五苓散对阳虚水泛型慢性心力衰竭患者NT-proBNP、cTnI及CysC水平的影响  

Effect of Wuling Powder on NT-proBNP,CysC and cTnI Levels in Patients with Chronic Heart Failure of Yang Deficiency and Water Generalization

作　　者：鲁文涛 袁彬 张会超 LU Wentao;YUAN Bin;ZHANG Huichao(Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou 450007,China;Henan Provincial Hospital of Traditional Chinese Medicine and The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]郑州市中医院,河南郑州450007 [2]河南省中医院,河南中医药大学第二附属医院,河南郑州450000

出　　处：《中医药信息》2023年第10期60-65,共6页Information on Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项(20-21ZY3011)。

摘　　要：目的:探讨五苓散对阳虚水泛型慢性心力衰竭患者NT-proBNP、CysC及cTnI水平的影响。方法:选择符合纳入标准的阳虚水泛型慢性心力衰竭患者86例依据随机数字表随机分为对照组和试验组,每组各43例。对照组患者给予常规西药治疗,试验组在对照组的基础上口服五苓散,两组患者均连续治疗4周。比较两组患者治疗前后中医症状积分及血清N端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-pro BNP)、心肌肌钙蛋白Ⅰ(cardiac troponin I,c TnI)以及胱抑素C(Cystatin C,CysC)含量,对比两组患者治疗前后六分钟步行试验(6minutewalktest,6MWT)和左室射血分数(left ventricular ejection fraction,LVEF),并比较临床疗效。结果:治疗后,两组患者胸闷、呼吸困难、肺气肿、咳嗽气喘、夜间不能平卧及水肿症状评分均显著低于治疗前(P<0.05),且试验组以上各项中医症状评分均显著低于对照组(P<0.01);试验组治疗总有效率为95.35%(41/43),显著高于对照组81.40%(35/43)(P<0.05);治疗后两组患者血清NT-proBNP、cTnI、CysC含量均显著低于治疗前(P<0.05),且试验组血清NT-proBNP、cTnI、CysC含量均显著低于对照组(P<0.05,P<0.01);治疗后两组患者6MWT和LVEF均显著高于治疗前(P<0.05),且试验组6MWT和LVEF均显著高于对照组(P<0.01)。结论:五苓散可能通过增强运动耐量、改善射血分数以及抑制交感神经减少心肌的能量消耗等机制发挥治疗慢性心衰的临床疗效,减轻临床症状。Objective:To investigate the effect of Wuling Powder on the levels of NT-proBNP,CysC and cTnI in patients with chronic heart failure of yang deficiency type.Methods:86 patients with generalized chronic heart failure due to yang deficiency were selected as the subjects of this prospective study.The case collection time was from June 2020 to June 2022.All included cases were screened according to the inclusion and exclusion criteria.86 subjects were divided into the control group and the experimental group,with 43 subjects in each group.The patients in the control group were treated with Western medicine,while the patients in the test group took the same in addition to Wuling Powder.The two groups of patients were treated continuously for 4 weeks.After the course of treatment,the TCM symptom score and efficacy index of the two groups were compared and the efficacy was counted.The contents of serum N-terminal pro B-type natriuretic peptide(NT-proBNP),cardiac troponinⅠ(cTnI),cystatin C(CysC),6-minute walk test(6MWT)and left ventricular ejection fraction(LVEF)were compared between the two groups before and after treatment.Results:After treatment,the scores of chest tightness,dyspnea,emphysema,cough and asthma,inability to lie flat at night,and edema symptoms in the two groups were significantly lower than those before treatment(P<0.05).After treatment,the scores of the above TCM symptoms in the test group were significantly lower than those in the control group(P<0.05);the total effective rate of 95.35%in the test group was significantly higher than that in the control group(P<0.05);after treatment,the levels of NT-proBNP,cTnI and CysC in serum of the two groups were significantly lower than those before treatment(P<0.05).After treatment,the levels of NT-proBNP,cTnI and CysC in serum of the test group were significantly lower than those of the control group(P<0.05);After treatment,the 6MWT and LVEF of the two groups were significantly higher than those before treatment(P<0.05),and after treatment,the 6MWT and LVEF o

关 键 词：慢性心力衰竭 阳虚水泛型 五苓散 N端B型利钠肽原 心肌肌钙蛋白Ⅰ 胱抑素C 

分 类 号：R259[医药卫生—中西医结合]