摘要
目的:探讨参附强心丸对慢性心力衰竭(CHF)患者肾素-血管紧张素-醛固酮系统(RAAS)及心房利钠多肽(ANP)和脑利钠多肽(BNP)的影响。方法:90例CHF患者随机按诊病前后分为西药组和观察组各45例。西药组服用依那普利片,5 mg/次,2次/d;倍他乐克片,0.1 g/次,2次/d;地高辛片,0.25 mg/次,1次/d,必要时服用。观察组在西药组治疗的基础上加用参附强心丸,6 g/次,3次/d。两组疗程均为12周。采用超声心动图测定左室舒张末期内径(LVED)、收缩末期内径(LVSD)、心室射血分数(LVEF)和心输出量(CO),记录Lee氏心衰计分和6 min步行实验(6 MWT)评分,检测抗利尿激素(ADH)、N末端前脑利钠肽(NT-proBNP)、血管紧张素Ⅱ(AngⅡ)和醛固酮水平,治疗前后各评定1次。结果:观察组Lee氏心衰疗效总有效率为86.67%,西药组为68.89%,观察组优于西药组(P<0.05);治疗后观察组LVED和LVSD小于西药组(P<0.01);治疗后两组LVEF和CO都有增加(P<0.01),观察组LVEF和CO增加更为显著(P<0.01);两组治疗后Lee氏心衰积分比治疗前下降,观察组低于西药组(P<0.01);两组治疗后6 MWT均比治疗前有所改善,观察组改善更为显著(P<0.01);治疗后观察组血AngⅡ、醛固酮水平、NT-proBNP和ADH水平均低于西药组(P<0.01)。结论:在西医常规治疗的基础上参附强心丸能进一步改善CHF患者心功能,并能抑制RAAS系统,调节ANP和BNP,逆转心室重塑,这可能是其重要的作用机制。
Objective：To observe influence of Shenfu Qiangxin pills to patients＇ renin-angiotensinaldosterone system （RAAS）,atrial natriuretic polypeptide （ANP） and brain natriuretic peptide （BNP） in treating chronic heart failure （CHF）.Method：Ninety cases with CHF were randomly divided into control group （45 cases） and observation group （45 cases） by diagnosis time.Patients in control group received enalapril tablets with 5 mg/time and 2 times/day; Metoprolol tablets with 0.1 g/time and 2 times/day.Digoxin tablets with 0.25 mg/time and 1 time/day,everyone took necessarily.Based on the treatment of control group,patients in observation group received Shenfu Qiangxin pills with 6 g/time and 3 times/day.Course of treatment in two groups were both 12 weeks.Left ventricular end diastolic （LVED）,left ventricular end systolic diameter （LVSD）,left ventricular ejection fraction （LVEF） and cardiac output （CO） were detected by echocardiogram,Lee＇s heart failure scores and six-minute walk test （6 MWT） were recorded,levels of antidiuretic hormone （ADH）,Nterminal pro-brain natriuretic peptide （NT-proBNP）,angiotensin-Ⅱ （Ang Ⅱ） and aldosterone were detected,all of those were evaluated for one time before and after treatment.Result：Total effective rate of curative effect of Lee＇s heart failure scores in the observation group was 86.67％ superior to 68.89％ of which in the control group （P ＜ 0.05）.After treatment,LVED and LVSD in the observation group were small than those in the control group （P ＜0.01）,LVEF and CO in both groups increased （P ＜0.01）,and which increased more dramaticlly in the observation group than in the control group （P ＜ 0.01）.Compared with the time before treatment,integral of Lee＇s heart failure scores decreased,and which in the observation group were lower than those in the control group （P ＜ 0.01）.6 MWT in both groups also ameliorated,and which was more significant in the observation group than in the control grou
出处
《中国实验方剂学杂志》
CAS
北大核心
2014年第15期204-207,共4页
Chinese Journal of Experimental Traditional Medical Formulae
基金
四川省教育厅项目(川教函[2011]538号11ZB130)
关键词
慢性心力衰竭
参附强心丸
肾素-血管紧张素-醛固酮系统
心房利钠多肽
脑利钠多肽
chronic heart failure
Shenfu Qiangxin pills
renin-angiotensin-aldosterone system
atrial natriuretic polypeptide
brain natriuretic peptide
