参附汤辅助治疗改善症状性慢性心力衰竭患者的生活质量和肝功能障碍。
Shenfu decoction as adjuvant therapy for improving quality of life and hepatic dysfunction in patients with symptomatic chronic heart failure.
机构信息
Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China; Guang׳anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China.
出版信息
J Ethnopharmacol. 2015 Jul 1;169:347-55. doi: 10.1016/j.jep.2015.04.016. Epub 2015 May 1.
ETHNOPHARMACOLOGICAL RELEVANCE
Shenfu decoction (SFD) is a water extract of the dried root or root stalk of Panax ginseng C. A. Mey (Asian ginseng) and the lateral root of Aconitum carmichaeli Debx (prepared by Fuzi, Heishunpian in Chinese). It has been used to treat heart failure for over a thousand years. The main active components of SFD, ginsenosides and higenamine, enhance heart contractility, increase the coronary blood supply, improve ischemic myocardial metabolism, scavenge free radicals and protect myocardial ultrastructure.
AIM OF THE STUDY
To investigate the effect of SFD on quality of life (QOL) and hepatic function in symptomatic chronic heart failure (CHF) patients.
MATERIALS AND METHODS
Forty patients enrolled in the study were randomized into two groups: an SFD group (18 cases) and a control group (22 cases). All the patients received standard heart failure therapy, and the SFD group patients were also treated with Shenfu granules for 14 days as an adjunctive therapy. The effects of SFD on QOL, plasma alanine aminotransferase (ALT) level, cardiac function, left ventricular ejection fraction (LVEF) and tumor necrosis factor-α (TNF-α) level were studied. ALT threshold in hepatic injury are 21U/L for men and 17U/L for women.
RESULTS
Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores were improved by 35.27±10.72 vs. 23.87±11.96 in the SFD and control groups respectively (p<0.01). Subgroup analysis of the MLHFQ results demonstrated that both physical and emotional scores were significantly higher in the SFD group (21.00±5.66 vs. 16.75±6.25, p<0.05; 4.64±4.84 vs. 1.13±2.85, p<0.05). Circulating ALT was significantly decreased by SFD (13.3IU/L vs. 0.6IU/L, p<0.01). The grading of cardiac function and LVEF were increased by 1.6±0.5 vs. 1.1±0.3 and 18%±13% vs. 8%±8% in the SFD and control groups respectively (p<0.05 and p<0.05). The level of TNF-α declined more in SFD than control group (64.8±5.0 to 57.6±4.1, p<0.05; vs. 61.6±5.9 vs. 57.7±3.2. p>0.05).
CONCLUSION
Compared with standard heart failure treatment, oral SFD as an adjuvant therapy significantly improved QOL and hepatic injury in CHF patients.
民族药理学相关性
参附汤（SFD）是一种从人参（亚洲人参）的干燥根或根茎和乌头（附子，黑顺片）的侧根提取的水提取物。它已被用于治疗心力衰竭超过一千年。SFD 的主要活性成分，人参皂苷和辛弗林，增强心肌收缩力，增加冠状动脉血流量，改善缺血性心肌代谢，清除自由基并保护心肌超微结构。
研究目的
研究参附汤对有症状的慢性心力衰竭（CHF）患者生活质量（QOL）和肝功能的影响。
材料和方法
将 40 名入组患者随机分为两组：参附汤组（18 例）和对照组（22 例）。所有患者均接受心力衰竭标准治疗，参附汤组患者还接受参附颗粒辅助治疗 14 天。研究参附汤对 QOL、血浆丙氨酸氨基转移酶（ALT）水平、心功能、左心室射血分数（LVEF）和肿瘤坏死因子-α（TNF-α）水平的影响。肝损伤的 ALT 阈值为男性 21U/L，女性 17U/L。
结果
参附汤组的明尼苏达州心力衰竭生活质量问卷（MLHFQ）评分改善 35.27±10.72 分，而对照组改善 23.87±11.96 分（p<0.01）。MLHFQ 结果的亚组分析表明，参附汤组的生理和情绪评分均显著升高（21.00±5.66 分比 16.75±6.25 分，p<0.05；4.64±4.84 分比 1.13±2.85 分，p<0.05）。参附汤可显著降低循环 ALT（13.3IU/L 比 0.6IU/L，p<0.01）。参附汤组的心功能分级和 LVEF 分别提高 1.6±0.5 级和 18%±13%，而对照组分别提高 1.1±0.3 级和 8%±8%（p<0.05 和 p<0.05）。TNF-α 水平在参附汤组下降更明显（64.8±5.0 降至 57.6±4.1，p<0.05；61.6±5.9 降至 57.7±3.2，p>0.05）。
结论
与心力衰竭标准治疗相比，口服参附汤作为辅助治疗可显著改善心力衰竭患者的生活质量和肝损伤。
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