抗心衰方对慢性心力衰竭患者心功能及氧化应激功能的影响

Effect of Kangxinshuai Formula on Cardiac Function and Oxidative Stress in Patients with Chronic Heart Failure

    摘要
  • 摘要:
      目的  观察抗心衰方对气阴两虚、痰瘀水停型慢性心力衰竭(简称慢性心衰)患者心功能及氧化应激功能的影响。
      方法  选取符合纳入标准的慢性心衰患者100例, 按随机数字表法分为观察组和对照组各50例。对照组予慢性心衰标准化治疗, 观察组在对照组治疗基础上联用抗心衰方, 疗程均为12周。观察患者治疗前后中医证候积分及临床疗效、纽约心脏协会(NYHA)心功能分级疗效、6 min步行试验(6MWT)、明尼苏达心衰生活质量问卷(MLHFQ)、超声心动图指标左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室射血分数(LVEF)、血清N末端B型脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2)、内源性抗氧化应激因子血红素氧合酶-1(HO-1)、过氧化物酶(SOD)、谷胱甘肽过氧化物酶(GPx)、醌氧化还原酶-1(NQO-1)水平或活性的变化，并对安全性指标进行评估。
      结果  治疗后, 观察组中医证候积分及临床疗效、NYHA心功能分级临床疗效、6MWT、MLHFQ评分、超声心动图指标、NT-proBNP、sST2均有改善(P < 0.05), 观察组优于对照组(P < 0.05, P < 0.01);2组内源性抗氧化应激因子水平均有提高(P < 0.01), 观察组优于对照组(P < 0.01)。
      结论  抗心衰方联合慢性心衰标准化治疗可提高慢性心衰的临床疗效、改善心功能分级及预后, 其可能机制与提高内源性抗氧化应激因子水平、减轻心肌氧化应激损伤、改善抗氧化能力、延缓心肌重塑有关。

     

    Abstract:
      OBJECTIVE  To observe the effect of Kangxinshuai formula on cardiac function and oxidative stress in patients suffering from chronic heart failure with qi-yin deficiency and phlegm-stasis combined with water-stagnation (chronic heart failure for short).
      METHODS  A total of 100 patients with chronic heart failure who met the inclusion criteria were selected and divided into 50 cases each in the observation group and the control group according to the random number table. The control group was given standardized treatment for chronic heart failure, while the observation group was treated with the Kangxinshuai formula on top of the treatment of the control group. The course of treatment was 12 weeks. Before and after the treatment, we observed the changes in the traditional Chinese medicine (TCM) syndrome score, clinical efficacy, New York Heart Association (NYHA) cardiac function classification, 6 min walking test (6MWT), Minnesota heart failure quality of life questionnaire (MLHFQ), echocardiographic parameters left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), serum N-terminal pro brain natriuretic peptide (NT-proBNP), soluble growth stimulator gene 2 protein (sST2), as well as endogenous antioxidant stress factors heme oxygenase-1 (HO-1), peroxidase (SOD), glutathione peroxidase (GPx), quinone oxidoreductase-1 (NQO-1), and evaluated the related safety indexes.
      RESULTS  After treatment, the TCM syndrome score, clinical efficacy, NYHA cardiac function classification, 6MWT, MLHFQ score, echocardiographic parameters, NT-proBNP, and sST2 showed better results in the observation group (P < 0.05), so the clinical effects of the observation group were better than those of the control group (P < 0.05, P < 0.01). Besides, endogenous anti-oxidative stress factor levels were improved in both groups (P < 0.01), while the observation group performed better than the control group (P < 0.01).
      CONCLUSION  Kangxinshuai formula combined with standardized treatment for chronic heart failure can improve the clinical efficacy, cardiac function classification and prognosis of chronic heart failure. The possible mechanism is related to increasing the level of endogenous anti-oxidative stress factors, reducing cardiac oxidative stress damage, improving antioxidant capacity, and delaying cardiac remodeling.

     

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