Modified Treatment of Zhenwu Tang Combined with Xiaoyao San for Chronic Cardiac Failure Concomitant with Depression and Syndromes of Qi-deficiency and Liver-Qi Stagnation

XUE Hong-li; ZHAO Peng

doi:10.13422/j.cnki.syfjx.2016190144

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Modified Treatment of Zhenwu Tang Combined with Xiaoyao San for Chronic Cardiac Failure Concomitant with Depression and Syndromes of Qi-deficiency and Liver-Qi Stagnation

更新时间：2024-01-04

- Modified Treatment of Zhenwu Tang Combined with Xiaoyao San for Chronic Cardiac Failure Concomitant with Depression and Syndromes of Qi-deficiency and Liver-Qi Stagnation
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 22, Issue 19, Pages: 144-148(2016)
- 作者机构：
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- DOI：10.13422/j.cnki.syfjx.2016190144
  CLC： R259
- Published：2016
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XUE Hong-li, ZHAO Peng. Modified Treatment of Zhenwu Tang Combined with Xiaoyao San for Chronic Cardiac Failure Concomitant with Depression and Syndromes of Qi-deficiency and Liver-Qi Stagnation[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 144-148.
DOI：

XUE Hong-li, ZHAO Peng. Modified Treatment of Zhenwu Tang Combined with Xiaoyao San for Chronic Cardiac Failure Concomitant with Depression and Syndromes of Qi-deficiency and Liver-Qi Stagnation[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 144-148. DOI： 10.13422/j.cnki.syfjx.2016190144.

摘要

目的：探讨真武汤合逍遥散加减治疗慢性心力衰竭伴发抑郁症的临床疗效，及对血管紧张素Ⅱ（AngⅡ），N末端B型利钠肽原（NT-proBNP），白细胞介素-6（IL-6），肿瘤坏死因子-α（TNF-α）和血清超敏C-反应蛋白（hs-CRP）水平的影响。方法：将148例患者随机分为对照组和观察组。对照组口服路优泰，1片/次，3次/d。观察组口服真武汤合逍遥散加减，1剂/d。疗程12周。进行治疗前后汉密尔顿抑郁量表（HAMD），汉密尔顿焦虑量表（HAMA），匹兹堡失眠质量指数（PSQI）和明尼苏达心衰生活质量调查表（MLHFQ）评分；采用超声心动图检测治疗前后左室舒张末期内径（LVED），收缩末期内径（LVSD），左心室射血分数（LVEF）和心输出量（CO），进行治疗前后Lee氏心衰评分；检测治疗前后AngⅡ，NT-proBNP，IL-6，TNF-α和hs-CRP水平。结果：观察组心衰疗效总有效率、郁症疗效总有效率、中医证候疗效总有效率高于对照组（P<0.05，P<0.01）；观察组治疗后HAMD，HAMA，PSQI，MLHFQ量表评分均低于对照组（P<0.01）；治疗后观察组LVED，LVSD和Lee氏评分低于对照组，LVEF和CO高于对照组（P<0.01）；治疗后观察组AngⅡ，NT-proBNP，IL-6，TNF-α和hs-CRP水平低于对照组（P<0.01）。结论：采用真武汤合逍遥散治疗慢性心力衰竭伴抑郁障碍患者，能改善患者的心衰和抑郁症状，提高患者生活质量，调节AngⅡ，NT-proBNP介质和炎症介质水平，对于心衰和抑郁均有显著疗效。

Abstract

Objective: To discuss the clinical efficacy of modified treatment of Zhenwu Tang combined with Xiaoyao San in treating chronic cardiac failure with depression

and investigate its effects on levels of angiotensin Ⅱ (AngⅡ)

N-terminal pro brain natriuretic peptide (NT-proBNP)

interleukin-6 (IL-6)

tumor necrosis factor-α (TNF-α)

and serum hypersensitive C-reactive protein (hs-CRP). Method: One hundred and forty-eight patients were randomly divided into control group and observation group. Patients in control group took neurostan

1 tablet/time

3 times/day

while patients in observation group took modified treatment of Zhenwu Tang combined with Xiaoyao San

1 dose/day. The treatment course was 12 weeks for both groups. Before and after treatment

scores of Hamilton's depression scale (HAMD)

Hamilton anxiety scale (HAMA)

Pittsburgh sleep quality index (PSQI) and Minnesota heart failure quality of life questionnaire (MLHFQ) were graded. Left ventricular end diastolic diameter (LVED)

left ventricular systolic dimension (LVSD)

left ventricular ejection fraction (LVEF) and cardiac output (CO) were detected by echocardiogram

and the score of Lee's heart failure was grated both before and after treatment. Levels of AngⅡ

NT-proBNP

IL-6

TNF-α and hs-CRP were detected before and after treatment. Result: The total effective rate for heart failure

the total effective rate for depression and clinical efficacy rate of traditional Chinese medicine(TCM) syndrome in observation group were higher than those in control group (P<0.05

P<0.01). Scores of HAMD

HAMA

PSQI and MLHFQ in observation group were lower than those in control group (P<0.01). Scores of LVED

LVSD and Lee in observation group were lower than those in control group after treatment

while the scores of LVEF and CO were higher than those in control group (P<0.01). The levels of AngⅡ

NT-proBNP

IL-6

TNF-α and hs-CRP in observation group were lower than those in control group after treatment (P<0.01). Conclusion: Zhenwu Tang combined with Xiaoyao San can ameliorate cardiac failure and depression symptoms

improve quality of life and regulate levels of AngⅡ

NT-proBNP medium and level of inflammatory mediator in treating chronic cardiac failure concomitant with depression

and the effect was obvious.

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