益气活血汤对慢性充血性心力衰竭患者抗炎细胞因子及心功能的影响

目的观察益气活血汤对气虚血瘀型慢性充血性心力衰竭（CHF）患者血清细胞因子及心功能的影响。方法60例气虚血瘀型CHF患者,随机分为治疗组和对照组各30例,对照组给予常规CHF西药治疗,治疗组在常规西药治疗基础上加服益气活血汤,连续治疗6周。测定2组患者治疗前后血清炎性细胞因子[肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）,抗炎细胞因子：白细胞介素10（IL-10）、转换生长因子β1（TGF-β1）]水平的变化;同时测量2组患者治疗前后心脏收缩功能指标：左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）、左室射血分数（LVEF）、心输出量（CO）;心脏舒张功能指标：二尖瓣舒张早期最大血流速度（E）、舒张晚期最大血流速度（A）,计算E/A比值的变化。结果治疗后2组均可降低炎性细胞因子TNF-α、IL-6水平,升高抗炎性细胞因子IL-10、TGF-β1水平,明显改善心力衰竭患者的LVESD、LVEDD、LVEF、CO及E/A,治疗组改善程度尤为显著（P〈0.05,P〈0.01）。结论益气活血汤可能通过调控细胞因子的水平改善心功能,治疗心力衰竭。

Effect of boosting qi and activating blood decoction on anti-inflammatory cytokine and cardiac function in patients with chronic congestive heart failure

Objective To observe the influence of boosting qi and activating blood decoction on serum cell factors and ventricular function in patients with chronic heart failure（CHF）.Method Sixty CHF patients with qi asthenia causing blood stasis are divided into two groups of treatment and control at random with 30 patients for each group.Patients in the control group were treated with the conventional Western medicine of anti-CHF,while patients in the treatment group took boosting qi and activating blood decoction and the conventional Western medicine of anti-CHF.The therapeutic period is six weeks.Measuring the changes of serum inflammation cell factor TNF-α,IL-6,anti-inflammation cell factor IL-10 and TGF-β1 from the patients of the two groups before and after treatment,and in the meantime measuring these patients＇ LVESD,LVEDD,LVEF,CO.In the aspect of valvula bicuspidalis relaxation of heart relaxation function index,the largest blood stream speed in the early period is E,and A in the late period,and then the changes of specific value E/A are calculated.Results After treatment,serum inflammation cell factor TNF-α,IL-6 decreased,anti-inflammation cell factor IL-10 and TGF-β1 increased,and LVESD,LVEDD,LVEF,CO,and E/A improved obviously in both groups,especially in treatment group（P〈0.05 or P〈0.01）.Conclusion Boosting qi and activating blood decoction could cure congestive heart failure and improve heart function through regulating the levels of cytokines.