黄芪对慢性心力衰竭患者心功能与血清肿瘤坏死因子水平的影响

目的探索黄芪对慢性心力衰竭(心衰)患者心功能与血清肿瘤坏死因子(TNF-α)水平的影响。方法心气(阳)虚证慢性心衰患者45例按照随机数字表法随机分为西药组和中药组,两组均给予口服地高辛、利尿剂等标准治疗,中药组加服黄芪颗粒剂2.25 g,每日2次,连续治疗2周。检测治疗前后NYHA心功能分级、血清TNF-α、左室射血分数(LVEF)、6 min步行距离等指标,并进行相关性分析。结果治疗后两组TNF-α水平下降(P<0.05),且中药组[(54.77±9.34)μg/L]低于西药组[(62.10±9.94)μg/L](P<0.05);治疗后两组LVEF升高(P<0.05),且中药组(64.45±12.47)%高于西药组(56.03±13.33)%(P<0.05);治疗后两组6 min步行距离提高(P<0.05),且中药组(446.97±68.82)m长于西药组(345.40±63.62)m(P<0.05);心功能分级改善中药组优于西药组(P<0.05)。心功能改善与TNF-α水平呈负相关。结论黄芪可以减轻钙超载心肌损伤,改善心衰患者心脏的收缩和舒张功能。

英文摘要:

Objective To explore the effects of Astragalus on cardiac function and serum tumor necrosis factor-α(TNF-α)level in patients with chronic heart failure(CHF).Methods Forty-five patients of Xin-qi deficiency or Xin-yang deficiency types were assigned to the Chinese medicine(CM)group and the Western medicine (WM)group by a randomizing digital table.Standard treatment for correcting heart failure,including digoxin, diuretics,etc.was administered to both groups,but to the CM group oral medication of Astragalus granule was given additionally at the dosage of 2.25 g twice a day,the treatment for both was continued for two weeks. NYHA cardiac functional grading,serum TNF-αlevel,left ventricular ejection fraction(LVEF)and walk distance in 6 min(WD)were measured before and after treatment,and a correlation analysis was carried out.Results After therapy,the level of TNF-αin the two groups decreased(P<0.05)and it was lower in the CM group [(54.77±9.34)μg/L]than in the WM group[(62.10±9.94)μg/L](P<0.05);LVEF in the two groups increased (P<0.05)and it was higher in the CM group[(64.45±12.47)%]than that in the WM group [(56.03±13.33)%](P<0.05);both groups’ WD increased(P<0.05)and it was longer in the CM group [(446.97±68.82)m]than in the WM group[(345.40±63.62)m](P<0.05);the improvement of cardiac functional grading in the CM group was outstriper than the WM group(P<0.05).The improvement in cardiac function was negativly corretated with TNF-αlevel.Conclusion Astragalus can alleviate the calcium overload-induced myocardial damage and improve both systolic and diastolic functions of heart in patients with CHF.

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