风心病1号方联合卡维地洛、依那普利治疗风湿性心脏病心力衰竭的疗效及对Th17细胞轴相关细胞因子的影响  

Effect of Fengxin disease No. 1 decoction combined with carvedilol and enalapril on heart failure in rheumatic heart disease and its effect on Th17 cell axis related cytokines

作　　者：陈蕾[1] CHEN Lei(The Fourth Hospital of Xi＇ an,Xi＇ an 710004,Shaanxi,China)

机构地区：[1]陕西省西安市第四医院,陕西西安710004

出　　处：《现代中西医结合杂志》2018年第23期2532-2535,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨风心病1号方联合卡维地洛、依那普利治疗风湿性心脏病心力衰竭的疗效及对Th17细胞轴相关细胞因子的影响。方法将92例风湿性心脏病心力衰竭患者随机分为实验组46例和对照组46例。在强心、利尿基础上,对照组给予卡维地洛联合依那普利治疗,实验组在对照组治疗基础上联合风心病1号方治疗。观察2组临床疗效及治疗前后中医证候积分、心功能指标、心率(HR)、血压(SBP、DBP)及白细胞介素-6(IL-6)、IL-17、IL-21、IL-23水平和不良反应发生情况。结果实验组的临床总有效率显著高于对照组(P<0.05)。治疗后,实验组中医证候积分、心室舒张末容量(EDV)、心室收缩末容量(ESV)、HR、SBP、DBP及血清IL-6、IL-17、IL-21、IL-23水平均显著低于治疗前及对照组(P均<0.05),左室射血分数(LVEF)显著高于治疗前及对照组(P均<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论风心病1号方联合卡维地洛、依那普利治疗风湿性心脏病心力衰竭患者临床疗效确切,可显著改善患者心功能,减轻心力衰竭症状,其机制可能与降低Th17细胞轴相关细胞因子水平,减轻炎性反应有关。Objective It is to investigate the effect of Fengxin disease No. 1 decoction combined with carvedilol and enalapril on heart failure in rheumatic heart disease and its effect on Th17 cell axis related cytokines. Methods 92 patients with rheumatic heart disease and heart failure were randomly divided into the experimental group of 46 cases and the control group of 46 cases. The control group was treated with carvedilol and enalapril. The experimental group was treated with Fengxin disease No. 1 decoction on the basis of treatment in the control group. The clinical efficacy and TCM symptom scores,heart function index,heart rate（ HR）,blood pressure（ SBP,DBP）,and interleukin-6（ IL-6）,IL-17,IL-21,IL-23 before and after treatment and adverse reactions occured were observed in the two groups. Results The total clinical effective rate of the experimental group was significantly higher than that of the control group（ P〈0. 05）. After treatment,the TCM syndrome scores,EDV,ESV,HR,SBP,DBP and serum IL-6,IL-17,IL-21,IL-23 levels in the experimental group were significantly lower while LVEF was significantly higher than before treatment and control group（ P〈0. 05）.There was no significant difference in the incidence of adverse reactions between the two groups（ P〈0. 05）. Conclusion Fengxin disease No. 1 decoction combined with carvedilol and enalapril is clinically effective in the treatment of patients with rheumatic heart disease and heart failure,which can significantly improve the heart function and relieve the symptoms of heart failure. The mechanism may be related to the reduction of Th17 cell axis-related cells and attenuating inflammatory responses.

关 键 词：风心病1号方 卡维地洛 依那普利 风湿性心脏病心力衰竭 Th17细胞轴 

分 类 号：R541.2[医药卫生—心血管疾病]