Department of Cardiology, Shaoxing Traditional Chinese Medicine Hospital, The Affiliated Shaoxing Hospital of Zhejiang Chinese Medical University, Shaoxing 312000, China.
Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing 312000, China.
J Tradit Chin Med. 2019 Jun;39(3):418-424.
To examine the clinical efficacy of Jiawei Shenfu decoction on tumor necrosis factor-al- pha (TNF-α) and nuclear factor-kappa B (NF-κB) levels in patients who have chronic heart failure with syndromes of deficiency of heart Yang.
A total of 63 patients with syndromes of deficiency of heart Yang (chronic heart failure) were enrolled. Patients were randomly divided into the control group and Jiawei Shenfu group. All patients received standard medications for treatment of chronic heart failure. Patients in the Jiawei Shenfu group were additionally provided Jiawei Shenfu decoction one dose daily. Treatments continued for 4 consecutive weeks. The primary endpoint was the change in plasma B-type natriuretic peptide (BNP), NF-κB, and TNF-α levels during 4 weeks of treatment.
At the 4-week follow-up, a significant reduction in BNP levels compared with baseline was observed in both groups, but the Jiawei Shenfu decoction group showed a significantly greater reduction than did the control group. The Jiawei Shenfu group also showed superior performance regarding the Minnesota Living with Heart Failure Questionnaire score, the Chinese medicine syndrome score, heart rate, left ventricular ejection fraction, and 6-min walking distance compared with the control group. The degree of changes in NF-κB and TNF-α levels in the Jiawei Shenfu group was more significant than that in the control group.
Routine medicine combined with Jiawei Shenfu decoction for patients with heart Yang deficiency syndrome in chronic heart failure can improve the left ventricular ejection fraction and cardiac function, and reduce BNP levels. The mechanism may be related to inhibition of pro-inflamma- tory cytokines and the NF-κB-induced kinase pathway, leading to amelioration of the inflammatory response.
观察加味参附汤对心阳亏虚型慢性心力衰竭患者肿瘤坏死因子-α（TNF-α）和核因子-κB（NF-κB）水平的临床疗效。
共纳入 63 例心阳亏虚证（慢性心力衰竭）患者。将患者随机分为对照组和加味参附汤组。所有患者均接受慢性心力衰竭的标准药物治疗。加味参附汤组患者加服加味参附汤，每日 1 剂。连续治疗 4 周。主要终点是治疗 4 周时血浆 B 型利钠肽（BNP）、NF-κB 和 TNF-α水平的变化。
在 4 周随访时，两组的 BNP 水平与基线相比均显著降低，但加味参附汤组的降低幅度明显大于对照组。加味参附汤组在明尼苏达州心力衰竭生活质量问卷评分、中医证候评分、心率、左心室射血分数和 6 分钟步行距离方面也优于对照组。加味参附汤组 NF-κB 和 TNF-α 水平的变化程度明显大于对照组。
常规药物联合加味参附汤治疗慢性心力衰竭心阳亏虚证患者可提高左心室射血分数和心功能，降低 BNP 水平。其机制可能与抑制促炎细胞因子和 NF-κB 诱导的激酶通路有关，从而改善炎症反应。
