芪苈强心胶囊联合托伐普坦片对冠心病慢性心力衰竭MMPs/TIMPs调节作用的研究  

Qili Qiangxin Capsule(芪苈强心胶囊)Combined with Topavtan Tablets in Regulation of MMPs/TIMPs of Patients with Coronary Heart Disease Chronic Heart Failure

作　　者：甄宇治[1] 宋适恒[1] 邢军[1] ZHEN Yuzhi;SONG Shiheng;XING Jun(The First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China)

机构地区：[1]河北医科大学第一医院,河北石家庄050031

出　　处：《中华中医药学刊》2021年第9期165-168,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省卫生计生委科研基金(20160212)。

摘　　要：目的观察芪苈强心胶囊联合托伐普坦片治疗冠心病心力衰竭的临床疗效,并研究其对MMPs/TIMPs的影响。方法选取116例冠心病心力衰竭患者,随机分为两组,每组58例。两组均采用常规治疗,对照组在常规治疗的基础上口服托伐普坦片,初始剂量为15 mg/d,逐渐增加至30 mg/d,最大剂量为60 mg/d;观察组在对照组的基础上加以口服芪苈强心胶囊,4粒/次,3次/d,两组均以4周为1个疗程,两组连续治疗2个疗程。比较两组的临床疗效;比较两组患者治疗前后的心率(HR)、6 min步行距离测试(6MWT)、左室收缩期末内径(LVESD)、左室射血分数(LVEF)、左室舒张期末内径(LVEDD);比较治疗前及治疗后基质金属蛋白酶(MMP)-2、MMP-9、MMP-13、金属蛋白酶组织抑制因子(TIMP)-1、TIMP-2的水平;同时在治疗前后采用明尼苏达生活质量问卷(MLHFQ)评价两组患者的生活质量。结果观察组总有效率为91.4%,明显优于对照组(P<0.05)。观察组的阳气亏虚血瘀证中医证候各项积分均显著优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后两组的气短喘息、神疲乏力、心悸、怕冷喜温、胃脘冷痛、畏寒肢冷、面色紫黯等中医证候积分均显著降低(P<0.05),观察组各中医证候积分均显著优于对照组(P<0.05)。治疗后两组患者6MWT、LVEF水平明显升高(P<0.05),HR、LVESD、LVEDD水平及MLHFQ评分明显降低(P<0.05),并且观察组的6MWT、LVEF、HR、LVESD、LVEDD水平及MLHFQ评分的变化幅度明显优于对照组(P<0.05)。治疗后两组患者的MMP-2、MMP-9及MMP-13水平均明显低于治疗前(P<0.05),TIMP-1、TIMP-2则明显升高(P<0.05),并且观察组MMP-2、MMP-9、MMP-13及TIMP-1、TIMP-2变化幅度显著高于对照组(P<0.05)。结论芪苈强心胶囊联合托伐普坦片治疗冠心病心力衰竭可调节MMPs/TIMPs的表达,有效改善心功能,具有较好的临床疗效。Objective To observe the clinical efficacy of Qili Qiangxin Capsule(芪苈强心胶囊) combined with Topavtan Tablets in the treatment of coronary heart disease(CHD) chronic heart failure and study its impact on MMPs/TIMPs. Methods A total of 116 patients with CHD and heart failure were randomly divided into two groups with 58 cases in each group. Conventional treatment was used in both groups. In the control group, on the basis of conventional treatment, Tovartan Tablets were taken orally. The initial dose was 15 mg/day, gradually increased to 30 mg/day, and the maximal dose was 60 mg/day. The observation group took Qili Qiangxin Capsule orally on the basis of control group, 4 granules/time, 3 times/day. Four weeks was a course of treatment. Two groups were continuously treated for 2 courses of treatment. The clinical efficacy of the two groups was compared. Heart rate(HR), 6 min walking distance test(6 MWT), left ventricular end-systolic diameter(LVESD), left ventricular ejection fraction(LVEF), and left ventricular end-diastolic diameter(LVEDD) were compared between the two groups before and after treatment. The levels of matrix metalloproteinase(MMP-2), MMP-9, MMP-13, metalloproteinase tissue inhibitor(TIMP)-1 and TIMP-2 were compared before and after treatment. Minnesota Quality of Life Questionnaire(MLHFQ) was used to evaluate the quality of life of both groups before and after treatment. Results The total effective rate of the observation group was 91.4%, which was significantly better than that of the control group(P<0.05). The scores of TCM syndromes of Yang qi deficiency and blood stasis syndrome in the observation group were significantly better than those in the control group, and the comparison between the two groups was statistically significant(P<0.05). After treatment, the scores of TCM syndromes in the two groups were significantly reduced(P<0.05), such as shortness of breath, fatigue, palpitation, fear of cold and warmth, epigastric cold and pain, fear of cold limb and purple and dark complexio

关 键 词：芪苈胶囊 托伐普坦片 冠心病心力衰竭 MMPS/TIMPS 

分 类 号：R259.416.1[医药卫生—中西医结合]