参附注射液治疗冠心病心力衰竭的临床研究

目的观察参附注射液对冠心病心力衰竭（心肾阳虚证）患者的临床治疗效果，探讨参附注射液治疗心力衰竭的作用机制。方法62例冠心痛心力衰竭（心肾阳虚证）患者随机分为对照组和参附组。对照组给予常规抗心力衰竭治疗。参附组在对照组治疗基础上加用参附注射液静脉输注。治疗前后进行心功能评价，并测定血浆脑钠（BNP）、凋亡因子Fas、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF—α）的水平。结果与治疗前相比，两组患者经治疗心功能均有改善，BNP、Fas、IL-6和TNF—α等细胞因子的血浆水平均有下降。与对照组相比，参附组的NYHA心功能分级、Lee心力衰竭积分及中医证候评分的改善更明显（P〈0．05）。而且BNP、Fas和TNF—α血浆水平的下降更显著（P〈0．05）。结论参附注射液可改善心肾阳虚证冠心痛心力衰竭患者的临床症状，改善左心收缩功能，其治疗作用可能与抑制Fas和TNF—α的表达有关。

Clinical Study of Shenfu Injection for Heart Failure of Coronary Heart Disease

Objective To observe the clinical effects of Shenfu injection for heart failure（HF） patients（pts） with Yang-deficiency syndrome of heart and kidney, and to investigate its mechanism. Methods Sixty - two pts with HF of coronary heart disease （CHD） and with Yang- deficiency syndrome of heart and kidney were randomly divided into two groups：Control group treated with regular treatment and Shenfu injection group treated with Shenfu injection and regular treatment. The heart function, plasma level of B- type natriuretic peptide （BNP）, Fas, interleukin- 6（IL -6） and tumor necrosis factor alpha（TNF- α） were observed and compared before and after treatment. Results The heart functions in two groups were improved and level of all the cytokines including BNP, Fas,IL- 6 and TNF-α were decreased after the treatment. Compared with the control group,the heart function rating, Lee＇s heart failure score and TCM syndrome score in Shenfu injection group were improved（P〈0.05） ,and the level of BNP, Fas and TNF - were decreased significantly（P〈0.05）. Conclusion Shenfu injection could improve the heart function of HF pts with Yang - deficiency syndrome of heart and kidney,which might be due to the depression of the level of Fas and TNF - α.