摘要
目的探讨生脉散合加味升陷汤对气虚血瘀型射血分数降低的心力衰竭(HFrEF)患者的治疗效果,及对患者免疫炎症反应的影响。方法选取90例气虚血瘀型HFrEF患者,根据治疗方案分为2组,其中常规组(42例)口服沙库巴曲缬沙坦钠片,联合组(48例)在常规组基础上加用生脉散合加味升陷汤,每日1剂,分2次早晚服用。分别在治疗前后采用中医证候积分评估患者症状;超声心动图技术测量患者的左心室舒张末期内径(LVEDD)和左心室射血分数(LVEF);酶联免疫吸附试验检测正五聚蛋白3(PTX3)、肿瘤坏死因子-α(TNF-α)、半乳糖凝集素3(Gal-3)、白细胞介素(IL)-8、IL-6、IL-33、血管紧张素Ⅱ(AngⅡ);免疫荧光分析法检测N-末端脑钠肽前体(NT-proBNP);根据症状和美国纽约心脏病协会(NYHA)心功能分级评估疗效。结果治疗后2组患者的中医证候积分、LVEDD、TNF-α、IL-8、IL-6、IL-33、NT-proBNP、Gal-3、AngⅡ、PTX3水平均降低,且联合组均低于常规组(P<0.05);LVEF升高,且联合组高于常规组(P<0.05)。治疗后,联合组总有效率高于常规组(P<0.05)。结论生脉散合加味升陷汤辅助治疗能够有效降低气虚血瘀型HFrEF患者体内的免疫炎性细胞因子水平,改善患者的临床症状,提高临床疗效。
Objective To investigate the therapeutic effect of Sheng Mai San mixed Jiawei Sheng Xian Tang on patients with heart failure with reduced ejection fraction(HFrEF)of Qi deficiency blood stasis type,and its impact on the immune inflammatory response of patients.Methods Ninety patients with HFrEF of Qi deficiency blood stasis type were selected and divided into two groups according to the treatment plan.Patients of the conventional group(42 cases)took sacubitril/valsartan sodium tablets orally.Patients of the combined group(48 cases)were treated with Sheng Mai San combined with Jiawei Sheng Xian Tang on the basis of the conventional group,one dose per day,and divided it in two servings used in the morning and evening.The symptoms of the patients were evaluated by using traditional Chinese medicine(TCM)syndrome score before and after the treatment respectively.Echocardiography technology was used to measure the left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF).Enzyme-linked immunosorbent assay was used to detect pentaggrin 3(PTX3),tumor necrosis factor-α(TNF-α),galectin-3(Gal-3),interleukin(IL)-8,IL-6,IL-33 and angiotensinⅡ(AngⅡ).N-terminal pro-brain natriuretic peptide(NT-proBNP)was detected by immunofluorescence analysis.The therapeutic effect was evaluated based on the symptoms and the New York Heart Association(NYHA)cardiac function classification in the United States.Results After treatment,the levels of TCM syndrome scores,LVEDD,TNF-α,PTX3,IL-8,IL-6,IL-33,NT-proBNP,Gal-3 and AngⅡdecreased in both groups,and those in the combined group were lower than those in the conventional group(P<0.05).The LVEF increased,and which were higher in the combined group than those of the conventional group(P<0.05).After the treatment,the total effective rate of the combined group was higher than that of the conventional group(P<0.05).Conclusion The Sheng Mai San mixed Jiawei Sheng Xian Tang as adjuvant therapy can effectively reduce the levels of immune inflammatory cytokines in HFrEF patients of Qi deficiency blood stasis type,improve their clinical symptoms and enhance therapeutic effect.
作者
李迎杰
张航
郝少婷
许菲
郭魏超
宋惠
王艳芬
LI Yingjie;ZHANG Hang;HAO Shaoting;XU Fei;GUO Weichao;SONG Hui;WANG Yanfen(Department of Heart Disease 2,Handan Mingren Hospital,Handan 056000,China;Department of Cardiology 2,Tangshan People's Hospital;Department of Heart Disease 3,Handan Mingren Hospital)
出处
《天津医药》
2025年第8期860-864,共5页
Tianjin Medical Journal
基金
河北省中医药管理局科研计划项目(2025616)。
关键词
心力衰竭
生脉散
升陷汤
气虚血瘀
炎症
左心室射血分数
heart failure
Sheng Mai San
Sheng Xian Tang
Qi deficiency blood stasis
inflammation
left ventricular ejection fraction
