加味益气升降汤对慢性心力衰竭患者心功能及肾素-血管紧张素-醛固酮系统影响的研究  

Effect of modified Yiqi Shengjiang Decoction on cardiac function and renin-angiotensin-aldosterone system in patients with chronic heart failure

作　　者：王宇 于慧卿[1] 李永新[1] 高立威[1] 刘晓艳[1] WANG Yu;YU Hui-qing;LI Yong-xin;GAO Li-wei;LIU Xiao-yan(Department of Cardiology,Shijiazhuang TCM Hospital,Shijiazhuang Hebei 050051)

机构地区：[1]石家庄市中医院心病科,河北石家庄050051

出　　处：《世界中西医结合杂志》2020年第3期567-570,584,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2015039)。

摘　　要：目的探讨加味益气升降汤对慢性心力衰竭患者心功能及肾素-血管紧张素-醛固酮系统的影响。方法选择2015年5月—2018年4月收治的慢性心力衰患者100例,按患者临床资料采用频率匹配设计分为对照组和治疗组,各50例。对照组采用西药治疗,在此基础上,治疗组采用加味益气升降汤治疗,连续治疗4周后,比较两组临床疗效、心功能[左室射血分数(left ventricle ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、E/A值]、血浆脑钠肽(brain natriuretic peptide,BNP)水平、肾素-血管紧张素-醛固酮系统[血浆肾素活性(plasma renin activity,PRA)、血浆醛固酮(aldosterone,ALD)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)]、不良反应。结果治疗后治疗组总有效率96.00%优于对照组82.00%,两组比较差异有统计学意义(P<0.05)。治疗4周后,两组患者LVEF、E/A水平较治疗前升高,LVEDD、BNP水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组LVEF、E/A水平较对照组高,LVEDD、BNP水平较对照组低,两组比较差异有统计学意义(P<0.05)。治疗4周后,两组患者ALD、PRA、AngⅡ水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组ALD、PRA、AngⅡ水平较对照组低,两组比较差异有统计学意义(P<0.05)。治疗期间,治疗组不良反应发生率为10.00%;对照组不良反应发生率为6.00%,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论常规西药联合加味益气升降汤可提高慢性心力衰治疗效果,降低肾素-血管紧张素-醛固酮系统活性,改善心功能,且安全性高。Objective To investigate the effect of modified Yiqi Shengjiang Decoction on cardiac function and renin-angiotensin-aldosterone system in patients with chronic heart failure.Methods A total of 100 patients with chronic heart failure admitted to hospital from May,2015 to April,2018 were included and divided into the control group and the treatment group according to frequency matching design of clinical data,with 50 cases in each group.The control group was given western medicine,and the treatment group was given modified Yiqi Shengjiang Decoction based on the treatment of the control group.After 4-week treatment,the clinical efficacy,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),E/A],brain natriuretic peptide(BNP),renin-angiotensin-aldosterone system[plasma renin activity(PRA),plasma aldosterone(ALD),angiotensinⅡ(AngⅡ)],adverse events in both groups were compared.Results After treatment,The total effective rate in the treatment group was 96%,which was higher than that(82%)in the control group,with statistical significance(P<0.05).After 4-week treatment,both groups had an increase in the levels of LVEF and E/A,and a reduction in the LVEDD and BNP levels,with statistical significance(P<0.05);and the treatment group had higher levels of LVEF and E/A and lower levels of LVEDD and BNP than the control group,with statistical significance(P<0.05).After treatment,ALD,PRA and AngⅡin both groups decreased,with statistical significance(P<0.05);and the treatment group had lower levels than the control group,with significance(P<0.05).The incidence of adverse events was 10.00%in the treatment group and 6.00%in the control group,withoutstatistical significance between the two groups(P>0.05).Conclusion For chronic heart failure,conventional treatment combined with modified Yiqi Shengjiang Decoction can improve the clinical effect,decrease the activity of renin-angiotensin-aldosterone system,and improve cardiac function with safety.

关 键 词：慢性心力衰竭 加味益气升降汤 西药 心功能 肾素-血管紧张素-醛固酮系统 

分 类 号：R541.6[医药卫生—心血管疾病]