Influence of Tiaopi Huxin Decoction on  Ventricular Remodeling and Prognosis of Chronic Heart Failure Based on  Theory of Heart Spleen Correlation

Lei WANG; Wei CHEN

doi:10.13422/j.cnki.syfjx.20200432

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Influence of Tiaopi Huxin Decoction on Ventricular Remodeling and Prognosis of Chronic Heart Failure Based on Theory of Heart Spleen Correlation

Clinic | 更新时间：2020-08-11

- Influence of Tiaopi Huxin Decoction on Ventricular Remodeling and Prognosis of Chronic Heart Failure Based on Theory of Heart Spleen Correlation
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 13, Pages: 144-149(2020)
- 作者机构：
  
  1.广西中医药大学赛恩斯新医药学院，南宁 530222
  2.广西中医药大学第一附属医院，南宁 530023
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200432
  CLC： R24;R54;R249;R541
- Published Online：17 January 2020，
  
  Published：05 July 2020
- 稿件说明：
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汪磊,陈炜.基于“心脾相关理论”的调脾护心方对慢性心力衰竭心室重构和预后的影响[J].中国实验方剂学杂志,2020,26(13):144-149.

WANG Lei,CHEN Wei.Influence of Tiaopi Huxin Decoction on Ventricular Remodeling and Prognosis of Chronic Heart Failure Based on Theory of Heart Spleen Correlation[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(13):144-149.
汪磊,陈炜.基于“心脾相关理论”的调脾护心方对慢性心力衰竭心室重构和预后的影响[J].中国实验方剂学杂志,2020,26(13):144-149. DOI： 10.13422/j.cnki.syfjx.20200432.

WANG Lei,CHEN Wei.Influence of Tiaopi Huxin Decoction on Ventricular Remodeling and Prognosis of Chronic Heart Failure Based on Theory of Heart Spleen Correlation[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(13):144-149. DOI： 10.13422/j.cnki.syfjx.20200432.

摘要

目的

观察基于“心脾相关理论”的调脾护心方治疗慢性心力衰竭（CHF）的临床疗效及抗炎和抗心室重构作用的机制研究。

方法

将140例患者随机按数字表法分为对照组和观察组各70例。两组患者均研究期间脱落、失访4例，剔除2例，共完成64例。观察组研究期间脱落、失访6例，剔除0例，共完成64例。两组患者均口服氯沙坦钾片，50 mg/次，1次/d；和酒石酸美托洛尔片，200 mg/次，1次/d；和螺内酯片，20～40 mg/次，1次/d；对照组采用景参益气颗粒，1袋/次，3次/d。观察组内服调脾护心方，1剂/d。两组疗程均为连续治疗12周。采用超声心动图记录治疗前后左室射血分数（LVEF），左室舒张末期内径(LVEDd)，左室收缩末期内径(LVEDs)，每搏输出量（SV），心输出量（CO）和二尖瓣口舒张早期及舒张晚期流速峰值（E/A）；进行治疗前后Lee氏心衰、气虚血瘀兼痰饮证和明尼苏达心衰生活质量调查表（MLHFQ）评分和6 min步行试验(6 MWT)评价；检测治疗前后

末端B型利钠肽原（NT-proBNP），半乳糖凝集素-3，肿瘤坏死因子-

（TNF-

），白细胞介素-6（IL-6），IL-17，转化生长因子-

(TGF)-

和基质金属蛋白酶-9(MMP-9)水平。

结果

治疗后观察组LVEDd和LVEDs均低于对照组（

0.05）；观察组LVEF，SV，CO和E/A均高于对照组（

0.05）；观察组患者Lee氏心衰和气虚血瘀兼痰饮证积分均低于对照组（

0.01）；观察组患者6 MWT多于对照组（

0.01）；观察组患者MLHFQ评分低于对照组（

0.01）；观察组患者NT-proBNP，半乳糖凝集素-3，IL-17，IL-6，TNF-

，TGF-

和MMP-9水平均低于对照组（

0.01）；治疗后观察组心功能疗效好于对照组（

＝2.191，

0.05）。

结论

基于“心脾相关理论”的调脾护心方治疗CHF（气虚血瘀兼痰饮证）患者，能进一步改善心衰临床症状、体征，提高患者的运动耐量和生活质量及临床疗效，并具有抗炎和改善心室重构作用，有利于改善心衰预后。

Abstract

Objective

To observe clinical effect of Tiaopi Huxin decoction to chronic heart failure (CHF) and to study mechanism of action of anti-inflammatory and anti ventricular remodeling.

Method

One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. And during the study

there were four patients for falling off and missing visit

two eliminated patients in control group

and 64 patients finished the study

and there were six patients for falling off and missing visit in observation group

so 64 patients finished the study. Two groups of patients got losartan potassium tablets

50 mg/time

1 time/day

metoprolol tablets

200 mg/time

1 time/day

spironolactone tablets

20-40 mg/time

1 time/day

control group Jingshe Yiqi granule 1 bag/time

3 times/day

flushed with boiling water

patients in observation group added Tiaopi Huxin decoction

1 dose/day. The courses of treatment were 12 weeks. Before and after treatment

left ventricular ejection fraction (LVEF)

left ventricular end diastolic dimension (LVEDd)

leftventricular end-stolic diameter (LVEDs)

stroke volume (SV)

cardiac output (CO) and ratio of peak value of early diastolic velocity of mitral valve and peak velocity of late diastolic mitral valve (E/A) were recorded by echocardiography. And scores of Lee's heart failure

Qi deficiency and blood stasis

Minnesota Heart Failure Quality of life questionnaire (MLHFQ) and 6 minutes' walking test（6 MWT）were graded. And levels of N-terminal B-type natriuretic peptide (NT-proBNP)

galactose lectin-3

tumor necrosis factor-

(TNF-

)

interleukin-6 (IL-6)

IL-17

transforming growth factor (TGF) -

and matrix metalloproteinase-9 (MMP-9) were detected.

Result

After treatment

LVEDd and LVEDs were lower than that in control group (

0.05). LVEF

CO and E/A were higher than those in control group (

0.05). And scores of Lee's heart failure

Qi deficiency blood stasis and MLHFQ were lower than those in control group (

0.01). And 6 MWT was more than that in control group (

0.01). And levels of NT-proBNP

galactose lectin 3

IL-17

IL-6

TNF-

TGF-

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

0.01). Effect of cardiac function was better than that in control group (

=2.191

0.05).

Conclusion

On the basis of conventional western medicine treatment and according to theory of heart and spleen

Tiaopi Huxin decoction can improve the clinical symptoms and signs of heart failure

and it had effect of anti-inflammatory

and can improve ventricular remodeling

improve the exercise tolerance and quality of life of patients

improve the prognosis of heart failure

and its clinical effect is better than that of Western medicine alone.

关键词

Keywords

references

中国中西医结合学会心血管疾病专业委员会 . 慢性心力衰竭中西医结合诊疗专家共识 [J]. 中国中西医结合杂志 , 2016 , 36 ( 2 ): 133 - 141 .

牟海萍 , 刘婷 , 马宏博 . 理气化痰祛瘀法对慢性心力衰竭气虚血瘀型患者心脏康复的观察 [J]. 中国实验方剂学杂志 , 2019 , 25 ( 3 ): 131 - 136 .

丁邦晗 , 吴晓新 , 刘云涛 , 等 . “金三角”之下慢性心力衰竭治疗的中西医结合策略 [J]. 中国中医基础医学杂志 , 2015 , 21 ( 4 ): 436 - 437,456 .

田苗 , 陈智慧 , 张哲 , 等 . 基于心脾相关理论指导临床“从脾论治”心系疾病的现状 [J]. 中国中医急症 , 2017 , 26 ( 7 ): 1191 - 1193 .

祝德伟 , 戴小华 . 从心脾论治慢性心力衰竭浅析 [J]. 中西医结合心脑血管病杂志 , 2018 , 16 ( 1 ): 105 - 107 .

秦佳枫 , 徐瑛 . 健脾益气法治疗慢性心力衰竭的研究进展 [J]. 中西医结合心脑血管病杂志 , 2016 , 14 ( 4 ): 386 - 387 .

李娜 , 王齐有 , 陈玉 . 实脾饮加减治疗糖尿病合并心衰患者的临床观察 [J]. 成都中医药大学学报 , 2016 , 39 ( 4 ): 38 - 40 .

孟慧 , 王启新 , 卢文吉 , 等 . 保元汤调控AT1/P38 MAPK/TGF- β 途径改善心肌纤维化防治心力衰竭的机制研究 [J]. 中华中医药杂志 , 2019 , 34 ( 5 ): 2292 - 2297 .

中华医学会心血管病分会 . 中国心力衰竭诊断和治疗指南2014 [J]. 中华心血管病杂志 , 2014 , 42 ( 2 ): 98 - 122 .

冠心病中医临床研究联盟 , 中国中西医结合学会心血管疾病专业委员会 , 中华中医药学会心病分会 . 慢性心力衰竭中医诊疗专家共识 [J]. 中医杂志 , 2014 , 55 ( 14 ): 1258 - 1260 .

中华医学会心血管病学分会心力衰竭学组 . 中国心力衰竭诊断和治疗指南2018 [J]. 中华心血管病杂志 , 2018 , 46 ( 10 ): 760 - 789 .

王宙 , 周琳 , 刘洋 , 等 . 慢性心力衰竭的流行病学研究现状及其防治研究进展 [J]. 中国循证心血管医学杂志 , 2019 , 11 ( 8 ): 1022 - 1024 .

陈莹 , 刘悦 , 张艳 . 基于脾主运化水湿理论探讨慢性心衰的发病机制 [J]. 中国实验方剂学杂志 , 2018 , 24 ( 20 ): 229 - 234 .

林家茂 , 李珩 , 郭伟星 , 等 . 周杰教授从“心脾相关”论治慢性心力衰竭探析 [J]. 世界中西医结合杂志 , 2014 , 9 ( 4 ): 344 - 346，350 .

孙莹莹 , 刘玥 , 陈可冀 . 人参皂苷的心血管药理效应:进展与思考 [J]. 中国科学：生命科学 , 2016 , 46 ( 6 ): 771 - 778 .

孙敏 , 吴国泰 , 杜丽东 , 等 . 黄芪在心血管系统方面的药理活性研究进展 [J]. 甘肃中医药大学学报 , 2018 , 35 ( 5 ): 91 - 94 .

邓晓红 , 黄建华 , 董竞成 . 附子药理作用的分子机制研究进展 [J]. 江西中医药大学学报 , 2018 , 30 ( 1 ): 121 - 124 .

陈芬燕 , 郭韧 , 张毕奎 . 丹参酮Ⅱ A 的心血管药理作用研究进展 [J]. 中国中药杂志 , 2015 , 40 ( 9 ): 1649 - 1653 .

GANDHI P U , MOTIWALA S R , BELCHER A M , et al . Galectin-3 and mineralocorticoid receptor antagonist use in patients with chronic heart failure due to left ventricular systolic dysfunction [J]. Am Heart J , 2015 , 169 ( 3 ): 404 - 411 .

KUMAR M S , VAMSI G , SRIPRIYA R , et al . Expression of matrix metalloproteinases (MMP-8 and 9) in chronic periodontitis patients with and without diabetes mellitus [J]. J Periodontol , 2017 , 77 ( 11 ): 1803 - 1808 .

ZHANG Q , HU L Q , YIN C S , et al . Catechin ameliorates cardiac dysfunction in rats with chronic heart failure by regulating the balance between Th17 and Treg cells [J]. Inflamm Res , 2014 , 63 ( 8 ): 619 - 628 .

杨贵芳 , 彭文 , 赵琴 , 等 . 心力衰竭免疫学机制及治疗的研究进展 [J]. 中国循环杂志 , 2015 , 30 ( 2 ): 193 - 195 .

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