开心逍遥汤联合西药治疗慢性心力衰竭伴抑郁临床研究  

Clinical Study on Kaixin Xiaoyao Tang Combined with Western Medicine for Chronic Heart Failure Complicated with Depression

作　　者：孙有朋 李飞泽 李洁 SUN Youpeng;LI Feize;LI Jie

机构地区：[1]杭州市萧山区中医院,浙江杭州310000 [2]浙江省舟山市中医院,浙江舟山316000

出　　处：《新中医》2021年第21期59-63,共5页New Chinese Medicine

基　　金：2017年浙江省名老中医专家传承工作室(GZS2017026);2019年度浙江省中医药科学研究基金项目(2019ZB134)。

摘　　要：目的:观察开心逍遥汤联合草酸艾司西酞普兰片治疗慢性心力衰竭(CHF)伴抑郁的疗效。方法:选取80例CHF伴抑郁患者,按随机数字表法分为对照组及治疗组各40例。对照组给予常规抗心力衰竭治疗及草酸艾斯西酞普兰片治疗,治疗组在对照组基础上加用开心逍遥汤,2组疗程均为6周。比较2组临床疗效,观察2组治疗前后抑郁积分及心功能指标[左室射血分数(LVEF),左室收缩末期内径(LVESD),左室舒张末期内径(LVEDD)]、炎症细胞因子包括超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子(TNF-α)水平和脑钠肽(BNP)及血管紧张素Ⅱ(AngⅡ)水平。结果:治疗后,对照组总有效率为65.0%,治疗组总有效率为82.5%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组抑郁积分均较治疗前下降,治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组LVESD、LVEDD指标值均较治疗前下降,LVEF指标值较治疗前上升;治疗组LVESD、LVEDD指标值均低于对照组,LVEF指标值高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组hs-CRP、IL-6、TNF-α水平均较治疗前下降,治疗组hs-CRP、TNF-α水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组BNP、AngⅡ水平均较治疗前下降,治疗组上述2项水平均低于对照组,差异均有统计学意义(P<0.05)。结论:开心逍遥汤联合西药治疗CHF伴抑郁疗效显著,能明显改善CHF伴抑郁患者的心力衰竭症状及抑郁症状,改善心功能。Objective:To observe the curative effect of Kaixin Xiaoyao tang combined with escitalopram oxalate tablets for chronic heart failure complicated with depression(CHF).Methods:A total of 80 cases of patients with chronic heart failure complicated with depression were divided into the control group and the treatment group according to the random number table method,40 cases in each group.The control group was treated with routine anti-heart failure treatment and escitalopram oxalate tablets,and the treatment group was additionally treated with Kaixin Xiaoyao tang based on the treatment of the control group.Both groups were treated for six weeks.The clinical effects in the two groups were compared.Before and after treatment,the depression scores,the heart function indexes including left ventricular ejection fraction(LVEF),left ventricular end-systolic dimension(LVESD)and left ventricular end diastolic diameter(LVEDD),the levels of inflammatory factors including high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),as well as the B-type natriuretic peptide(BNP)and the angiotensinⅡ(AngⅡ)in the two groups were observed.Results:After treatment,the total effective rate was 65.0%in the control group and 82.5%in the treatment group,the difference being significant(P<0.05).After treatment,the depression scores in the two groups were decreased when compared with those before treatment,and the one in the treatment group was lower than that in the control group,differences being significant(P<0.05).After treatment,the values of LVESD and LVEDD in the two groups were decreased when compared with those before treatment,and LVEF values were increased;the values of LVESD and LVEDD in the treatment group were lower than those in the control group,and LVEF value was higher,differences being significant(P<0.05).After treatment,the levels of hs-CRP,IL-6 and TNF-αin the two groups were decreased when compared with those before treatment,and the levels in the treatment group were lower t

关 键 词：慢性心力衰竭 抑郁 开心逍遥汤 草酸艾司西酞普兰 

分 类 号：R541.6[医药卫生—心血管疾病]