祛痰通阳汤对慢性心力衰竭（气虚血瘀型）患者炎性因子和T淋巴细胞亚群的影响

目的] 探讨祛痰通阳汤对慢性心力衰竭（CHF，气虚血瘀型）患者临床疗效及对血清炎性因子和T淋巴细胞亚群的影响，为临床治疗提供理论依据。方法] 选取2015年1月—2018年6月本院心内科就诊的118例气虚血瘀型CHF患者作为研究对象，按照随机数字表法分为对照组和观察组，对照组给予常规抗心力衰竭西药治疗，观察组在对照组的基础上给予祛痰通阳汤，治疗4周。观察两组临床效果、治疗前后心功能指标、血清炎症因子和T淋巴细胞亚群水平变化情况。结果] 观察组临床有效率为88.14%，高于对照组72.88%（P<0.05）。治疗后，观察组患者左心室舒张末期内径（LVED）、左心室收缩末期内径（LVSD）水平较治疗前降低，且低于对照组（P<0.05）；而左心室射血分数（LVEF）水平较治疗前升高，且高于对照组（P<0.05）。观察组患者血清肿瘤坏死因子-α（TNF-α）、白介素（IL）-6、C反应蛋白（CRP）和N末端B型利钠肽原（NT-proBNP）及CD8⁺水平较治疗前降低，且低于对照组（P<0.05），而CD3⁺、CD4⁺和CD4⁺/CD8⁺水平较治疗前升高，且高于对照组（P<0.05）。结论] 祛痰通阳汤治疗CHF（气虚血瘀型）患者疗效显著，有助于改善心功能，可能与抑制患者炎症反应，增强免疫功能有关。

Effect of Qutan Tongyang Decoction on inflammatory factors and T lymphocyte subsets in patients with chronic heart failure of qi deficiency and blood stasis type

Objective] To explore the clinical effect of Qutan Tongyang Decoction on chronic heart failure(CHF) patients with qi deficiency and blood stasis and its influence on serum inflammatory factors and T lymphocyte subsets,so as to provide theoretical basis for clinical treatment.Methods] From January 2015 to June 2018,the 118 patients with chronic heart failure of qi deficiency and blood stasis type were divided into control group and observation group according to random number table. The control group was treated with routine western medicine for heart failure,and the observation group were treated with Qutan Tongyang Decoction for 4 weeks on the basis of the control group. The clinical effects,cardiac function indexes,serum inflammatory factors and T lymphocyte subsets were observed before and after treatment.Results] The clinical effective rate of the observation group(88.14%) was better than that (72.88%) in the control group(P<0.05). After treatment,the left ventricular end diastole (LVED),left ventricular end of systolic diameter (LVSD) levels in the observation group were lower than those in the control group(P<0.05),while the left ventricular ejection fraction (LVEF) levels were higher than those in the control group (P<0.05). The levels of serum tumor necrosis factor (TNF)-alpha,interleukin(IL)-6,C-reactive protein(CRP),N-terminal pro-brain-type natriuretic peptide (NT-proBNP) and CD8⁺ in the observation group were lower than those in the control group(P<0.05),while the levels of CD3⁺,CD4⁺ and CD4⁺/CD8⁺ levels were higher than those in the control group (P<0.05).Conclusion] Qutan Tongyang Decoction could enhance the clinical efficacy and improve cardiac function,which could may be related to inhibiting inflammation and enhancing immune function of CHF patients with qi deficiency and blood stasis.