养心活血汤调控RAAS治疗老年心力衰竭的临床研究  

Clinical Study of Yangxin Huoxue Decoction in Treating Elderly Heart Failure by Regulating RAAS

作　　者：胡龙涛[1] 蔡芳妮 任耀龙 吴晖[3] 陈锐 苏建 HU Longtao;CAI Fangni;REN Yaolong;WU Hui;CHEN Rui;SU Jian(Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,China)

机构地区：[1]陕西中医药大学第二附属医院,陕西咸阳712000 [2]陕西中医药大学附属医院 [3]安康市中医医院

出　　处：《中西医结合心脑血管病杂志》2022年第3期499-502,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：陕西省教育厅项目(No.19JK0236);陕西省中医药管理局项目(No.2019-GJ-LC019);安康市科技局项目(No.AK2019-SFZC-08)。

摘　　要：目的评价养心活血汤治疗老年心力衰竭(气阴两虚血瘀证)中医证候的临床疗效及对肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法选择老年心力衰竭病人60例,采用随机数字表法分为对照组和治疗组,各30例。两组均给予西医常规治疗,治疗组在常规治疗基础上加用养心活血汤,每日1剂。两组病人均治疗14 d。观察两组病人中医证候疗效,检测治疗前、治疗14 d后血清白细胞介素-6(IL-6)、N末端脑钠肽前体(NT-proBNP)、醛固酮、肾素、血管紧张素Ⅱ水平,采用明尼苏达心力衰竭生活质量调查表(MLHFQ)及6 min步行距离(6MWT)进行生活质量及运动耐力评价。结果治疗14 d后,治疗组中医证候疗效明显优于对照组(P<0.01);两组病人血清IL-6、NT-proBNP、醛固酮、肾素、血管紧张素Ⅱ水平均较前降低,且治疗组降低程度优于对照组(P<0.01);两组病人治疗后MLHFQ评分降低、6MWT提高,且治疗组改善程度明显优于对照组(P<0.01)。结论在西医治疗的基础上应用养心活血汤治疗老年心力衰竭(气阴两虚血瘀证)病人,能减轻机体炎症反应,抑制RAAS系统活性,提高运动耐量和生活质量,提高临床疗效。Objective To evaluate the clinical effect of Yangxin Huoxue Decoction on heart failure(qi-yin deficiency and blood stasis syndrome)in elderly patients and its effect on renin angiotensin aldosterone system(RAAS).Methods Sixty elderly patients with heart failure were randomly divided into control group and treatment group by number table method,with 30 cases in each group.Both groups were given conventional treatment of western medicine,and the treatment group was added with Yangxin Huoxue Decoction on the basis of conventional treatment,1 dose per day.Both groups were treated for 14 days.Serum interleukin-6(IL-6),N-terminal probrain natriuretic peptide(NT-probNP),aldosterone(ALD),renin,and angiotensinⅡ(AngⅡ)levels were detected before treatment and 14 d after treatment.Efficacy was evaluated using the Minnesota Living with Heart Failure Questionnaire(MLHFQ)and 6 minute walking test(6MWT).Results After 14 days of treatment,the clinical efficacy of the treatment group was significantly better than that of the control group(P<0.01).The serum levels of IL-6,NT-probNP,ALD,renin,and AngⅡin two groups were lower than that before,and the degree of reduction in the treatment group was better than that of the control group(P<0.01);after treatment,MLHFQ score was decreased and 6MWT was increased in two groups,and the improvement degree in the treatment group was significantly better than that in the control group(P<0.01).Conclusion On the basis of western medicine,Yangxin Huoxue Decoction can be used to treat elderly heart failure(qi-yin deficiency and blood stasis syndrome),which can reduce the inflammatory response of the body,inhibit the activity of RAAS system,improve exercise tolerance and quality of life.

关 键 词：心力衰竭 养心活血汤 肾素-血管紧张素-醛固酮系统 RAAS 脑钠肽 

分 类 号：R54[医药卫生—心血管疾病]