Effect Research Antiventricular Remodeling of Qili Qiangxin Capsules in Treating Dilated Cardiomyopathy

Yang YANG; Ming-lei JIN; Ling-yan SONG; Yu-feng GUO; Chun-yan SONG

doi:10.13422/j.cnki.syfjx.20191332

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Effect Research Antiventricular Remodeling of Qili Qiangxin Capsules in Treating Dilated Cardiomyopathy

Clinic | 更新时间：2021-02-09

- Effect Research Antiventricular Remodeling of Qili Qiangxin Capsules in Treating Dilated Cardiomyopathy
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 13, Pages: 99-104(2019)
- 作者机构：
  
  1.承德市中心医院，河北　承德067000；
  2.河北医科大学　第四医院，石家庄　 050011；
  3.承德医学院　附属医院，河北　承德067000；
  4.丰宁县中医院，河北　承德068350
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191332
  CLC： R54; R541; R542.2
- Received：05 January 2019，
  
  Published Online：31 January 2019，
  
  Published：05 July 2019
- 稿件说明：
移动端阅览
Yang YANG, Ming-lei JIN, Ling-yan SONG, et al. Effect Research Antiventricular Remodeling of Qili Qiangxin Capsules in Treating Dilated Cardiomyopathy[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(13): 99-104.
DOI：

Yang YANG, Ming-lei JIN, Ling-yan SONG, et al. Effect Research Antiventricular Remodeling of Qili Qiangxin Capsules in Treating Dilated Cardiomyopathy[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(13): 99-104. DOI： 10.13422/j.cnki.syfjx.20191332.

摘要

目的：

探讨芪苈强心胶囊对(阳气亏虚血瘀证)扩张型心肌病(DCM)患者心功能、心肌纤维化和心室重构的影响。

方法：

将107例DCM患者按随机数字表法分为对照组53例和观察组54例。对照组口服美托洛尔缓释片，47.5 mg/次，1次/d；口服沙库巴曲缬沙坦钠片，50 mg/次，1次/d；口服氢氯噻嗪片，20 mg/次，1次/d；口服螺内酯片，20 mg/次，1次/d。观察组在对照组治疗的基础上，加用芪苈强心胶囊，4 粒/次，3次/d，餐后服用。两组疗程均连续治疗6个月。采用超声心动图检查记录治疗前后左室舒张末期内径(LVEDd)，左室射血分数(LVEF)，左室收缩末期内径(LVESD)，室间隔厚度(IVST)，左室后壁厚度(LVPWT)，左室心肌质量(LVM)和左室心肌质量指数(LVMI)；进行治疗后美国纽约心脏病学会(NYHA)心功能分级；进行治疗前后Lee氏心衰评分和阳气亏虚血瘀证评分；检测治疗前后

末端B型利钠肽原(NT-proBNP)，可溶性ST2(sST2)，半乳糖凝集素-3(galectin-3)，血管紧张素Ⅱ(Ang-Ⅱ)，基质金属蛋白酶-2(MMP-2)，MMP-9，基质金属蛋白酶抑制因子-1(TIMP-1)，Ⅰ型前胶原羧基端肽(PIP)和Ⅰ型胶原羧端交联肽(CITP)水平。

结果：

治疗后观察组患者LVEDd，LVESD，IVST，LVPWT，LVM和LVMI均低于对照组(

0.05)，LVEF高于对照组(

0.05)；经秩和检验，治疗后观察组NYHA心功能分级轻于对照组(

＝2.031，

0.05)；治疗后3～6个月，观察组血浆NT-proBNP水平均低于对照组(

0.01)，Lee氏心衰评分和阳气亏虚血瘀证评分均低于对照组(

0.01)；观察组血清sST2，galectin-3，PIP和CITP水平均低于对照组(

0.01)；观察组血清MMP-2，MMP-9和Ang-Ⅱ水平均低于对照组，TIMP-1水平高于对照组(

0.01)。

结论：

在西医常规治疗的基础上，加服芪苈强心胶囊治疗DCM阳气亏虚血瘀证，可减轻DCM患者临床症状和心衰程度，改善心功能，并能调节sST2，galectin-3，MMPs和Ang-Ⅱ等因子表达，起到抑制心肌纤维化，减轻心室重构，延缓心衰的作用。

Abstract

Objective:

To discuss the effect of Qili Qiangxin capsules on cardiac function

myocardial fibrosis and ventricular remodeling of patients with dilated cardiomyopathy (DCM) and Yang Qi deficiency and blood stasis syndrome.

Method:

One hundred and seven patients were randomly divided into control group (53 cases) and observation group (54 cases) by random number table. Patients in control group got metoprolol succinate sustained-release tablet

47.5 mg/time

1 time/day

sacubitril valsartan sodium tablets

50 mg/time

1 time/day

hydrochlorothiazide tablets

20 mg/time

1 time/day

and spironolactone tablets

20 mg/time

1 time/day. In addition to the therapy of control group

patients in observation group were also given Qili Qiangxin capsules

4 granules/time

3 times/days. A course of treatment was 6 months. Before and after treatment

levels of left ventricular end-diastolic diameter (LVEDd)

left ventricular ejection fraction (LVEF)

left ventricular end systolic diameter (LVESD)

interventricular septal thickness (IVST)

left ventricular posterior wall thickness (LVPWT)

left ventricular myocardial mass (LVM) and left ventricular myocardial mass index (LVMI) were recorded by echocardiography. The classification of cardiac function was recorded by New York College of Cardiology (NYHA). Lee's heart failure and Yang Qi deficiency and blood stasis syndrome were scored. And levels of

-terminal B-type natriuretic peptide (NT-proBNP)

soluble ST2 (sST2)

galectin-3 (galectin-3)

angiotensin-Ⅱ(Ang-Ⅱ)

matrix metalloproteinase-2 (MMP-2)

MMP-9

matrix metalloproteinase inhibitor-1 (TIMP-1)

type I procollagen carboxy-terminal peptide (PIP) and type I collagen carboxy-terminal cross-linking peptide (CITP) were detected.

Result:

After treatment

levels of LVEDd

LVESD

IVST

LVPWT

LVM and LVMI were lower than those in control group (

0.05)

while LVEF was higher than that in control group (

0.05). According to the rank sum test

NYHA cardiac function classification was lighter than that in control group (

=2.031

0.05). After treatment

level of NT-proBNP was lower than that in control group (

0.01)

Lee's heart failure score and Yang Qi deficiency

blood stasis syndrome score sST2

galectin-3

PIP

CITP

MMP-2

MMP-9 and Ang-Ⅱ were lower than those in control group (

0.01).

Conclusion:

In addition to the routine western medicine

Qili Qiangxin capsules can relieve clinical symptoms

degree of heart failure of DCM patients and ventricular remodeling

ameliorate heart function

regulate levels of sST2

galectin-3

MMPs and Ang-Ⅱ

inhibit myocardial fibrosis

and delay heart failure.

关键词

Keywords

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