参松养心胶囊联合西药常规对慢性心力衰竭患者神经内分泌系统及内皮功能的影响

摘要

目的 研究参松养心胶囊联合西药常规对慢性心力衰竭(CHF)患者神经内分泌系统及内皮功能的影响.方法 60例CHF患者随机分为对照组和治疗组,每组30例,对照组予利尿剂、ACEI及β受体阻滞剂等常规西药治疗,治疗组在对照组治疗基础上加用参松养心胶囊治疗.2组均治疗12周后统计临床疗效,并观察2组治疗前后心脏超声左心室舒张末内径(LVEDd)、左心室收缩末内径(LAESd)、左心室射血分数(LVEF)、心排出量(CO)、计算短轴缩短率(FS)及血管内皮舒张功能[内皮依赖性血管舒张功能(FMD)、非内皮依赖性血管舒张功能(NED)];血管内皮功能及神经内分泌因子血浆内皮素(ET)、降钙素基因相关肽(CGRP)、血清一氧化氮(NO)、血浆B型利钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、血浆肾素(PRA).结果 治疗组临床疗效优于对照组,2组总有效率比较差异有统计学意义(P<0.05).2组治疗后心脏超声各项指标均较治疗前明显改善,差异均有统计学意义(P<0.05),且治疗组LVEDd、LAESd均低于对照组,LVEF、FS、CO均高于对照组,差异均有统计学意义(P<0.05).2组治疗后FMD、NED均较本组治疗前增强,ET、AngⅡ、ALD、PRA、BNP水平下降,NO及CGRP升高,差异均有统计学意义(P<0.05),且2组组间比较差异有统计学意义(P<0.05).2组治疗后心功能等级均显著改善,且治疗组改善优于对照组,差异均有统计学意义(P<0.05).结论 参松养心胶囊联合西药常规治疗CHF疗效确切,且能改善患者神经内分泌系统及内皮功能.%Objective To investigate the effects of Shensongyangxin capsule combined with western medicines on neuroendocrine system and endothelial function of patients with chronic heart failure (CHF).Methods Sixty patients with CHF were randomly divided into control group and observation group ,with 30 patients in each group .The patients in control group were treated by conventional western medicines including diuretics , ACEI and beta blockers , however , the patients in observation group,on the basis of control group ,were treated by Shensongyangxin capsule ,with a treatment course of 12 weeks for both grousp .Then the therapeutic effects were observed and compared between two groups .Moreover the changes of echocardiographic left ventricular end diastolic diameter ( LVEDd ) , left ventricular end systolic diameter ( LAESd ) , left ventricular ejection fraction ( LVEF ) , cardiac output ( CO ) , fractional shortening ( FS ) and vascular endothelial function;vascular endothelial function , neuroendocrine factors in plasma endothelin ( ET ) , calcitonin gene related peptide ( CGRP ) , serum nitric oxide (NO),plasma B type natriuretic peptide (BNP),angiotensin Ⅱ (Ang Ⅱ),aldosterone (ALD),plasma renin activity ( PRA) before and after treatment were observed and compared between two groups .Results The total effective rate in observation group was superior to that in control group ( P<00.5 ) .After treatment the cardiac ultrasound indexes were significantly improved in both groups , as compared with those before treatment ( P <0.05).The LVEDd and LAESd in observation group were obviously lower than those in control group ,however, the LVEF,FS,CO in observation group were significantly higher than those in control group (P<0.05).After treatment the FMD,NED, NO and CGRP were increased in both groups,but the levels of ET,Ang II,ALD,PRA,BNP were significantly decreased,as compared with those before treatment (P<0.05),moreover there were significant differences between two groups (P<0.05).After treatment the cardiac function grade was obviously improved in both groups , moreover the improvement degree in observation group was superior to that in control group ( P<0.05) .Conclusion Shensongyangxin capsule combined with western medicines has definite therapeutic effects on CHF,moreover,which can improve the neuroendocrine system and endothelial function of patients .