保元汤合血府逐瘀汤对慢性心力衰竭患者心功能及炎性因子的影响
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摘要
目的探讨保元汤合血府逐瘀汤对慢性心力衰竭患者心功能及炎性因子的影响。方法选取重庆市垫江县中医院心病科2016年12月～2018年6月收治的慢性心力衰竭患者70例作为研究对象,按随机数字表法将其分为对照组和治疗组,各35例。对照组予以慢性心力衰竭规范化药物治疗,治疗组在对照组的基础上加用保元汤合血府逐瘀汤治疗,两组均以2周为1个疗程。比较两组患者临床疗效、中医证候疗效和治疗前后的血浆N末端前脑钠肽(NT-pro BNP)水平、炎性因子指标[超敏C反应蛋白(hs-CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)]的变化情况。结果 1个疗程后,两组临床疗效和中医证候疗效比较结果显示,治疗组总有效率均明显高于对照组,差异有统计学意义(P <0.05)。治疗后,两组NT-pro BNP、hs-CRP、IL-6、TNF-α水平均较治疗前明显下降(P <0.01),且治疗组NT-pro BNP、hs-CRP、IL-6、TNF-α水平均明显低于对照组(P <0.05)。结论保元汤合血府逐瘀汤治疗慢性心力衰竭效果确切,可明显改善患者临床症状和中医证候,降低血浆NT-pro BNP水平和炎性因子水平。
Objective To investigate the effects of Baoyuan Decoction and Xuefu Zhuyu Decoction on cardiac function and inflammatory factors in patients with chronic heart failure. Methods Seventy patients with chronic heart failure who were admitted to Department of Cardiology, Traditional Chinese Medicine Hospital of Dianjiang County in Chongqing City from December 2016 to June 2018 were selected as research subjects, they were divided into the control group and the treatment group by random number table method, with 35 cases in each group. The control group was given standardized drug therapy for chronic heart failure, the treatment group was additionally treated with Baoyuan Decoction and Xuefu Zhuyu Decoction on the basis of the control group. Both groups took 2 weeks as a course of treatment. The clinical effect, TCM syndrome effect, plasma NT-pro BNP levels and inflammatory factor indices [high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)] were compared between the two groups before and after treatment. Results After one course of treatment, the results of comparison of clinical efficacy and TCM symptom efficacy between the two groups showed that the total effect rates of treatment group were all higher than those of control group, with statistically significant differences(P < 0.05). After treatment, the levels of NT-pro BNP, hs-CRP, IL-6, TNF-α in the two groups were all lower than those before treatment(P < 0.01), and the levels of NT-pro BNP, hs-CRP, IL-6, TNF-α in the tretment group were all lower than those in the control group(P < 0.05).Conclusion Baoyuan Decoction and Xuefu Zhuyu Decoction has reliable curative effects for patients with chronic heart failure, which can improve clinical symptoms and TCM syndromes significantly, and decrease the levels of NT-pro BNP and inflammatory factors.
Objective To investigate the effects of Baoyuan Decoction and Xuefu Zhuyu Decoction on cardiac function and inflammatory factors in patients with chronic heart failure. Methods Seventy patients with chronic heart failure who were admitted to Department of Cardiology, Traditional Chinese Medicine Hospital of Dianjiang County in Chongqing City from December 2016 to June 2018 were selected as research subjects, they were divided into the control group and the treatment group by random number table method, with 35 cases in each group. The control group was given standardized drug therapy for chronic heart failure, the treatment group was additionally treated with Baoyuan Decoction and Xuefu Zhuyu Decoction on the basis of the control group. Both groups took 2 weeks as a course of treatment. The clinical effect, TCM syndrome effect, plasma NT-pro BNP levels and inflammatory factor indices [high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)] were compared between the two groups before and after treatment. Results After one course of treatment, the results of comparison of clinical efficacy and TCM symptom efficacy between the two groups showed that the total effect rates of treatment group were all higher than those of control group, with statistically significant differences(P < 0.05). After treatment, the levels of NT-pro BNP, hs-CRP, IL-6, TNF-α in the two groups were all lower than those before treatment(P < 0.01), and the levels of NT-pro BNP, hs-CRP, IL-6, TNF-α in the tretment group were all lower than those in the control group(P < 0.05).Conclusion Baoyuan Decoction and Xuefu Zhuyu Decoction has reliable curative effects for patients with chronic heart failure, which can improve clinical symptoms and TCM syndromes significantly, and decrease the levels of NT-pro BNP and inflammatory factors.
引文
[1]谢磊,杨嘉珍.益气养心汤对慢性心力衰竭的疗效及对患者心功能、心肌酶谱的影响[J].世界中医药,2017,12(6):1354-1357,1360.
[2]晏平,郭敏军,李惠玲,等.慢性心力衰竭患者血清LpPLA2、Cg A水平与心室重构的关系[J].山东医药,2018,58(20):88-90.
[3]蔡昌新,李二琴,张婷,等.曲美他嗪对冠心病合并慢性心力衰竭患者的疗效[J].中国循证心血管医学杂志,2016,8(5):576-579.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[5]冠心病中医临床研究联盟,中国中西医结合学会心血管疾病专业委员会,中华中医药学会心病分会等.慢性心力衰竭中医诊疗专家共识[J].中医杂志,2014,55(14):1258-1260.
[6]刘金华.补阳还五汤治疗慢性心力衰竭40例临床分析[J].河北中医,2015,37(2):229-230.
[7]李克营,杨芳.苓桂术甘配方颗粒治疗慢性心力衰竭(心肾阳虚证)的临床观察[J].湖南中医药大学学报,2017,37(8):895-899.
[8]谢磊,杨嘉珍.益气养心汤对慢性心力衰竭的疗效及对患者心功能、心肌酶谱的影响[J].世界中医药,2017,12(6):1354-1357,1360.
[9]陈婵,赵慧辉,王娟,等.357例冠心病心力衰竭患者人口学信息与中医证候分布特点的研究[J].北京中医药,2012,31(3):163-165.
[10]罗良涛,赵慧辉,王娟,等.中医医院冠心病慢性心力衰竭患者中医证候要素分布特点分析[J].北京中医药大学学报,2014,37(2):130-134.
[11]邢清敏,陆曙.中药对慢性心力衰竭NT-pro BNP影响的研究[J].河南中医,2015,35(6):1248-1249.
[12]陆红.益气活血中药联合曲美他嗪治疗老年慢性心力衰竭的临床疗效观察[J].中西医结合心脑血管病杂志,2016,14(17):2033-2035.
[13]廖易,刘俊,石颖,等.疏肝利水中药治疗慢性心力衰竭合并抑郁疗效及对AngⅡ、NT-pro BNP的影响[J].现代中西医结合杂志,2017,26(19):2084-2087.
[14]周洪武,程时杰,李雅琴,等.中药益气温阳活血利水方对慢性心力衰竭患者心功能及NT-pro BNP水平的影响[J].心脑血管病防治,2017,17(4):318-320.
[15]尚莉莉,全爱君,王馨,等.祛痰通阳汤对慢性心力衰竭模型大鼠超声心动图及血清AngⅡ含量、心肌组织AT1 m RNA表达的影响[J].中医杂志,2018,59(1):56-60.
[16]王芳英,袁园,丁姝月,等.劳拉西泮联合振源胶囊治疗慢性心力衰竭伴焦虑症状的疗效观察[J].医学临床研究,2017,34(12):2410-2411.
[17]李尚洪,张斌霞.中药治疗慢性心力衰竭的作用机制[J].吉林中医药,2016,36(4):359-362.
[18]冷建春,魏颖.参附救心汤对不同类型心力衰竭的疗效对比研究[J].中国现代医生,2018,56(2):114-117,121.
[19]陈会花,章忱,吕嵘,等.舒张性心力衰竭实验动物模型的研究进展[J].中国实验动物学报,2017,25(3):336-339.
[20]梁森森,陈碧銮,黄旋,等.参蛭四逆汤对老年慢性心力衰竭患者左室射血分数和Lee心衰计分的影响[J].湖北中医杂志,2017,39(1):1-3.
[21]李艳.美托洛尔联合曲美他嗪治疗冠心病心力衰竭患者临床疗效分析[J].中国现代医生,2017,55(25):42-44.
[22]张义全,雷芳,陈亮,等.心脉隆注射液联合芪苈强心胶囊对老年慢性心力衰竭患者血清BNP、NF-KB及胱抑素C水平的影响[J].西部中医药,2018,31(2):1-5.
[23]Wrigley BJ,Lip GY,Shantsila E.The role of monocytes and inflammation in the patho-physiology of heart failure[J].Eur J Heart Fail,2011,13(11):1161-1171.
[24]黄志文,彭春玲,田丽红,等.左西孟旦注射液在老年慢性心力衰竭中的应用疗效及安全性分析[J].中国医药科学,2017,7(13):63-65,80.
[25]Byrkjeland R,Nilsson BB,Westheim AS,et al.Inflammatory markers as related to disease severity in patients with chronic heart failure:limited effects of exercise training[J].Scand J Clin Lab Invest,2011,71(7):598-605.
[2]晏平,郭敏军,李惠玲,等.慢性心力衰竭患者血清LpPLA2、Cg A水平与心室重构的关系[J].山东医药,2018,58(20):88-90.
[3]蔡昌新,李二琴,张婷,等.曲美他嗪对冠心病合并慢性心力衰竭患者的疗效[J].中国循证心血管医学杂志,2016,8(5):576-579.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[5]冠心病中医临床研究联盟,中国中西医结合学会心血管疾病专业委员会,中华中医药学会心病分会等.慢性心力衰竭中医诊疗专家共识[J].中医杂志,2014,55(14):1258-1260.
[6]刘金华.补阳还五汤治疗慢性心力衰竭40例临床分析[J].河北中医,2015,37(2):229-230.
[7]李克营,杨芳.苓桂术甘配方颗粒治疗慢性心力衰竭(心肾阳虚证)的临床观察[J].湖南中医药大学学报,2017,37(8):895-899.
[8]谢磊,杨嘉珍.益气养心汤对慢性心力衰竭的疗效及对患者心功能、心肌酶谱的影响[J].世界中医药,2017,12(6):1354-1357,1360.
[9]陈婵,赵慧辉,王娟,等.357例冠心病心力衰竭患者人口学信息与中医证候分布特点的研究[J].北京中医药,2012,31(3):163-165.
[10]罗良涛,赵慧辉,王娟,等.中医医院冠心病慢性心力衰竭患者中医证候要素分布特点分析[J].北京中医药大学学报,2014,37(2):130-134.
[11]邢清敏,陆曙.中药对慢性心力衰竭NT-pro BNP影响的研究[J].河南中医,2015,35(6):1248-1249.
[12]陆红.益气活血中药联合曲美他嗪治疗老年慢性心力衰竭的临床疗效观察[J].中西医结合心脑血管病杂志,2016,14(17):2033-2035.
[13]廖易,刘俊,石颖,等.疏肝利水中药治疗慢性心力衰竭合并抑郁疗效及对AngⅡ、NT-pro BNP的影响[J].现代中西医结合杂志,2017,26(19):2084-2087.
[14]周洪武,程时杰,李雅琴,等.中药益气温阳活血利水方对慢性心力衰竭患者心功能及NT-pro BNP水平的影响[J].心脑血管病防治,2017,17(4):318-320.
[15]尚莉莉,全爱君,王馨,等.祛痰通阳汤对慢性心力衰竭模型大鼠超声心动图及血清AngⅡ含量、心肌组织AT1 m RNA表达的影响[J].中医杂志,2018,59(1):56-60.
[16]王芳英,袁园,丁姝月,等.劳拉西泮联合振源胶囊治疗慢性心力衰竭伴焦虑症状的疗效观察[J].医学临床研究,2017,34(12):2410-2411.
[17]李尚洪,张斌霞.中药治疗慢性心力衰竭的作用机制[J].吉林中医药,2016,36(4):359-362.
[18]冷建春,魏颖.参附救心汤对不同类型心力衰竭的疗效对比研究[J].中国现代医生,2018,56(2):114-117,121.
[19]陈会花,章忱,吕嵘,等.舒张性心力衰竭实验动物模型的研究进展[J].中国实验动物学报,2017,25(3):336-339.
[20]梁森森,陈碧銮,黄旋,等.参蛭四逆汤对老年慢性心力衰竭患者左室射血分数和Lee心衰计分的影响[J].湖北中医杂志,2017,39(1):1-3.
[21]李艳.美托洛尔联合曲美他嗪治疗冠心病心力衰竭患者临床疗效分析[J].中国现代医生,2017,55(25):42-44.
[22]张义全,雷芳,陈亮,等.心脉隆注射液联合芪苈强心胶囊对老年慢性心力衰竭患者血清BNP、NF-KB及胱抑素C水平的影响[J].西部中医药,2018,31(2):1-5.
[23]Wrigley BJ,Lip GY,Shantsila E.The role of monocytes and inflammation in the patho-physiology of heart failure[J].Eur J Heart Fail,2011,13(11):1161-1171.
[24]黄志文,彭春玲,田丽红,等.左西孟旦注射液在老年慢性心力衰竭中的应用疗效及安全性分析[J].中国医药科学,2017,7(13):63-65,80.
[25]Byrkjeland R,Nilsson BB,Westheim AS,et al.Inflammatory markers as related to disease severity in patients with chronic heart failure:limited effects of exercise training[J].Scand J Clin Lab Invest,2011,71(7):598-605.