目的观察复方真武冲剂治疗阳虚水泛型心力衰竭的临床疗效,并探索其对心功能、心室重构及炎症因子水平的影响。方法选择2023年5月至2024年3月安徽中医药大学第一附属医院老年病中心心血管内科收治心力衰竭(阳虚水泛型)病人60例。采用随...目的观察复方真武冲剂治疗阳虚水泛型心力衰竭的临床疗效,并探索其对心功能、心室重构及炎症因子水平的影响。方法选择2023年5月至2024年3月安徽中医药大学第一附属医院老年病中心心血管内科收治心力衰竭(阳虚水泛型)病人60例。采用随机数字表法分组,对照组采用正规西药治疗,观察组在对照组基础上加服复方真武冲剂,疗程均为4周。统计两组治疗前后临床疗效,评估病人6 min步行试验的距离(6-minute walk test,6MWT),检测并比较两组病人的心功能[氨基末端脑利钠肽前体(NT-proBNP)、左心室射血分数(LVEF)]、心室重构[左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)]、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)和血清淀粉样蛋白A(SAA)]等指标。结果经治疗后观察组心功能改善总有效率为93.3%,明显高于对照组总有效率76.7%(χ^(2)=6.05,P<0.05)。两组治疗后,观察组6MWT距离增加多于对照组[(488.97±52.65)m比(455.43±43.08)m,P<0.05],观察组NT-proBNP水平较对照组下降更明显[(106.19±26.74)ng/L比(134.38±28.10)ng/L,P<0.05],观察组LVEF提高程度优于对照组[(54.10±4.29)%比(47.50±3.81)%,P<0.05],观察组LVEDD、LVESD较对照组下降更明显(P<0.05),观察组CRP、PCT、IL-6和SAA水平均较对照组下降更明显(P<0.05)。结论复方真武冲剂联合常规西较单纯西药更好地改善阳虚水泛型心力衰竭病人心脏功能,逆转心室重构,减轻炎症反应,其机制可能与其能更好地抑制心肌细胞炎症反应有关。展开更多
Femoral head necrosis(FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage.The mechanism behind abnormal apoptosis in FHN broilers,leading to cartilage damage,remains uncle...Femoral head necrosis(FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage.The mechanism behind abnormal apoptosis in FHN broilers,leading to cartilage damage,remains unclear;although endoplasmic reticulum stress(ERS) has been found to play a role in glucocorticoid-induced FHN broilers.In this study,we collected samples from broilers with femoral head separation(FHS) and femoral head separation accompanied with growth plate lacerations(FHSL) in a broiler farm.The aim was to investigate the potential association between the severity of FHN,bone remodeling and cartilage damage.Additionally,primary chondrocytes were treated with methylprednisolone(MP) to construct an in vitro FHN model,followed by inhibition or activation of ERS or hypoxia inducible factor-1α(HIF-1α) to further investigate the mechanism of apoptosis in cartilage.The results suggested that cartilage appeared to be the appropriate tissue to investigate the potential mechanisms of FHN,as the degree of cartilage damage was found to be closely related to the severity of the disease.Bone quality was only affected in FHSL broilers,although factors related to bone metabolism were significantly altered among FHN-affected broilers.In addition,cartilage in FHN-affected broilers exhibited high levels of apoptosis and upregulated expression of ERS-related and HIF-1α,which was consistent with both in vivo and in vitro findings after MP treatment.The results were further supported by treatment with HIF-1α or ERS inhibition or activation.In conclusion,bone remodeling and cartilage homeostasis were affected in FHN broilers,but only cartilage damage was significantly exacerbated with FHN development.Moreover,activation of ERS or HIF-1α resulted in apoptosis in cartilage,thus exhibiting a significant correlation with FHN severity.展开更多
文摘目的观察复方真武冲剂治疗阳虚水泛型心力衰竭的临床疗效,并探索其对心功能、心室重构及炎症因子水平的影响。方法选择2023年5月至2024年3月安徽中医药大学第一附属医院老年病中心心血管内科收治心力衰竭(阳虚水泛型)病人60例。采用随机数字表法分组,对照组采用正规西药治疗,观察组在对照组基础上加服复方真武冲剂,疗程均为4周。统计两组治疗前后临床疗效,评估病人6 min步行试验的距离(6-minute walk test,6MWT),检测并比较两组病人的心功能[氨基末端脑利钠肽前体(NT-proBNP)、左心室射血分数(LVEF)]、心室重构[左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)]、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)和血清淀粉样蛋白A(SAA)]等指标。结果经治疗后观察组心功能改善总有效率为93.3%,明显高于对照组总有效率76.7%(χ^(2)=6.05,P<0.05)。两组治疗后,观察组6MWT距离增加多于对照组[(488.97±52.65)m比(455.43±43.08)m,P<0.05],观察组NT-proBNP水平较对照组下降更明显[(106.19±26.74)ng/L比(134.38±28.10)ng/L,P<0.05],观察组LVEF提高程度优于对照组[(54.10±4.29)%比(47.50±3.81)%,P<0.05],观察组LVEDD、LVESD较对照组下降更明显(P<0.05),观察组CRP、PCT、IL-6和SAA水平均较对照组下降更明显(P<0.05)。结论复方真武冲剂联合常规西较单纯西药更好地改善阳虚水泛型心力衰竭病人心脏功能,逆转心室重构,减轻炎症反应,其机制可能与其能更好地抑制心肌细胞炎症反应有关。
基金supported by the National Natural Science Foundation of China (32072936 and 32273080)。
文摘Femoral head necrosis(FHN) is a common leg disorder in the poultry industry often leads to significant cartilage damage.The mechanism behind abnormal apoptosis in FHN broilers,leading to cartilage damage,remains unclear;although endoplasmic reticulum stress(ERS) has been found to play a role in glucocorticoid-induced FHN broilers.In this study,we collected samples from broilers with femoral head separation(FHS) and femoral head separation accompanied with growth plate lacerations(FHSL) in a broiler farm.The aim was to investigate the potential association between the severity of FHN,bone remodeling and cartilage damage.Additionally,primary chondrocytes were treated with methylprednisolone(MP) to construct an in vitro FHN model,followed by inhibition or activation of ERS or hypoxia inducible factor-1α(HIF-1α) to further investigate the mechanism of apoptosis in cartilage.The results suggested that cartilage appeared to be the appropriate tissue to investigate the potential mechanisms of FHN,as the degree of cartilage damage was found to be closely related to the severity of the disease.Bone quality was only affected in FHSL broilers,although factors related to bone metabolism were significantly altered among FHN-affected broilers.In addition,cartilage in FHN-affected broilers exhibited high levels of apoptosis and upregulated expression of ERS-related and HIF-1α,which was consistent with both in vivo and in vitro findings after MP treatment.The results were further supported by treatment with HIF-1α or ERS inhibition or activation.In conclusion,bone remodeling and cartilage homeostasis were affected in FHN broilers,but only cartilage damage was significantly exacerbated with FHN development.Moreover,activation of ERS or HIF-1α resulted in apoptosis in cartilage,thus exhibiting a significant correlation with FHN severity.
