心衰Ⅰ号方治疗阳虚水泛证射血分数保留型心衰临床研究  

Clinical efficacy of No.1 Xinshuai formula in Yang deficiency and water flooding syndrome patients with HFpEF

作　　者：俞臻 杨文莉 林欣[3] 王令谆[3] 赵云贺 包桐 YU Zhen;YANG Wenli;LIN Xin;WANG Lingzhun;ZHAO Yunhe;BAO Tong(The Second Hospital of Nanjing,Medical School of Nanjing University,Nanjing 210003,China;The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210023,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京市第二医院,江苏南京210003 [2]南京中医药大学第一临床医学院,江苏南京210023 [3]南京中医药大学附属医院,江苏南京210029

出　　处：《陕西中医》2025年第2期201-205,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(YB2020007)。

摘　　要：目的:基于炎症因子白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)、高敏C反应蛋白(hs-CRP)、心衰标志物血清可溶性生长刺激表达基因2蛋白(sST2)、氨基末端脑钠肽前体(NT-proBNP)研究心衰I号方对射血分数保留型心衰(HFpEF)患者(阳虚水泛证)的临床疗效。方法:选择60例HFpEF心衰患者,均分为对照组和试验组各30例。对照组接受标准抗心衰治疗,试验组则在此基础上加用心衰Ⅰ号中药方剂。在治疗前及治疗14 d后,对两组患者中医症候进行评估,并监测sST2、NT-proBNP、IL-1β、IL-18及hs-CRP等指标变化。结果:治疗后两组患者的中医症候积分(单项及总分)和sST2水平均明显低于本组治疗前(P<0.05),且试验组较对照组均明显降低(P<0.05);治疗后两组患者IL-1β和hs-CRP水平较治疗前均明显降低,且试验组IL-1β水平较对照组降低显著(P<0.01),试验组hs-CRP水平也显著低于对照组,差异具有统计学意义(P<0.05);治疗后两组NT-proBNP和IL-18较治疗前下降(P<0.05),且试验组低于对照组。结论:心衰Ⅰ号方与标准抗心衰治疗联合应用,可以明显改善HFpEF患者的临床症候,改善心脏功能,其作用机制可能与抑制炎症反应相关。Objective:To explore the effects of No.1 Xinshuai formula plus conventional based on heart failure markers sST2,NT-proBNP and inflammatory factors IL-1β,IL-18,hs-CRP in heart failure with preserved ejection fraction.Methods:60 patients with HFpEF heart failure were enrolled clinically and divided into control group and experimental group,30 cases each.The control group received standard anti-heart failure treatment,while the experimental group was treated with No.1 Xinshuai formula on this basis.Before treatment and after 14 days of treatment,the TCM evidence of the two groups was evaluated,and the changes of sST2,NT-proBNP,IL-1β,IL-18 and hs-CRP were monitored.Results:The TCM evidence scores(individual and total)and sST2 levels of the two sets after therapy were obviously reduced compared with those before therapy in this set(P<0.05),and both experimental sets were markedly less in comparison with the control set(P<0.05);IL-1βand hs-CRP levels were markedly less in both sets after therapy relative to pre-treatment levels,and the level of IL-1βin the experimental group was extremely decreased compared with that in the control group(P<0.01),the level of hs-CRP in the experimental group was also remarkably less than that in the control group,which was statistical significance(P<0.05);NT-proBNP and IL-18 declined substantially in two sets after therapy than before therapy(P<0.05),and they were both less in the experimental sets than in the control sets,but there was no apparent statutory meaning.Conclusion:No.1 Xinshuai formula,applied in combination with standard anti-heart failure treatment,can significantly improve the clinical evidence of HFpEF patients and improve cardiac function,and its mechanism of action may be related to the inhibition of inflammatory response.

关 键 词：射血分数保留型心衰 心衰Ⅰ号方 阳虚水泛 心衰标志物 炎症因子 

分 类 号：R541.6[医药卫生—心血管疾病]