心衰Ⅰ号治疗射血分数保留型心力衰竭急性发作期阳虚水泛证疗效及对sST2、NT-proBNP、IL-8、TNF-α的影响  

Efficacy of heart failure I on acute exacerbation of heart failure with preserved ejection fraction with syndrome of Yang deficiency and water flooding and its effect on sST2,NT-proBNP,IL-8,and TNF-α

作　　者：赵云贺 王令谆[2] 陈晓虎[2] 林欣[2] 缪晓帆[2] 王艺蓓 杨文莉 包桐 ZHAO Yunhe;WANG Lingzhun;CHEN Xiaohu;LIN Xin;MIAO Xiaofan;WANG Yibei;YANG Wenli;BAO Tong(The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China;The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu,China)

机构地区：[1]南京中医药大学第一临床医学院,江苏南京210023 [2]南京中医药大学附属医院,江苏南京210029 [3]南京医科大学第二附属医院,江苏南京210011

出　　处：《现代中西医结合杂志》2025年第3期312-317,324,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省中医临床医学创新中心研究项目(省中医高血压病临床医学创新中心重点项目)(苏中医科教函〔2023〕1号);江苏省中医药科技发展计划项目(YB2020007)。

摘　　要：目的探讨心衰Ⅰ号治疗射血分数保留型心力衰竭(HFpEF)急性发作期阳虚水泛证患者的疗效及对心功能指标、心力衰竭标志物、炎症因子水平的影响。方法选取南京中医药大学附属医院心内科2023年3—12月收治的100例HFpEF急性发作期阳虚水泛证患者,随机分为对照组和试验组,每组50例。对照组予以标准抗心力衰竭治疗,试验组在标准抗心力衰竭治疗基础上加用心衰Ⅰ号治疗,2组均治疗14 d。比较2组患者治疗前后中医单项症状评分及总分、左心室舒张末期内径(LVEDD)、6分钟步行试验(6MWT)距离及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)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平和治疗14 d后心功能分级疗效。结果治疗后,2组患者中医单项症状评分及总分和血清sST2、NT-proBNP、IL-8、TNF-α水平均明显低于治疗前(P均<0.05),且试验组均明显低于对照组(P均<0.05);试验组LVEDD明显短于治疗前及对照组(P均<0.05),对照组治疗前后比较差异无统计学意义(P>0.05);2组患者6MWT距离均明显长于治疗前(P均<0.05),且试验组明显长于对照组(P<0.05);试验组心功能分级治疗总有效率明显高于对照组[66%(33/50)比48%(24/50),P<0.05]。结论联用心衰Ⅰ号方较单纯标准抗心力衰竭治疗可以更明显改善HFpEF急性发作期阳虚水泛证患者的中医证候和心脏功能,其机制可能与抑制炎症反应有关。Objective It is to explore the efficacy of heart failureⅠin the treatment of patients with acute exacerbation of heart failure with preserved ejection fraction(HFpEF)with syndrome of Yang deficiency and water flooding and its effects on the levels of cardiac function indexes,heart failure markers,and inflammatory factors.Methods A total of 100 patients with acute exacerbation of HFpEF with syndrome of Yang deficiency and water flooding treated in the Department of Cardiology of the Affiliated Hospital of Nanjing University of Chinese Medicine from March to December 2023 were selected and randomly divided into control group and experimental group,with 50 patients in each group.The control group was treated with standard anti-heart failure therapy,and the experimental group was treated with heart failure I on the basis of standard anti-heart failure therapy,both groups were treated for 14 days.The single symptom scores and total scores of Chinese medicine,left ventricular end-diastolic internal diameter(LVEDD),6-minute walk test(6MWT)distance,and serum levels of soluble suppression of tumorigenicity-2(sST2),NT-proBNP,interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)of patients in the two groups before and after treatment,and the efficacy of cardiac function grading after 14 days of treatment were compared.Results After treatment,the single symptom scores and total scores of Chinese medicine and serum levels of sST2,NT-proBNP,IL-8,and TNF-αof patients in the two groups were significantly lower than those before treatment(all P<0.05),and the experimental group was significantly lower than the control group(all P<0.05);the LVEDD of the experimental group was significantly shorter than that before treatment and of the control group(both P<0.05),the difference was not statistically significant between before and after treatment in the control group(P>0.05);the 6MWT distances of patients in the two groups were significantly longer than those before treatment(all P<0.05),and the experimental group was significan

关 键 词：射血分数保留型心力衰竭 心衰Ⅰ号 阳虚水泛 氨基末端脑钠肽前体 炎症因子 

分 类 号：R541.6[医药卫生—心血管疾病]