforming growth factor-β1( TGF-β1),connective tissue growth factor( CTGF),procollagen Ⅰ( PC Ⅰ),procollagen Ⅲ( PC Ⅲ). Results(1)During the trial,1 case in the treatment group and 2 cases in the control group fell off. Finally 67 cases completed the trial,among 34 cases in the treatment group and 33 cases in the control group.(2) After treatment,there were statistically significant differences on the levels of TGF-β1,CTGF,PC Ⅰ,PC Ⅲ and ratio of PC Ⅰ/PC Ⅲ between the two groups( P<0.05).(3)The total effective rates of TCM syndrome were 85.23% in the treatment group and 51.52% in the control group. There was statistically significant difference on the efficacy of TCM syndrome between the two groups( P<0.05).(4)After treatment,there was statistically significant difference on the MLHFQ score between the two groups,and the MLHFQ score of the treatment group was lower than that of the control group( P < 0.05). Conclusion Luhong Formula combined with spironolactone can significantly inhibit the myocardial fibrosis progression in patients with CHF,alleviate the symptoms and improve the life quality of patients.