[1]黄光明.理中汤加减治疗慢性心力衰竭及对患者血清BNP、IL-10及NOS水平的影响研究[J].陕西中医,2021,(2):159-162.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.006]
　HUANG Guangming.Modified Lizhong decoction on clinical symptoms and levels of serum BNP,IL-10 and NOS in patients with chronic heart failure[J].,2021,(2):159-162.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.006]
点击复制

理中汤加减治疗慢性心力衰竭及对患者血清BNP、IL-10及NOS水平的影响研究
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年2期
页码:
159-162
栏目:
临床研究
出版日期:
2021-02-05

文章信息/Info

Title:
Modified Lizhong decoction on clinical symptoms and levels of serum BNP,IL-10 and NOS in patients with chronic heart failure
作者:
黄光明
(芜湖市中医院心内科,安徽 芜湖 241000)
Author(s):
HUANG Guangming
(Department of Cardiology,Wuhu Hospital of Traditional Chinese Medicine,Wuhu 241000,China)
关键词:
慢性心力衰竭;  理中汤;  B型钠尿肽;  白细胞介素-10;  一氧化氮合酶
Keywords:
Chronic heart failure;  Lizhong decoction;  B-type natriuretic peptide;  Interleukin-10;  Nitric oxide synthase
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7369.2020.02.006
文献标志码:
A
摘要:
目的:观察理中汤加减对慢性心力衰竭(CHF)患者临床症状改善、血清B型钠尿肽(BNP)、白细胞介素-10(IL-10)、一氧化氮合酶(NOS)水平的影响。方法:选取110例CHF患者随机分为观察组56例与对照组54例。对照组入院后给予常规抗心衰西药治疗,观察组在其基础上给予理中汤加减。比较两组短期(1个月内)临床疗效,并记录其治疗前、治疗3个月后临床症状(中医症候积分)改善、心功能生化指标[BNP、超敏肌钙蛋白T(hs-TnT)、氨基末端脑钠肽(NT-proBNP)]、炎症细胞因子[肿瘤坏死因子-α(TNF-α)、IL-10、氧化应激和核因子-κB(NF-κB)]及血管内皮细胞指标[一氧化氮(NO)、NOS]变化及不良反应情况。结果:治疗1个月内,观察组有效率为85.71%,显著高于对照组的68.52%(P<0.05); 治疗3个月后,两组患者中医症候积分、BNP、hs-TnT、NT-proBNP、TNF-α、NF-κB、NO、NOS水平与治疗前比较均存在下降趋势(均P<0.05),且观察组变化幅度更大(均P<0.05); 治疗过程中,观察组不良反应发生情况优于对照组。结论:给予CHF患者理中汤加减治疗可有利于其临床症状的改善,提高疗效,其作用机制可能与降低炎症因子水平、改善心功能及血管内皮细胞功能有关,与其病情转归有利。
Abstract:
Objective:To observe the effects of modified Lizhong decoction on improvement of clinical symptoms and levels of serum B-type natriuretic peptide(BNP),interleukin-10(IL-10)and nitric oxide synthase(NOS)in patients with chronic heart failure(CHF).Methods:Totally 110 patients with CHF were selected and randomly divided into observation group(n=56)and control group(n=54).Control group was treated with conventional western medicine for anti-heart failure therapy after admission,and observation group was given modified Lizhong decoction on this basis.The clinical efficacy in short term(within 1 month)was compared between the two groups,and the improvement of clinical symptoms(TCM syndromes scores),as well as cardiac function biochemical indicators [BNP,hypersensitive troponin T(hs-TnT),N-terminal pro-brain natriuretic peptide(NT-proBNP)],inflammatory cytokines [tumor necrosis factor-α(TNF-α),IL-10,nuclear factor kappa beta(NF-κB)] and vascular endothelial cell indexes NO,NOS and adverse reactions were recorded before treatment after 3 months of treatment.Results:Within 1 month of treatment,the effective rate in observation group was significantly higher than that in control group(85.71% vs 68.52%).After 3 months of treatment,the scores of TCM syndromes and levels of BNP,hs-TnT,NT-proBNP,TNF-α,NF-κB,NO and NOS in the two groups showed decreasing trends compared with those before treatment(all P<0.05),and the changes were greater in observation group(all P<0.05).During treatment,the occurrence of adverse reactions in observation group were better than those in control group.Conclusion:Modified Lizhong decoction for patients with CHF can help improve the clinical symptoms and enhance the clinical efficacy.And its role mechanism may be related to reducing the levels of inflammatory factors and improving cardiac function and vascular endothelial cell function,and it is beneficial to the outcomes of the disease.

参考文献/References:

[1] 苏依拉其木格,白 龙,乌日罕,等.慢性心力衰竭中医主要证候要素与理化指标相关性研究[J].天津中医药大学学报,2017,36(3):191-196.
[2] Franciosa JA,Weber KT,Levine TB,et al.Hydralazine in the long-term treatment of chronic heart failure:Lack of difference from placebo[J].American Heart Journal,2015,104(3):587-594.
[3] 赵汉清,贾 评,蒋欢欢,等.利水活血温阳方对慢性心力衰竭的疗效观察[J].陕西中医,2016,37(12):1578-1579.
[4] Rickard J,Bassiouny M,Tedford RJ,et al.Long-term outcomes in patients with ambulatory New York heart association class Ⅲ and Ⅳ heart failure undergoing cardiac resynchronization therapy[J].American Journal of Cardiology,2015,115(1):82-85.
[5] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员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2018[J].中华心血管病杂志,2018,46(10):760-789.
[6] 国家食品药品监督管理总局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:77-84.
[7] 毋领娟,王永霞,邢作英,等.慢性心力衰竭中西医结合诊疗方案与单纯西医方案的临床效果评价[J].中华中医药杂志,2018,33(8):3728-3731.
[8] 丁 鹏,李春娟.β受体阻滞剂联合他汀类药物治疗慢性心衰临床观察[J].陕西医学杂志,2017,46(2):264,272.
[9] 王 娟,赵慧辉,陈建新,等.慢性心力衰竭患者中医证候与原发病的相关性研究[J].国际中医中药杂志,2019,41(4):331-334.
[10] 林海丹,巫燕慧,陈英男,等.“双心同治”治疗慢性心力衰竭的理论探讨[J].湖北中医药大学学报,2019,21(2):51-54.
[11] 俞兴群,王 玲.慢性心力衰竭中医证候特征与客观化研究[J].中医学报,2015,30(11):1667-1669.
[12] 王 毅,杨 征.托伐普坦和沙库巴曲缬沙坦钠片对慢性心力衰竭患者心功能及血清钠水平的影响研究[J].陕西医学杂志,2019,48(4):470-472.
[13] 冯辉辉,许 铁.NT-proBNP对急性心力衰竭患者发生利尿剂抵抗的预测价值[J].中国急救复苏与灾害医学杂志,2020,15(1):29-33.
[14] 魏合成.芪苈强心胶囊联合曲美他嗪对慢性心力衰竭患者炎症及血管内皮功能的影响[J].河北医药,2015,37(20):3067-3069.
[15] 武妤霞,刘 珊,郭 颖,等.《伤寒论》太阴病提纲证之主方探讨[J].环球中医药,2017,10(10):54-56.
[16] 何新慧.《伤寒论》虚寒下利方学用心悟[J].环球中医药,2017,10(5):558-559.
[17] 陈宗伟,沈志涛,郑振国,等.芪苈强心胶囊配合保元汤加减治疗慢性心力衰竭临床研究[J].陕西中医,2020,41(2):191-193.
[18] 申 珊.理中汤联合西药治疗脾胃虚寒型慢性胃炎的临床疗效观察[J].中医药信息,2015,32(5):101-103.

相似文献/References:

[1]杨自生,金 琪,简立国.参苓养心汤治疗慢性心衰的疗效及对心功能、活动耐力、 NTProBNP、hsCRP的影响*[J].陕西中医,2019,(2):167.
　YANG Zisheng,JIN Qi,JIAN Liguo..The effect of Shenling Yangxin decoction on chronic heart failure and its effect on cardiac function，activity endurance，NTProBNP and hsCRP[J].,2019,(2):167.
[2]孙 哲,杨 默,石宗华.丹参多酚酸盐与丹参酮治疗慢性心力衰竭临床研究[J].陕西中医,2019,(5):591.
　SUN Zhe,YANG Mo,SHI Zonghua..Clinical effect and mechanism of salvianolate and Tanshinone in the treatment of chronic heart failure[J].,2019,(2):591.
[3]向宗兴,拓 文,仇卫峰,等.黄芪保心汤配合西药治疗慢性心力衰竭临床研究*[J].陕西中医,2019,(8):1085.
　XIANG Zongxing,TUO Wen,QIU Weifeng,et al.Clinical value of Huangqi Baoxin decoction combined with western medicine in the treatment of chronic heart failure[J].,2019,(2):1085.
[4]尚加芬.参芪附仙饮联合盐酸曲美他嗪片辨治慢性心力衰竭心肾阳虚证临床研究[J].陕西中医,2020,(1):38.
[5]陈宗伟,沈志涛,郑振国,等.芪苈强心胶囊配合保元汤加减治疗慢性心力衰竭临床研究*[J].陕西中医,2020,(2):191.
　CHEN Zongwei,SHEN Zhitao,ZHENG Zhenguo,et al.Observation on the effect of Qili Qiangxin capsules assist Baoyuan decoction in the treatment of chronic heart failure[J].,2020,(2):191.
[6]凌 望,孙思明,王璐玲,等.温阳益气活血方改善慢性心力衰竭患者生活质量临床研究*[J].陕西中医,2020,(5):621.[doi:DOI:10.3969/j.issn.10007369.2020.05.019]
　LING Wang,SUN Siming,WANG Luling,et al.A Study on the quality of life about Wenyang Yiqi Huoxue therapy in the treatment of chronic heart failure[J].,2020,(2):621.[doi:DOI:10.3969/j.issn.10007369.2020.05.019]
[7]朱 杰,林兆奋△,胡 聃,等.中西医结合治疗慢性心力衰竭研究进展*[J].陕西中医,2020,(9):1342.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.046]
[8]刘 薇,张玉焕,李 争.芪参益气滴丸对老年气虚血瘀型心力衰竭患者心肌保护、炎症状态的影响[J].陕西中医,2021,(1):37.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.008]
　LIU Wei,ZHANG Yuhuan,LI Zheng.Effects of Qishen Yiqi dropping pills on myocardial protection,inflammatory state and serum cell adhesion molecule level in elderly patients with heart failure caused by qi deficiency and blood stasis[J].,2021,(2):37.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.008]
[9]胡 芳,谭明娜,谭小娥,等.加味五苓散联合西药治疗慢性心力衰竭疗效及对患者心功能、纤维化指标、炎性因子水平的影响[J].陕西中医,2021,(2):167.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.008]
　HU Fang,TAN Mingna,TAN Xiao'e,et al.Effects of modified Wuling powder combined with western medicine on levels of cardiac function,fibrosis indicators and inflammatory factors in patients with chronic heart failure[J].,2021,(2):167.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.008]
[10]郭 允,王学工.加味益气强心汤对心阳亏虚型慢性心衰患者心功能、血管内皮功能的影响[J].陕西中医,2021,(4):456.[doi:DOI:10.3969/j.issn.1000-7369.2020.04.013]

备注/Memo

备注/Memo:
基金项目:安徽省重点研究与开发计划项目(201904a07020109)
更新日期/Last Update: 2021-01-28