黄芪生脉饮对冠心病心力衰竭患者心功能、免疫功能和外周血miRNA-155表达的影响  

Effects of Huangqishengmaiyin on cardiac function,immune function and expression of plasma miRNA-155 in patients with coronary heart disease and heart failure

作　　者：蒋健刚[1] 杜晓马[1] 姚宇玫[2] 汤泽生 王晓华[1] 沈昕 晏程远 JIANG Jiangang;DU Xiaoma;YAO Yumei;TANG Zesheng;WANG Xiaohua;SHEN Xin;YAN Chengyuan(Department of Cardiology,Jinhua Hospital of Traditional Chinese Medicine affiliated to Zhejiang University of Traditional Chinese Medicine,Jinhua 321000,China)

机构地区：[1]浙江中医药大学附属金华市中医院心内科,321000 [2]浙江中医药大学附属第三医院心内科 [3]浙江中医药大学附属台州市中医院心内科

出　　处：《心电与循环》2021年第3期262-266,共5页Journal of Electrocardiology and Circulation

基　　金：金华市科技局科学研究基金项目(2018-4-103)。

摘　　要：目的探讨黄芪生脉饮对冠心病心力衰竭(气阴两虚证)患者心功能、免疫功能和外周血miRNA-155表达的影响。方法选取2017年1月至2020年6月在浙江中医药大学附属金华市中医院(75例)、浙江中医药大学附属第三医院(31例)、浙江中医药大学附属台州市中医院(20例)接受治疗的冠心病心力衰竭(气阴两虚证)患者126例为研究对象,随机分为对照组(常规治疗方案)和观察组(常规治疗方案+黄芪生脉饮),每组63例。比较两组患者心功能指标(左心室舒张末期内径、左心室收缩末期内径、左心室射血分数、6 min步行距离、N端脑钠肽前体)、免疫功能指标(CD4+细胞、CD4+CD25+FoxP3+Treg细胞比例)、外周血miRNA-155相对表达量、疗效及短期预后。结果治疗前,两组患者上述各项指标比较差异均无统计学意义(均P>0.05)。治疗后,两组患者心功能指标、免疫功能指标均得到改善(均P<0.05),外周血miRNA-155相对表达量均明显下降(P<0.05),观察组较对照组改善更明显(均P<0.05)。观察组总有效率明显高于对照组(95.2%比85.7%,P<0.05)。随访6个月,观察组再次住院率明显低于对照组(4.8%比15.9%,P<0.05)。结论常规治疗联用黄芪生脉饮治疗,可改善冠心病心力衰竭(气阴两虚证)患者心功能和免疫功能。Objective To explore the effects of Huangqishengmaiyin on cardiac function,immune function and expression of plasma miRNA-155 in patients with coronary heart disease(CHD)and heart failure(Qi and Yin deficiency).Methods A total of 126 patients with coronary heart disease and heart failure admitted to three hospitals(75 patients come from Jinhua hospital of traditional Chinese medicine affiliated to Zhejiang university of traditional Chinese medicine,31 patients come from the third affiliated hospital of Zhejiang university of traditional Chinese medicine,20 patients come from Taizhou hospital of traditional Chinese medicine affiliated to Zhejiang university of traditional Chinese medicine)from January 2017 to June 2020 were selected as the study subjects.They were randomly divided into observation group(n=63)treated with Huangqishengmaiyin based on routine therapy and control group(n=63)treated with routine therapy.Left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESd),left ventricular ejection fraction(LVEF),6-minite walk distance,NT-proBNP,CD4+cell,the proportion of CD4+CD25+FoxP3+Treg cell,the expression of miRNA-155 in peripheral blood,efficacy and short-term prognosis were compared between the two groups.Results Before treatment,all above parameters were similar between the two groups(all P>0.05).After treatment,cardiac function parameters and immune function markers were improved and the expression of miRNA-155 was decreased significantly in both groups(all P<0.05).These changes were more significant in observation group than in control group(all P<0.05).The total effective rate was significantly higher in observation group than in control group(95.2%vs.85.7%,P<0.05).After 6 months follow-up,the rates of readmission in the observation group was significantly lower than that in the control group(4.8%vs.15.9%,P<0.05).Conclusion HHuangqishengmaiyin combined with routine treatment may improve heart function and immune function of patients with CHD and heart failure(Qi and Yi

关 键 词：黄芪生脉饮 冠心病 心力衰竭 免疫功能 miRNA-155 

分 类 号：R541.6[医药卫生—心血管疾病] R541.4[医药卫生—内科学]