滋阴助阳抗衰汤联合西药治疗阳虚水泛型慢性心力衰竭疗效及对患者氧化应激、生活质量的影响  

Efficacy of Ziyin Zhuyang Kangshuai Decoction Combined with Western Medicine for Yang Insufficiency and Water Overflowing Type Chronic Heart Failure and Effect on Patients' Oxidative Stress and Quality of Life

作　　者：张志刚[1] 芮素芳[1] 赵新芳[1] 边文贵[1] 

机构地区：[1]石河子大学医学院第一附属医院,新疆石河子832000

出　　处：《中国实验方剂学杂志》2017年第16期164-170,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：新疆兵团科技攻关计划课题项目(2016AD020)

摘　　要：目的:探讨阳虚水泛型慢性心力衰竭(CHF)应用滋阴助阳抗衰汤联合西药治疗的临床效果及对患者氧化应激、生活质量的影响。方法:选取石河子大学医学院第一附属医院2014年6月—2016年6月收治的116例CHF患者,根据随机数字表法均分为两组。所有患者均采取常规基础治疗,对照组在此基础上,给予西医标准抗心衰药物治疗;观察组在对照组基础上,予以滋阴助阳抗衰汤治疗。记录比较两组中医证候疗效、心功能疗效,超声心动图指标及血浆氨基末端脑钠肽前体(NT-proBNP)水平,氧化应激指标,明尼苏达心力衰竭生活质量调查表(MLHFQ)总评分,用药安全性评价。结果:连续治疗3个月后,观察组中医证候总有效率、心功能总有效率分别为90.6%,84.9%,均明显高于对照组的75.5%,67.9%(P<0.05)。与治疗前比较,两组治疗后左心室射血分数(LVEF),二尖瓣血流E/A(E/A),左室收缩末期内径(LVESD),左室舒张末期内径(LVEDD)及血浆NT-proBNP水平均显著改善(P<0.01);且与对照组同期比较,观察组治疗后超声心动图指标及血浆NTproBNP水平改善程度更为显著(P<0.01)。与治疗前比较,两组治疗后血浆氧化应激指标丙二醛(MDA)水平显著下降(P<0.01),过氧化氢酶(CAT),超氧化物歧化酶(SOD)及谷胱甘肽过氧化物酶(GSH-Px)水平均显著上升(P<0.01);且观察组治疗后血浆氧化应激指标水平改善效果均显著优于对照组同期(P<0.01)。与治疗前比较,两组治疗后MLHFQ总评分均显著下降(P<0.01);且观察组治疗后MLHFQ总评分较对照组同期显著降低(P<0.01)。观察组不良反应率与对照组比较差异无统计学意义。结论:CHF患者应用滋阴助阳抗衰汤联合西药治疗更能短期内改善中医证候,提高心功能,维持机体氧化-抗氧化系统平衡,延缓心肌重构,提升生活质量,疗效显著且安全性高。可为临床防治CHF提供新方向。Objective：To explore the clinical efficacy of Ziyin Zhuyang Kangshuai decoction combined with western medicine for Yang insufficiency and water overflowing type chronic heart failure（CHF） and observe its effect on patients＇ oxidative stress and quality of life.Method：The 116 patients with CHF in our hospital from June 2014 to June 2016 were selected and divide into two groups according to random number table.Routine therapy was given in both groups,and patients in control group also received standard western anti heart failure drug;while the patients in observation group received Ziyin Zhuyang Kangshuai decoction based on the treatment in control group.The efficacy for traditional Chinese medicine（TCM） syndromes,cardiac function,echocardiographic index,the level of N-terminal pro-brain natriuretic peptide（NT-proBNP）,oxidative stress,the overall score of Minnesota Living with Heart Failure Questionnaire（MLHFQ） and drug safety evaluation were recorded and compared between two groups.Result：After therapy for 3 months,overall effective rate of TCM syndromes and cardiac function was 90.6% and 84.9% respectively in observation group,significantly higher than75.5% and 67.9% in control group（P〈0.05）.As compared with the conditions before treatment,the left ventricular ejection fraction（LVEF）,mitral flow E/A,left ventricular end-systolic diameter（LVESD）,left ventricular end-diastolic diameter（LVEDD） and NT-proBNP level were significantly improved in both groups after treatment（P〈0.01）.The improvement in echocardiographic index and NT-proBNP in observation group was better than that in control group after treatment（P〈0.01）.As compared with the conditions before treatment,the level of plasma oxidative stress index malonaldehyde（MDA） was decreased significantly after treatment in both groups（P〈0.01）;the levels of catalase（CAT）,superoxide dismutase（SOD） and GSH-Px were increased significantly（P〈0.01）.The improvement in oxidative stress in observatio

关 键 词：滋阴助阳抗衰汤 西药治疗 阳虚水泛型 慢性心力衰竭 氧化应激 生活质量 

分 类 号：R287[医药卫生—中药学] R259[医药卫生—中医学]