黄芪保心汤对扩张型心肌病心衰患者心功能及神经内分泌因子的影响

卢磊; 张培影; 刘晓丹; 陈永刚; 刘敏; 张庆

黄芪保心汤对扩张型心肌病心衰患者心功能及神经内分泌因子的影响

1.
南京中医药大学附属徐州市中医院，江苏徐州 221000
2.
徐州市中心医院心血管内科，江苏徐州 221000

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出版历程
- 收稿日期: 2017-11-27
- 刊出日期: 2018-03-10

Influence of Huangqibaoxin Decoction on the Heart Function and Neuroendocrine Cytokines in Dilated Cardiomyopathy Patients with Heart Failure

1.
Xuzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Xuzhou, 221000, China
2.
Internal Medicine-Cardiovascular Department of Xuzhou Central Hospital, Xuzhou, 221000, China

摘要

摘要: 观察黄芪保心汤对扩张型心肌病（DCM）心衰患者心功能及神经内分泌因子的影响。方法将96例扩张型心肌病心衰患者随机分为治疗组50例和对照组46例。2组均给予规范西医治疗，治疗组联合应用黄芪保心汤，每日2次，每次100 mL。2组均连续治疗3月。分别于治疗2周、3月观察治疗前后2组患者临床症状、体征、心功能分级并判定临床疗效；治疗前、治疗3月后检测2组患者血浆N末端B型钠尿肽（NT-proBNP）、肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD）、内皮素（ET）水平；治疗前、治疗3月行6 min步行试验，并予彩超检查左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左心室射血分数(LVEF)。结果治疗2周、3月时治疗组临床疗效总有效率分别为82.0%、94.0%，对照组分别为73.9%、80.4%，治疗组均明显优于对照组(P＜0.05)。治疗3个月时2组LVEDD、LVESD均有降低，LVEF升高，而治疗组较对照组明显改善(P＜0.05)。6 min步行试验结果2组均有提高，治疗组优于对照组(P＜0.05)。治疗3月时2组患者NT-proBNP、PRA、AngⅡ、ALD、ET水平均有下降(P＜0.05)，治疗组优于对照组(P＜0.05)。结论黄芪保心汤联合西药可以改善扩张型心肌病心衰患者的心功能。其机制可能与其抑制RASS系统过度激活、保护内皮功能、抑制心室重构有关。
- 扩张型心肌病 /
- 心脏彩超 /
- 神经内分泌 /
- 心室重构 /
- 黄芪保心汤 /
- 中西医结合
Abstract: OBJECTIVE To observe the influence of Huangqibaoxin decoction on the heart function and neuroendocrine cytokines in dilated cardiomyopathy (DCM) patients with heart failure. METHODS According to random number method， 96 DCM patients with heart failure were randomly divided into the treatment group (50 cases) and the control group (46 cases). Both groups were given standard western treatment， and the treatment was also treated with Huangqibaoxin decoction， 2 times/day， 100Ml/time. Both groups were treated for three months continuously. The clinical symptoms， body signs， cardiac function classification were observed and the clinical effects were evaluated of both groups at 2-week， 3-month respectively of the treatment. The N-terminal-brain natriuretic peptide (NT-pro BNP)， plasma renin activity (PRA)， AngiotensinⅡ (AngⅡ)， aldosterone (ALD) and endothelin (ET) levels of patients in both groups were detected before and three months after the treatment. Before and three months after the treatment， the 6-minute walk test was performed， and the left ventricular end diastolic diameter (LVEDD)， left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were examined by ultrasonography. RESULTS Total rate of clinical efficacy in the treatment group was 82.0%， 94.0% respectively， and those of the control group was 73.9%， 80.4% respectively at 2-week and 3-month， the treatment group was significantly better than the control group (P<0.05). At 3-month of the treatment， levels of LVEDD and LVESD were decreased and LVEF increased in both groups， and the treatment group significantly improved than the control group (P<0.05). The 6-minute walk test results were both improved in both groups， and the treatment group was better than the control group (P<0.05). NT-pro BNP， PRA， AngⅡ， ALD and ET of patients in both groups were decreased at 3-month of the treatment (P<0.05)， the treatment group was better than the control group(P<0.05). CONCLUSIONS The combination of Huangqibaoxin decoction and western medicine can improve the heart function of DCM patients with heart failure. The mechanism may be related to the inhibition of the overactivation of RASS system， the protection of endothelial function and the inhibition of ventricular remodeling.
- dilated cardiomyopathy /
- heart ultrasonography /
- neuroendocrine /
- ventricular remodeling /
- Huangqibaoxin decoction /
- combination of traditional Chinese and western medicine

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