扩心方治疗慢性心力衰竭临床观察  

Clinical Observations of Kuoxin Recipe(扩心方)in Treatment of Chronic Heart Failure

作　　者：吴琼 王佑华[1] 李广浩[1] 马梦娇 周茂琳 安世英[1] 毛美娇[1] 曹敏[1] 周端[1] WU Qiong;WANG Youhua;LI Guanghao;MA Mengjiao;ZHOU Maolin;AN Shiying;MAO Meijiao;CAO Min;ZHOU Duan(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《辽宁中医杂志》2024年第1期106-109,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82004319,81873264);上海申康医院发展中心临床三年行动计划重大临床研究(SHDC2020CR4054);上海市卫生健康委员会卫生行业临床研究专项(201940230);第五批全国优秀中医临床人才项目。

摘　　要：目的观察扩心方对慢性心力衰竭(chronic heart failure,CHF)患者心衰症状、心脏功能、心室重构及炎症因子的影响。方法纳入120例CHF患者,随机分为规范化西药治疗组(对照组)和扩心方联合规范化西药组(观察组),两组各60例,治疗12周,观察两组患者治疗前后心衰症状及心功能改善情况、明尼苏达心力衰竭生活质量量表(MLHFQ)评分、六分钟步行试验(6MWT)、心超、血清脑钠肽(BNP)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β(TGF-β)、血管内皮生长因子(VEGF)水平变化。结果①治疗后,对照组、观察组临床总有效率分别为56.7%、83.3%,观察组改善优于对照组(P<0.05)。②治疗后,观察组在MLHFQ评分、6MWT、BNP变化上改善均优于对照组(P<0.05)。③治疗后,观察组在左室舒张末期内径(LVEDD)、左室射血分数(LVEF)改善优于对照组(P<0.05),两组在左室收缩末期内径(LVESD),室间隔厚度(IVS)、左室后壁厚度(LVPWT)差异无统计学意义(P>0.05)。④治疗后,观察组在血清IL-6、TNF-α、TGF-β、VEGF水平低于对照组(P<0.05),血清IL-2水平两组差异无统计学意义(P>0.05)。结论扩心方可改善CHF患者临床症状,提高心功能,其机制可能与改善心室重构、抑制炎性细胞因子相关。Objective To observe the effect of Kuoxin Recipe(扩心方)on cardiac function,ventricular remodeling and inflammatory factors in patients with chronic heart failure.Methods A total of 120 patients with chronic heart failure were collected and randomly divided into a observation group and a control group with 60 cases in each group.The control group was given conventional western medicine,while the observation group was given Kuoxin Recipe in addition to western medicine.The course of the treatment was 12 weeks.The heart failure symptoms and cardiac function improvement,Minnesota Heart Failure Quality of Life Scale(MLHFQ)score,six-minute walk test(6MWT),cardiac ultrasound,serum levels of brain sodium peptide(BNP),interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),transformed growth factor-β(TGF-β)and vascular endothelial growth factor(VEGF)were evaluated before and after treatment.Results①The total effective rate of the observation group(83.3%)was better than that of the control group(56.7%,P<0.05).②After treatment,the improvement degree of MLHFQ score,6 MWT distance and the level of BNP in the observation group were better than those in the control group(P<0.05).③The observation group showed better improvement in left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)compared to those in the control group(P<0.05).There was no statistically significant difference in left ventricular end systolic diameter(LVESD),ventricular septal thickness(IVS)or left ventricular posterior wall thickness(LVPWT)between the two groups(P>0.05).④After treatment,the observation group showed changes in serum levels of IL-6,TNF-α,TGF-βand VEGF were lower than those of the control group(P<0.05),and there was no statistically significant difference in serum IL-2 levels between the two groups(P>0.05).Conclusion Kuoxin Recipe can improve clinical symptoms and cardiac function in chronic heart failure patients,and its mechanism may be related to improving ventricular remode

关 键 词：慢性心力衰竭 扩心方 临床疗效 心室重构 炎症因子 

分 类 号：R256.2[医药卫生—中医内科学]