Clinical Efficacy and Mechanism of Xiao Qinglongtang in Treating Chronic Heart Failure with Cold Phlegm in Lung

Zhao-yu LI; Yong-cheng WANG; Guo-feng ZHOU; Rui LIN; Wen-ting WANG; Si-jia WU; Feng DONG; Xiao LI

doi:10.13422/j.cnki.syfjx.20201976

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Clinical Efficacy and Mechanism of Xiao Qinglongtang in Treating Chronic Heart Failure with Cold Phlegm in Lung

更新时间：2021-12-03

- Clinical Efficacy and Mechanism of Xiao Qinglongtang in Treating Chronic Heart Failure with Cold Phlegm in Lung
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 1, Pages: 17-22(2021)
- 作者机构：
  
  1.山东中医药大学，济南 250014
  2.山东中医药大学附属医院，济南 250011
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20201976
  CLC： R22;R242;R2-031;R287
- Received：02 March 2020，
  
  Published Online：24 July 2020，
  
  Published：05 January 2021
- 稿件说明：
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李兆钰,王永成,周国锋等.小青龙汤治疗寒痰阻肺型慢性心力衰竭的临床疗效及作用机制[J].中国实验方剂学杂志,2021,27(01):17-22.

LI Zhao-yu,WANG Yong-cheng,ZHOU Guo-feng,et al.Clinical Efficacy and Mechanism of Xiao Qinglongtang in Treating Chronic Heart Failure with Cold Phlegm in Lung[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(01):17-22.
李兆钰,王永成,周国锋等.小青龙汤治疗寒痰阻肺型慢性心力衰竭的临床疗效及作用机制[J].中国实验方剂学杂志,2021,27(01):17-22. DOI： 10.13422/j.cnki.syfjx.20201976.

LI Zhao-yu,WANG Yong-cheng,ZHOU Guo-feng,et al.Clinical Efficacy and Mechanism of Xiao Qinglongtang in Treating Chronic Heart Failure with Cold Phlegm in Lung[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(01):17-22. DOI： 10.13422/j.cnki.syfjx.20201976.

摘要

目的

观察小青龙汤治疗寒痰阻肺型慢性心力衰竭的临床疗效，探讨其作用机制。

方法

将符合诊断的慢性心衰寒痰阻肺证患者87例，采用随机数字表法分为观察组和对照组，两组同时接受西医常规治疗，观察组42例在西医基础上加予中药小青龙汤加减治疗，对照组45例予以相同剂量安慰剂，连续用药4周。比较两组治疗前后心功能疗效、中医证候积分及疗效；检测两组治疗前后左室射血分数（LVEF）和N末端B型脑钠肽前体（NT-proBNP）；比较两组治疗前后心率变异性（HRV）中正常窦性心搏RR间期的标准差（SDNN），全程相邻窦性心搏RR间期差值均方根（RMSSD），高频功率（HF）和低频功率（LF）等反映自主神经功能指标的变化；检测白细胞介素-6（IL-6），超敏C反应蛋白（hs-CRP）等炎性指标水平的变化。

结果

两组患者治疗后，观察组心功能总有效率高于对照组（

0.05）；与本组治疗前比较，两组治疗后中医证候积分均有减少（

0.05），总有效率观察组高于对照组（

0.01）。与本组治疗前比较，两组治疗后各检测指标比较显示LVEF显著提高（

0.01），NT-proBNP显著降低（

0.01），观察组效果较对照组显著（

0.01）。与本组治疗前比较，两组治疗后HRV中SDNN，RMSSD，HF，LF指标均升高（

0.01），观察组各指标改善更显著（

0.01）。与本组治疗前比较，两组治疗后IL-6和hs-CRP水平均下降（

0.01），观察组炎症因子水平显著低于对照组（

0.01）。

结论

小青龙汤治疗慢性心衰寒痰阻肺证具有一定的临床疗效，可改善患者临床症状，调节自主神经平衡，抑制炎症因子，为中医药治疗慢性心衰提供新的临床思路。

Abstract

Objective

To observe the clinical efficacy of Xiao Qinglongtang on chronic heart failure with cold phlegm in lung， and explore its mechanism of action.

Method

A total of 87 patients with definite chronic heart failure were divided into observation group and control group by random number table method．The two groups received routine western medicine at the same time. Forty-two cases in observation group were treated with Xiao Qinglongtang based on western medicine， and 45 cases in control group received the same dose of placebo. Both groups were treated for 4 weeks， and then their cardiac function， traditional Chinese medicine （TCM） syndrome score and efficacy were compared before and after treatment. Left ventricular ejection fraction （LVEF） and

-terminal pro-brain natriuretic peptide （NT-proBNP） were measured in both groups before and after treatment. The changes of standard deviation of NN intervals （SDNN）， square root of the mean squared differences of successive NN intervals （RMSSD）， high frequency （HF） and low frequency （LF） that reflect autonomic nerve function indexes in heart rate variability （HRV） after treatment were compared between two groups. The changes of inflammatory indicators such as interleukin-6 （IL-6） and highly sensitive C reaction protein （hs-CRP） were detected.

Result

After treatment， the total effective rate for cardiac function in observation group was higher than that in control group （

0.05）. The TCM symptom scores were improved after treatment in both groups （

0.05）， and the total effective rate in observation group was higher than that in control group （

0.01）. After treatment， LVEF levels significantly increased （

0.01） and NT-proBNP levels significantly decreased （

0.01） in both groups， and the effect in observation group was more obvious （

0.01）. After treatment， SDNN， RMSD， HF and LF indicators in HRV were all higher than those before treatment in both groups （

0.01）， and the improvement in observation group was more significant than that in control group （

0.01）. The levels of IL-6 and hs-CRP decreased after treatment in both groups （

0.01）， and the level of observation group was significantly lower than that of control group （

0.01）.

Conclusion

Xiao Qinglongtang has certain clinical efficacy in treating chronic heart failure with cold phlegm in lung as it can improve the clinical symptoms of patients， regulate autonomic nervous balance， and inhibit inflammatory factors， providing new clinical ideas to treat chronic heart failure in TCM.

关键词

Keywords

references

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