参附注射液治疗急性失代偿性心力衰竭的随机对照临床研究  

Shenfu Injection in treatment of acute decompensated heart failure

作　　者：李志芳[1] 姚瑞[1] 李莉[1] 陈阳[1] 赵国俊[1] 郝正阳[1] 冯胜东[1] 孔令尧[1] 张彦周[1] 

机构地区：[1]郑州大学第一附属医院心内科,450000

出　　处：《中华老年心脑血管病杂志》2017年第1期31-34,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的观察参附注射液治疗急性失代偿性心力衰竭(ADHF)的临床疗效,探讨可能的作用机制。方法入选ADHF患者100例,采用随机数字表法分为参附组和对照组,每组50例,2组均给予常规治疗心力衰竭药物,参附组给予参附注射液80ml+5%葡萄糖100ml静脉滴注,疗程10~14d。检测治疗前后血浆N末端B型脑钠肽前体(NT-proBNP)、肌钙蛋白T(cTnT)、白细胞介素(IL)-6、IL-8、IL-10、TNF-α及LVEF、左心室舒张末容积(LVEDV)、左心室短轴缩短率(LVFS)等相关指标,评估2组患者治疗后心功能(NYHA)分级的改善情况,6min步行距离(6-MWD),同时观察药物的不良反应。结果参附组治疗后总有效率明显高于对照组(96.0%vs80.0%,χ2=7.212,P=0.027),6-MWD较对照组明显延长[(473.06±24.09)mvs(430.09±23.31)m,P=0.043)];2组治疗后NT-proBNP、cTnT、IL-6、IL-8、TNF-α和LVEDV较治疗前下降,IL-10、LVFS、LVEF较治疗前升高,参附组变化幅度明显高于对照组,差异有统计学意义(P<0.05);参附组3例出现皮疹、1例出现头痛等不良反应。结论参附注射液改善ADHF患者心功能的机制可能为降低促炎性因子,升高抗炎性因子表达,纠正心力衰竭时两者的失衡状态。Objective To study the therapeutic effect of Shenfu Injection on acute decompensated heart failure（ADHF）and its mechanism of action.Methods One hundred ADHF patients were divided into Shenfu Injection treatment group（n=50）and control group（n=50）.Those in Shenfu Injection treatment group received conventional treatment plus intravenous drip of Shenfu Injection（80ml）＋5% glucose injection（100ml）for 10-14 days.The plasma NT-proBNP,cTnT,IL-6,IL-8,IL-10,TNF-αlevels and LVEF,LVEDV,LVFS were measured.Improvement of NYHA Classification and 6-MWD was assessed in two groups after treatment.Adverse reactions of Shenfu Injection were recorded.Results The total effective rate was significantly higher and the 6-MWD was significantly longer in Shenfu Injection treatment group than in control group after treatment（96.0%vs 80.0%,χ2=7.212,P=0.027;473.06±24.09 mvs 430.09±23.31 m,P=0.043）.The plasma NT-proBNP,cTnT,IL-6,IL-8,TNF-αlevels and LVEDV were significantly lower in two groups after treatment.The plasma IL-10 level,LVFS and LVEF were significantly higher in Shenfu Injection group than in control group after treatment（P〈0.05）.Adverse reactions of Shenfu Injection occurred in Shenfu Injection group such as rash and headache.Conclusion Shenfu Injection improves the cardiac function of ADHF patients by reducing the proinflammatory factors and increasing the expression of anti-inflammatory factors.

关 键 词：心力衰竭 肌钙蛋白T 白细胞介素6 白细胞介素8 中药疗法 

分 类 号：R541.6[医药卫生—心血管疾病]