天麻钩藤饮对高血压心肌纤维化患者血清炎症指标的影响

目的 探讨天麻钩藤饮对高血压心肌纤维化患者血清中炎症指标IL-6、IL-1 β、TNF-α、hs-CRP表达的影响.方法 纳入2013年8月至2015年2月我中心确诊为原发性高血压患者112例,按照左室质量指数(left ventricular mass index,LVMI)值将上述患者分为非左室肥厚(non left ventricular hypertrophy,NLVH)组40例和左室肥厚(left ventricular hypertrophy,LVH)组72例,将LVH组患者72例随机分为开博通组35例和天麻钩藤饮37例,均给药4周.观察治疗前后各组患者血压和LVMI变化,及各组患者外周血清中炎症指标IL-6、IL-1 β、TNF-α、hs-CRP的表达.结果 治疗后三组患者收缩压、舒张压和LVMI较治疗前明显下降(P＜0.01).治疗前LVH组患者血清IL-6、IL-1 β、TNF-α、hs-CRP表达水平较NLVH组显著升高(P＜0.05);治疗4周后,LVH组中两组患者血清IL-6、IL-1 β、TNF-α、hs-CRP表达水平均较治疗前显著降低(P＜0.05),治疗后两组血清TNF-α、IL-6、IL-1 β、hs-CRP表达水平比较无统计学差异(P＞0.05).结论 天麻钩藤饮可通过抑制TNF-α、IL-6、IL-1 β、hs-CRP水平进而阻止高血压心肌纤维化的发生发展.

The effect of Tianma Gouteng decoction on the expression of serum cytokines in patients with hypertension myocardial fibrosis

Objective To study the effect of Tianma Gouteng decoction on the expression of serum cytokines of patients with hypertension myocardial fibrosis.Methods 112 patients with essential hypertension admitted in our center between Aug.2013 and Feb.2015 were divided into non left ventricular hypertrophy (NLVH) group (n=40) and left ventricular hypertrophy (LVH) group (n=72) according left ventricular mass index (LVMI).72 patients in LVH group were randomly divided into captopril group (n=35) and Tianma Gouteng decoction group (n=37).The expression of tumor necrosis factor (TNF)-α,interleukin (IL)-6,IL-1 β and hs-CRP in serum were measured before and after treatment,the change of blood pressure and LVMI were observed before and after treatment.Results SBP,DBP,and LVMI significantly decreased after treatment in all three groups (P＜0.01).Before treatment,the expression of TNF-α,IL-6,IL-1β,and hs-CRP in LVH group were higher than those in NLVH group (P＜0.05); after 4 weeks' treatment,serum TNF-α,IL-6,IL-1β,and hs-CRP significantly decreased in both captopril group and Tianma Gouteng decoction group,while there were no statistically significant differences between two groups (P＞0.05).Conclusion Tianma Gouteng decoction can suppresses the development of hypertension myocardial fibrosis by down-regulating the levels of serum TNF-α,IL-6,IL-1 β and hs-CRP.