生脉养心颗粒联合西药治疗老年慢性心力衰竭50例临床观察  

Clinical Observation on 50 Elderly Chronic Heart Failure Patients Treated with Shengmai Yangxin Granules (生脉养心颗粒) Combined with Western Medicine

作　　者：石衍梅 刘晓倩[2] 尉若川 李虹[2] 薛一涛[3] 李长生[2] 

机构地区：[1]山东中医药大学,济南市250014 [2]山东省千佛山医院 [3]山东中医药大学附属医院

出　　处：《中医杂志》2016年第23期2021-2024,共4页Journal of Traditional Chinese Medicine

基　　金：山东省医药卫生科技发展计划项目(2011BJZD02)

摘　　要：目的探讨生脉养心颗粒治疗老年慢性心力衰竭患者的临床疗效及可能作用机制。方法将100例气阴两虚、瘀血阻络证老年慢性心力衰竭患者随机分成治疗组和对照组各50例。对照组采用常规西药治疗,治疗组在常规西药基础上加服生脉养心颗粒,两组疗程均为12周。观察两组患者的临床疗效,检测治疗前后左室射血分数(LVEF)、脑钠肽(BNP)、白细胞介素6(IL-6)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)、内皮素1(ET-1)、血管加压素(VP)的含量。结果治疗组临床显效18例,有效25例,无效7例,总有效率为86%;对照组显效19例,有效15例,无效16例,总有效率为68%,两组比较差异有统计学意义(P<0.05),治疗组优于对照组。治疗后两组IL-6、TNF-α、ET-1、VP及BNP均较治疗前明显降低,而IL-10、LVEF较治疗前明显升高(P<0.01);治疗后治疗组IL-6、TNF-α、ET-1及BNP均低于对照组,IL-10及LVEF高于对照组(P<0.05)。结论生脉养心颗粒可能通过降低炎症因子及内皮素的激活,从而改善老年慢性心力衰竭患者心功能、提高临床疗效。Objective To explore the clinical efficacy and the probable mechanism of Shengmai Yangxin Granules in treating elderly patients with chronic heart failure. Methods One hundred elderly patients with chronic heart failure whose pattern is Qi and Yin deficiency and obstruction of collaterals by blood stasis were randomly divided into a treatment group and a control group,with 50 cases in each. Both groups were treated with regular western medicine,while the treatment group was added with Shengmai Yangxin Granules. The treatment course was 12 weeks for both groups. The clinical efficacy was observed,and left ventricular ejection fraction（ LVEF）,as well as the levels of brain natriuretic peptide（ BNP）,interleukin-6（ IL-6）,interleukin-10（ IL-10）,tumor necrosis factor-α（ TNF-α）,endothelin-1（ ET-1） and vasopressin（ VP） were tested in two groups before and after the treatment. Results In the treatment group,18 cases were markedly effective,25 effective,and 7 ineffective. The total effective rate was86%. In the control group,19 cases were markedly effective,15 effective,16 ineffective. The total effective rate was68%. There was statistically significant difference between the two groups（ P 〈 0. 05） and the efficacy of the treatment group was better. After treatment,levels of IL-6,TNF-α,ET-1,VP and BNP in both groups decreased obviously,and level of IL-10 and LVEF increased evidently compared with those before treatment（ P 〈 0. 01）. After treatment,levels of IL-6,TNF-α and ET-1 in the treatment group were lower,while level of IL-10 and LVEF were higher than those in the control group（ P 〈 0. 05）. Conclusion Shengmai Yangxin Granules could improve the cardiac function of elderly patients with chronic heart failure probably by lowering inflammatory factors and activating endothelin.

关 键 词：慢性心力衰竭 生脉养心颗粒 心功能 炎性因子 内皮素 血管加压素 

分 类 号：R541.6[医药卫生—心血管疾病]