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益气温阳和活血利水法对充血性心力衰竭患者神经内分泌系统的影响
引用本文:安海英,黄丽娟,金敬善,金玫,刘红旭.益气温阳和活血利水法对充血性心力衰竭患者神经内分泌系统的影响[J].中国中西医结合杂志,2002,22(5):349-352.
作者姓名:安海英  黄丽娟  金敬善  金玫  刘红旭
作者单位:北京中医医院,北京,100010
摘    要:目的:研究益气温阳、活血利水法对充血性心力衰竭患者神经内分泌系统的影响。方法:将心功能Ⅲ-Ⅳ级,辨证属气(阳)虚血瘀、水饮证患者49例随机分为治疗组(29例)和对照组(20例),治疗组采用益气温阳、活血利水法治疗,对照组服用开搏通。结果:两组治疗后血浆血管紧张素Ⅱ(ATⅡ)、心房肽(ANP)、内皮素(ET)、一氧化氮(NO)水平降低,组间比较差异无显著性(P>0.05);血小板α颗粒膜蛋白140(GMP-140)水平降低,效果优于对照组(P<0.05)。结论:益气温阳、活血利水法对心衰患者神经内分泌的调节作用与血管紧张素转换酶抑制剂部分相似,有可能改善心衰患者的心室重构;通过抑制血小板的活性,可能对防止血栓的形成及改善心衰的进程有利。

关 键 词:益气温阳  活血利水法  充血性心力衰竭  神经内分泌系统  治疗  中西医结合治疗
修稿时间:2001年11月20

Preliminary Exploration on Effect of Yiqi Wenyang Huoxue Lishui Treatment on Neuroendocrine System in Patients with Congestive Heart Failure
Authors:AN Hai ying  HUANG Li juan  JIN Jing shan
Abstract:OBJECTIVE: To study the effect of Yiqi Wenyang Huoxue Lishui principle (YWHL, a therapeutic principle with Chinese medicine for reinforcing Qi warming Yang, activating blood circulation and promoting urination) on some neuroendocrine factors in patients with congestive heart failure (CHF). METHODS: Forty-nine patients of CHF with heart function of grade III-IV were randomly divided into 2 groups. The 29 cases in the treated group were treated with YWHL and the 20 cases in the control group treated with captopril. Changes of angiotensin II (AT II), atrial natriuretic peptide (ANP), endothelin (ET), nitric oxide (NO) and alpha-granule membrance protein -140 (GMP-140) were observed. RESULTS: After treatment, plasma level of AT II, ANP, ET, and NO lowered in both groups with insignificant difference, but the GMP-140 reduced more significantly in the treated group (P < 0.05). CONCLUSION: YWHL showed a regulatory effect of neuroendicrine system partially similar to that of angiotensin-converting enzyme inhibitor, it possibly can improve the ventricular remodeling and would be beneficial to prevent the thrombus formation and improve heart failure by means of inhibiting platelet activity.
Keywords:reinforcing Qi and warming Yang  activating blood circulation and promoting urination  heart failure  neuroendocrine factor
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