温肾益心丹对充血性心力衰竭炎症细胞因子水平的影响  

Effects of Wenshen Yixin pellet(温肾益心丹) on levels of inflammatory cytokines in patients with congestive heart failure

作　　者：姚淮芳[1] 胡业彬[1] 程晓昱[1] 汪健[1] 张皖东[2] 张叶祥[1] 

机构地区：[1]安徽中医学院第一附属医院干部病房心血管内科,安徽合肥230031 [2]中国中医研究院基础研究所,北京100700

出　　处：《中国中西医结合急救杂志》2005年第3期149-152,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：安徽省教育厅自然科学基金项目(2003kj246)

摘　　要：目的:观察温肾益心丹结合西医基础治疗对充血性心力衰竭(CHF)患者的临床疗效及其对白细胞介素1(IL1)、IL6和肿瘤坏死因子α(TNFα)的影响。方法:31例CHF患者按照住院顺序随机分为对照组和研究组,根据美国纽约心脏学会(NYHA)心功能分级方法分级,并制定统一疗效判定标准。对照组予常规西医治疗;研究组在西医常规治疗剂量1/2～2/3基础上加服温肾益心丹;疗程均为2周。治疗前后对患者的心功能及临床症状进行观测,记录并采集血标本,用酶联免疫吸附法(ELISA)检测血清IL1、IL6和TNFα含量。结果:研究组:治疗后患者NYHA心功能分级有所改善(总有效率达81.25%),血清IL6和TNFα水平则明显下降(P均<0.001),IL1治疗后也有下降,但差异无显著性(P>0.05)。对照组:治疗后患者NYHA心功能分级也有所改善(总有效率达73.33%),血清IL1、IL6和TNFα水平均有下降,但较治疗前差异无显著性(P均>0.05)。两组治疗后比较,研究组血清IL6和TNFα下降更显著(P均<0.05),血清IL1水平两组间差异无显著性(P>0.05)。结论:温肾益心丹结合西医治疗能有效改善CHF患者的心功能,降低CHF患者血清中IL6和TNFα水平,且优于单纯西医治疗。提示温肾益心丹对血清IL6和TNFα浓度水平的抑制可能是其发挥治疗作用的机制之一。Objective: To observe the effects of Wenshen Yixin pellet(温肾益心丹) combined with basic western medicine for treatment of patients with congestive heart failure (CHF), and its influence on the serum levels of tumor necrosis factorα(TNFα), interleukin6 (IL6) and IL1. Methods: Thirtyone patients with CHF were randomly divided into two groups according to the order of admission. The control group (15 cases) was treated with conventional western medicine, including digitalin, diuretic, vessel dilator, angiotensin converting enzyme inhibitor.The trial group (16 cases) was added with Wenshen Yixin pellet on the basis of 1/22/3 dosage of routine western medicine. The therapeutic course was two weeks. The heart function was graded by New York Heart Association(NYHA) criteria, and the curative effect was estimated with the same criteria. The levels of IL1, IL6 and TNFα in serum were detected at baseline and 14 days after treatment by enzyme linked immunoadsorbent assay (ELISA).The changes of clinical symptoms and physical signs as well as heart function were observed before and after treatment. Results: In trial group after treatment, NYHA grade was improved (the total effective rate was 81.25%), the levels of IL6 and TNFα were significantly decreased (both P<0.05), IL1 decreased but P>0.05. In the control group after treatment, NYHA grade was improved too (the total effective rate was 73.33%), serum IL1, IL6 and TNFα were all decreased but all P>0.05. As compared to the control group, the serum levels of IL6 and TNFα were decreased more significantly in trial group, but the level of IL1 was not significantly changed. Conclusion: Wenshen Yixin pellet can improve the cardiac function in patients with CHF, decrease the levels of IL6 and TNFα, and its effects are superior to that of the treatment with western medicine alone. It indicates that the mechanisms of Wenshen Yixin pellet in treating CHF may be due to the inhibitory effect of Wenshen Yixin pellet on IL6 and TNFα levels. The efficacy for CHF may be rel

关 键 词：温肾益心丹 心力衰竭 充血性 白细胞介素-1 白细胞介素-6 肿瘤坏死因子-α 

分 类 号：R259[医药卫生—中西医结合]