益气温阳和活血利水法对充血性心力衰竭患者神经内分泌系统的影响

作者	单位
安海英	北京中医医院北京100010
黄丽娟	北京中医医院北京100010
金敬善	北京中医医院北京100010
金玫	北京中医医院北京100010
刘红旭	北京中医医院北京100010

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中文摘要:

目的 :研究益气温阳、活血利水法对充血性心力衰竭患者神经内分泌系统的影响。方法 :将心功能Ⅲ～Ⅳ级 ,辨证属气 (阳 )虚血瘀、水饮证患者 4 9例随机分为治疗组 (2 9例 )和对照组 (2 0例 ) ,治疗组采用益气温阳、活血利水法治疗 ,对照组服用开搏通。结果 :两组治疗后血浆血管紧张素Ⅱ (ATⅡ )、心房肽(ANP)、内皮素 (ET)、一氧化氮 (NO)水平降低 ,组间比较差异无显著性 (P >0 0 5 ) ;血小板α颗粒膜蛋白14 0 (GMP 14 0 )水平降低 ,效果优于对照组 (P <0 0 5 )。结论 :益气温阳、活血利水法对心衰患者神经内分泌的调节作用与血管紧张素转换酶抑制剂部分相似 ,有可能改善心衰患者的心室重构 ;通过抑制血小板的活性 ,可能对防止血栓的形成及改善心衰的进程有利。

英文摘要:

Objective: To study the effect of Yiqi Wenyang Huoxue Lishui principle (YWHL, a therapeutic principle with Chinese medicine for reinforcing Qi, warming Yang, activating blood circulation and promoting urination) on some neuroendocrine factors in patients with congestive heart failure (CHF). Methods: Forty nine patients of CHF with heart function of grade Ⅲ Ⅳ were randomly divided into 2 groups. The 29 cases in the treated group were treated with YWHL and the 20 cases in the control group treated with captopril. Changes of angiotensin Ⅱ(ATⅡ), atrial natriuretic peptide (ANP), endothelin (ET), nitric oxide (NO) and α granule membrance protein 140 (GMP 140) were observed. Results: After treatment, plasma level of ATⅡ?ANP?ET, and NO lowered in both groups with insignificant difference, but the GMP 140 reduced more significantly in the treated group (P<0 05). Conclusion: YWHL showed a regulatory effect of neuroendicrine system partially similar to that of angiotensin converting enzyme inhibitor, it possibly can improve the ventricular remodeling and would be beneficial to prevent the thrombus formation and improve heart failure by means of inhibiting platelet activity.

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