黄芪对心气阳虚证扩张型心肌病患者的干预作用及对抗心肌抗体的影响

沈丽娟; 梅晓鹏; 陆曙; 朱红俊; 杨庆有

doi:10.13422/j.cnki.syfjx.2017180157

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黄芪对心气阳虚证扩张型心肌病患者的干预作用及对抗心肌抗体的影响

中医药治疗扩张型心肌病的应用基础研究 | 更新时间：2024-01-04

- 黄芪对心气阳虚证扩张型心肌病患者的干预作用及对抗心肌抗体的影响
- Effects of Hedysari Radix on Cardiac Function Indexes and Anti-myocardial Antibodies in Patients with Dilated Cardiomyopathy of Heart Qi Yang Deficiency Type
- 中国实验方剂学杂志 2017年23卷第18期页码：157-162
- 作者机构：
- 作者简介：
- 基金信息：
  
  无锡市医院管理中心科研项目（YGZXM14047）
- DOI：10.13422/j.cnki.syfjx.2017180157
  中图分类号： R259
- 纸质出版日期：2017
- 稿件说明：
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沈丽娟, 梅晓鹏, 陆曙, 等. 黄芪对心气阳虚证扩张型心肌病患者的干预作用及对抗心肌抗体的影响[J]. 中国实验方剂学杂志, 2017,23(18):157-162.

SHEN Li-juan, MEI Xiao-peng, LU Shu, et al. Effects of Hedysari Radix on Cardiac Function Indexes and Anti-myocardial Antibodies in Patients with Dilated Cardiomyopathy of Heart Qi Yang Deficiency Type[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(18): 157-162.
沈丽娟, 梅晓鹏, 陆曙, 等. 黄芪对心气阳虚证扩张型心肌病患者的干预作用及对抗心肌抗体的影响[J]. 中国实验方剂学杂志, 2017,23(18):157-162. DOI： 10.13422/j.cnki.syfjx.2017180157.

SHEN Li-juan, MEI Xiao-peng, LU Shu, et al. Effects of Hedysari Radix on Cardiac Function Indexes and Anti-myocardial Antibodies in Patients with Dilated Cardiomyopathy of Heart Qi Yang Deficiency Type[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(18): 157-162. DOI： 10.13422/j.cnki.syfjx.2017180157.

摘要

目的：观察黄芪颗粒剂对心气虚和（或）阳虚证素的扩张型心肌病（dilated cardiomyopathy，DCM）患者干预作用及对抗心肌抗体的影响，为黄芪的临床应用提供理论依据。方法：选择无锡市中医医院和无锡市人民医院2013年5月至2016年1月期间住院的DCM心气虚和（或）阳虚证素患者134例为DCM组，随机分为常规组（采用西医常规治疗）67例，中药组（在常规组治疗基础上+黄芪60 g）67例。并随机抽取30例健康体检者作为正常组。在治疗第1，28天观察N终端脑钠肽（NT-proBNP），左室射血分数（LVEF），左室舒张期末内径（LVEDD），抗心肌抗体抗β1肾上腺能受体自身抗体（ant-β1），抗肌球蛋白重链自身抗体（ant-MHC），抗毒蕈碱-2受体自身抗体（ant-M2），抗腺嘌呤核苷（ADP/ATP）转位酶自身抗体（ant-ANT）水平，临床症状、体征、纽约心脏病协会（NYHA）心功能分级等的变化。结果：临床疗效，中药组患者中医证候疗效总有效率为91.9%，常规组患者中医证候疗效总有效率为71.0%，中药组高于常规组（P<0.05）。心功能，中药组与常规组患者治疗后NYHA分级的疗效总有效率分别为82.3%，83.9%，两组比较差异无统计学意义。中药组治疗后NT-proBNP水平低于常规组同期水平（P<0.05）。治疗后两组LVEF明显升高（P<0.05）；LVEDD明显下降（P<0.05）。两组治疗后各指标差异无统计学意义。抗心肌抗体，与正常组比较，DCM组各抗心肌抗体明显升高（P<0.05）。治疗后两组患者血清抗心肌抗体ant-β1，ant-MHC，ant-M2水平明显降低（P<0.05），中药组治疗后ant-ANT水平较治疗前显著降低（P<0.05）。中药组治疗后ANT水平低于常规组同期水平（P<0.05）。中药组低血压及心律失常发生率低于常规组（P<0.05）。两组肾功能不全及刺激性干咳发生率无统计学差异。结论：黄芪能调节心气虚和（或）阳虚证素的DCM患者抗心肌抗体水平，降低血清NT-proBNP水平，提高中医证候疗效，减轻患者症状，改善心功能，减少不良事件的发生。

Abstract

Objective: To observe the effects of Hedysari Radix on cardiac function indexes of dilated cardiomyopathy (DCM) patients with heart Qi and Yang deficiency syndrome

investigate the effect of Hedysari Radix on anti-heart antibodies in DCM patients

and explore its possible mechanism.Method: The 134 DCM patients in Wuxi Traditional Chinese Medicine Hospital and Wuxi People's Hospital from May 2013 to January 2016 were randomly divided into routine control group (routine western medicine treatment

67 cases) and Chinese medicine group (routine treatment+Hedysari Radix 60 g

67 cases).The 30 healthy cases were randomly selected as normal group. At the beginning and the end of experiment

the levels of Nterminalpro brain natriuretic peptide(NT-proBNP)

left ventricular dimension at end-diastole (LEVDD)

left ventricle ejection fraction (LVEF)

anti-β1 adrenergic receptor autoantibody (ant-β1)

anti-myosin heavy chain autoantibody (ant-MHC)

anti-muscarinic receptor-2 autoantibody (ant-M2)

anti-adenine nucleotide (ADP/ATP)

and translocase auto antibody (ant-ANT) were measured; and the changes in clinical symptoms

signs and cardiac function grade in New York Heart Association (NYHA) were observedt.Result: The total effective rate of syndrome was 91.9% in Chinese medicine group higher than 71.0% in routine control group (P<0.05). The total effective rate of NYHA cardiac function grade was 82.3% and 83.9% respectively in Chinese medicine group and routine control group

with no significant differences between these two groups. NT-proBNP level in Chinese medicine group was lower than that in routine control group at the same period after treatment (P<0.05). The LVEF level was significantly increased and LEVDD level was significant decreased in both groups after treatment (P<0.05). There were no significant differences in various indexes between two groups after treatment. Various anti-heart antibodies in DCM group were significantly higher than those in normal group (P<0.05). The ant-β1

ant-MHC and ant-M2 levels were decreased in both groups after treatment (P<0.05)

and ant-ANT level was significantly decreased in Chinese medicine group after treatment (P<0.05). ANT level in Chinese medicine group was lower than that in routine control group at the same period (P<0.05)

and the incidence of hypotension and arrhythmia in Chinese medicine group was lower than that in routine control group. In addition

there were no significant differences in the incidence of renal insufficiency and irritative dry cough.Conclusion: Hedysari Radix can regulate the expression of the anti-myocardial antibodies

reduce the levels of NT-proBNP

improve the clinical curative effects

relieve cardiac functions

and reduce the incidence of adverse events in DCM patients with heart Qi and Yang deficiency syndrome.

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