毛冬青在慢性心力衰竭中抗炎作用的临床研究

摘要

[目的]观察中药毛冬青对慢性心力衰竭患者的抗炎作用,评估其通过抗炎改善患者生活质量的临床疗效.[方法]将60例慢性心力衰竭患者随机分为对照组和观察组,每组30例.对照组给予西医规范治疗方案,观察组在西医治疗的基础上加用毛冬青颗粒,治疗4周后观察安全性指标,检测患者血清中C反应蛋白(CRP)、肿瘤坏死因子-α (TNF-α)和白介素-6(IL-6)的变化,并进行心衰生活质量评分.[结果](1)治疗后观察组的血清TNF-α和IL-6水平显著下降(与治疗前比较,P＜0.05),而血清CRP水平虽有下降趋势,但与治疗前比较差异无统计学意义(P＞0.05).对照组治疗后各项指标均无明显变化,与治疗前比较差异无统计学意义(P＞0.05).治疗后组间比较,观察组血清TNF-α和IL-6水平的改善显著优于对照组(P＜0.05).(2)治疗后观察组在改善患者的明尼苏达心衰质量评分方面优于对照组(P＜0.05),特别是重症患者的生活质量提高更为显著(P＜0.05).(3)治疗后2组患者的血、尿、大便常规,以及肝、肾功能和电解质检查,均未出现明显异常变化.[结论]毛冬青颗粒作用安全,具有确切的抗炎作用,能通过其抗炎作用改善慢性心力衰竭患者炎症反应,从而改善慢性心力衰竭患者症状和预后,提高心衰患者的生活质量.%Objective To investigate the anti-inflammation action of Radix Ilicis Pubescentis in chronic heart failure (CHF) patients, and to evaluate its effect on improving the quality of life of CHF patients. Methods Sixty CHF patients were equally randomized into two groups. The control group was given western medical standard regimen, and the treatment group was given Radix Ilicis Pubescentis granules on the basis of western medical standard regimen. After treatment for 4 weeks, safety indexes were evaluated, and the changes of serum C-reactive protein (CRP), tumor necrosis factor-a (TNF-α) and interleukin 6 (IL-6) were observed. Meanwhile, Minnesota score of quality of life ( QOL) of CHF patients was evaluated. Results (1) Serum TNF-a and IL-6 levels were decreased in the treatment group after treatment (P <0.05 compared with those before treatment) , and serum CRP level presented decreasing trend (P > 0. 05 compared with that before treatment). The differences of serum TNF-α, IL-6 and CRP levels were insignificant in the control group before and after treatment (P > 0. 05). After treatment, the improvement of serum TNF-a and IL-6 levels in the treatment group was superior to that in the control group (P <0. 05). (2) The improvement of Minnesota score of QOL in the treatment group was superior to that in the control group (P < 0. 05), in particular for the severe CHF patients ( P < 0. 05). (3 ) No abnormal change was presented in blood, urine and stool routine examination, hepatic and renal function, or electrolyte examination. Conclusion Radix Ilicis Pubescentis granules are effective and safe on relieving the inflammatory reaction in CHF patients, and can improve the prognosis by relieving symptoms and improving QOL.