| 周 云,高山钟,缪志静,张 超,关敬树.真武汤合桂枝茯苓丸对心肾阳虚型慢性心力衰竭患者心功能、血生化指标及生活质量的影响[J].,2022,(7):1292-1296 |
| 真武汤合桂枝茯苓丸对心肾阳虚型慢性心力衰竭患者心功能、血生化指标及生活质量的影响 |
| Effects of Zhenwu Decoction Combined with Guizhi Fuling Pill on Cardiac Function, Blood Biochemical Indexes and Quality of Life in Patients With Chronic Heart Failure of Heart and Kidney Yang Deficiency Type |
| 投稿时间：2021-09-18 修订日期：2021-10-13 |
| DOI：10.13241/j.cnki.pmb.2022.07.020 |
| 中文关键词: 真武汤 桂枝茯苓丸 慢性心力衰竭 心功能 炎性因子 内皮功能 |
| 英文关键词: Zhenwu Decoction Guizhi Fuling Pill Chronic heart failure Cardiac function Inflammatory factors Endothelial function |
| 基金项目:上海市卫生健康委员会科研项目（202040398） |
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| 中文摘要: |
| 摘要 目的：探讨真武汤合桂枝茯苓丸对心肾阳虚型慢性心力衰竭（CHF）患者心功能、血生化指标及生活质量的影响。方法：选取2017年2月~2020年2月上海中医药大学附属曙光医院宝山分院收治的118例心肾阳虚型CHF患者，以随机数字表法分为研究组和对照组各59例，两组均予以常规西医治疗，研究组加用真武汤合桂枝茯苓丸治疗。观察两组临床疗效，比较两组中医证候积分、心功能、血清炎性因子、血管内皮功能指标以及生活质量的变化。结果：经过2个疗程的治疗，研究组91.53%（54/59）的临床总有效率高于对照组72.88%（43/59）（P<0.05）；两组中医证候积分均降低，研究组低于对照组（P<0.05）；两组左心室射血分数（LVEF）均升高、左心室舒张末期内径（LVEDD）均缩小、N末端 -脑钠肽前体（NT-proBNP）水平均降低，且研究组的LVEF高于对照组、LVEDD小于对照组、NT-proBNP水平低于对照组（P<0.05）；两组白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白介素-10（IL-10）、超敏C反应蛋白（hs-CRP）水平均降低，且研究组低于对照组（P<0.05）；两组血管内皮生长因子（VEGF）水平均升高，而血管内皮素-1（ET-1）、血管性血友病因子（vWF）水平均降低，且研究组VEGF水平高于对照组，ET-1、vWF水平低于对照组（P<0.05）；两组生活质量测定量表（QOL-100）各项评分均升高，且研究组高于对照组（P<0.05）。结论：真武汤合桂枝茯苓丸治疗心肾阳虚型CHF，可降低血清炎性因子水平，改善心功能及血管内皮功能，提高患者生活质量。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of Zhenwu Decoction combined with Guizhi Fuling Pill on cardiac function, blood biochemical indexes and quality of life in patients with chronic heart failure (CHF) of heart kidney yang deficiency type. Methods: 118 patients with CHF of heart kidney yang deficiency type treated in Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of traditional Chinese Medicine from February 2017 to February 2020 were selected and divided into control group and study group by random number table method, with 59 cases in each group. Both groups were treated with conventional western medicine, the patients in study group were treated with Zhenwu Decoction combined with Guizhi Fuling Pill additionally. The clinical effects of the two groups were observed, The changes of TCM syndrome score, cardiac function, serum inflammatory factors, vascular endothelial function index levels and quality of life were compared between the two groups. Results: After two courses of treatment, the total clinical effective rate of the study group was 91.53% (54/59) higher than that of the control group 72.88% (43/59) (P<0.05). The TCM syndrome scores of the two groups decreased, and that of the study group was lower than that of the control group (P<0.05). In both groups, left ventricular ejection fraction (LVEF) increased, left ventricular end diastolic diameter (LVEDd) decreased, and the level of N-terminal pro brain natriuretic peptide (NT proBNP) decreased, in the study group, LVEF was higher than that in the control group, LVEDd was less than that in the control group, and the level of NT proBNP was lower than that in the control group (P<0.05). The levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), interleukin-10 (IL-10) and high-sensitivity C-reactive protein (hs CRP) of the two groups decreased, and those of the study group was lower than those of the control group (P<0.05). In both groups, the level of vascular endothelial growth factor (VEGF) increased, the levels of vascular endothelin-1 (ET-1) and von Willebrand factor (vWF) decreased, in the study group, the level of VEGF was higher than that in the control group, and the levels of ET-1 and vWF were lower than those in the control group (P<0.05). The scores of quality of life scale (QOL-100) of the two groups increased, and those of the study group were higher lower than those of the control group (P<0.05). Conclusion: Zhenwu Decoction combined with Guizhi Fuling pill in the treatment of CHF with heart and kidney yang deficiency type can reduce the level of serum inflammatory factors, improve cardiac function and vascular endothelial function, and improve the quality of life of patients. |
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