参桂益心汤对慢性心力衰竭患者外周血单核细胞Toll样受体4/核转录因子-κB信号通路的影响  

Effect of Shengui Yixin Decoction on Toll-like Receptors 4/Nuclear Factor Kappa B in Patients with Chronic Heart Failure

作　　者：冯庆涛[1] 杨静[1] 张燕[1] 吕尚增 苗华为[1] 

机构地区：[1]河北省中医院,石家庄050011

出　　处：《中国实验方剂学杂志》2017年第23期146-151,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81573698);河北省中医药管理局科研计划项目(2014025)

摘　　要：目的:观察参桂益心汤对慢性心力衰竭患者外周血单核细胞Toll样受体4/核转录因子-κB(TLR4/NF-κB)信号通路的影响。方法:124例慢性心力衰竭患者按随机数字表法分为对照组(50例)和治疗组(74例),对照组给予西医常规药物治疗,治疗组在对照组基础上加用参桂益心汤,每日1剂,疗程4周。比较两组治疗前后心功能,包括心率(HR),左室射血分数(LVEF),左室舒张末期内径(LVDD),6 min步行实验距离(6 m WT);测定两组治疗前后外周血单核细胞TLR4,NF-κB及肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6),白细胞介素-1β(IL-1β)mRNA和蛋白表达;患者出院后随访6~18个月,观察两组再住院率、病死率及再住院次数。结果:与对照组比较,治疗组总有效率明显升高(P<0.05);与对照组比较,治疗组HR,LVDD明显降低,LVEF,6 m WT明显增加(P<0.05);治疗组较对照组TLR4,NF-κB,TNF-α,IL-6,IL-1βmRNA和蛋白表达明显降低(P<0.05);二组患者均较治疗前好转(P<0.05)。治疗组再住院率、病死率及再住院次数较对照组明显降低(P<0.05)。结论:参桂益心汤能够抑制慢性心力衰竭患者外周血单核细胞TLR4/NF-κB信号通路,抑制炎症,改善患者心功能。Objective： To observe the effect of Shengui Yixin decoction on plasma monocyte Toll-like receptors 4/nuclear factor kappa B （TLR4/NF-KB） signal pathway in patients with chronic heart failure. Method： A total of 124 patients with chronic heart failure were divided into control group （50 cases） and treatment group （74 cases） by random number table. The control group was given routine western medicine therapy. The treatment group was given Shengui Yixin decoction for 4 weeks, 1 agent/day in addition to the therapy of control group. Heart rate （HR）, left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVDD）, and 6 minute walking distance （6 mWT）, TLR4, NF-KB, tumor necrosis factor-a （TNF-a）, interleukin-6 （IL-6）, interleukinl/3 （IL-1/3） mRNA and protein expressions in two groups before and after treatment were observed. Patients were followed up for 6 to 18 months after discharge. Rate of rehospitalization, fatality and the number of rehospitalization were compared between two groups. Result： Compared with control group, the total efficiency of treatment group increased significantly （P 〈 0.05）. After the treatment, HR, LVDD,TLR4, NF-κB, TNF-α, IL-6 and IL-1β mRNA and protein expressions of treatment group were significantly lower than those of control group ; LVEF, 6 mWT of treatment group were significantly higher than those of control group （P 〈 0.05）. both groups showed alleviations compared with before hospitalization （P 〈 0.05 ）. Rehospitalization rate, death rate and frequency of rehospitalization of treatment group were lower than those of control group （P 〈 0.05 ）. Conclusion： Shengui Yixin decoction in treating patients with chronic heart failure can significantly inhibit TLR4/NF-KB signal pathway and inflammation and improve the patients＇ cardiac function.

关 键 词：慢性心力衰竭 参桂益心汤 TOLL样受体4 核转录因子-ΚB 

分 类 号：R287[医药卫生—中药学] R543[医药卫生—中医学]