摘要
目的:观察养心汤联合倍他乐克对扩张性心肌病合并心力衰竭患者的临床疗效,及对血清中高迁移率族蛋白B1(high mobility group protein,HMGB1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及白细胞介素-6(Interleukin-6,IL-6)含量的影响。方法:将80例扩张性心肌病合并心力衰竭患者随机分为治疗组和对照组,每组40例。两组患者均采用西医常规治疗。对照组口服倍他乐克治疗;治疗组在对照组基础上加用养心汤治疗,方药组成:黄芪20 g,白茯苓15 g,茯神15 g,半夏曲15 g,当归15 g,川芎9 g,远志9 g,肉桂9 g,柏子仁9 g,酸枣仁12 g,北五味子12 g,人参10 g,甘草10 g。每天1剂,常规水煮分早晚温服。两组患者均连续治疗3个月。比较两组患者左心室射血分数(left ventricular ejection fraction,LVEF)、舒张早期/舒张晚期最大血流速度(E/A)、6 min步行试验(6-minute walk test,6 MWT)、心力衰竭疗效积分、心率变异性和临床疗效,并检测两组患者血清中HMGB1、TNF-α及IL-6含量。结果:治疗后,治疗组患者的LVEF、E/A、6 MWT及心率变异性指标显著高于对照组,差异有统计学意义(P<0.01);心力衰竭计分系统各指标评分明显少于对照组,差异有统计学意义(P<0.01);治疗组有效率为95%,显著高于对照组75%,差异有统计学意义(P<0.05);治疗组患者血清中HMGB1、TNF-α及IL-6水平显著少于对照组,差异有统计学意义(P<0.01)。结论:养心汤联合倍他乐克对扩张性心肌病并心力衰竭患者,可改善患的心功能和心率变异性,提高临床疗效,其抑制患者血清中HMGB1、TNF-α及IL-6含量可能与治疗作用有关。
Objective： To observe effect of Yangxin decoction combined with betalic in treating dilated cardiomyopathy with heart failure and the influence on serum levels of high mobility group box-1 protein（ HMGB1）,tumor necrosis factor-α（ TNF-α）,and interleukin-6（ IL-6）. Methods： Eighty cases with dilated cardiomyopathy with heart failure were randomly divided into the control group（ 40 cases） and the treatment group（ 40 cases）. All cases were treated with Western routinal therapy. Patients of the treatment group were treated with Yangxin decoction（ one dose a day,conventional boiling,and warm taking in the morning and evening） and orally betalic. Composition： Huangqi（ Astragalus） 20 g,Baifuling（ Poria Alba） 15 g,Fushen（ Poria with Hostwood） 15 g,Banxiaqu（ Pinellia Tuber） 15 g,Danggui（ Angelica Sinensis） 15 g,Chuanxiong（ Ligusticum Wallichii） 9 g,Yuanzhi（ Polygala Tenuifolia） 9 g,Rougui（ Cinnamon） 9 g,Boziren（ Semen Boitae） 9 g,Suanzaoren（ Semen Zizyphi Spinosae） 12 g; Beiwuweizi（ Schizandra Sinensis Baill） 12 g,Renshen（ Ginseng） 10 g,Gancao（ Liquorice） 10 g. The two groups were treated continuously for 3months. Left ventricular ejection fraction（ LVEF）,E/A,6 minutes walk test（ 6 MWT）,socres of curative effect of heart failure,and heart rate variability were compared between two groups. Serum levels of HMGB1,TNF-α,and IL-6 were detected in two groups.Results： After treatment,LVEF,E/A,6 MWT,and indexes of heart rate variability of treatment group were evidently higher,while scores of curative effect of heart failure were obviously lower,than control groups（ P 〈0. 01）. The effective rate of the treatment group was 95% superior to control group 75%（ P 〈0. 05）. After treatment,serum levels of HMGB1,TNF-α,and IL-6 were remarkably lower than control group（ P 〈0. 01）. Conclusion： Efficacy of Yangxin decoction combined with betalic in treating dilated cardiomyopathy with heart failure can improve heart function and heart rate variability,increase efficacy,and down-regulation of serum levels of HMGB1,TNF-α,and IL-6 may be related to its effect.
出处
《中医学报》
CAS
2017年第10期1976-1980,共5页
Acta Chinese Medicine
基金
四川省卫生厅科研课题(120028)
关键词
养心汤
倍他乐克
扩张性心肌病
心力衰竭
心率变异性
中医药疗法
中西医结合
Yangxin decoction
betalic
dilated cardiomyopathy
heart failure
heart rate variability
TCM therapy
combination oftraditional Chinese and Western medicine
