益心汤治疗慢性心力衰竭疗效观察及对肾素-血管紧张素-醛固酮系统的影响

目的：观察益心汤治疗慢性心力衰竭（CHF）的临床疗效及对肾素-血管紧张素-醛固酮系统（RAAS）的影响。方法：将纳入的116例CHF患者按随机数字表法分为观察组和对照组各58例。对照组给予常规西药治疗，观察组在对照组基础上加用益心汤治疗。于治疗8周后评定临床疗效，并比较2组治疗前后心功能指标[左室射血分数（LVEF）、每搏输出量（SV）、心输出量（CO）]、心率变异性（HRV）指标[4 h内正常R-R间期标准差（SDNN）、24 h相邻正常的R-R间期差值均方的平方根（RMSSD）及相邻NN间期之差>50 ms的个数占总窦性心搏个数的百分比（PNN50）]、RAAS指标[血管紧张素-Ⅱ（Ang-Ⅱ）、醛固酮（ALD）、肾素活性（PRA）]水平。结果：治疗后，观察组总有效率为93.10%，对照组为77.59%,2组比较，差异有统计学意义（P<0.05）。治疗后，2组LVEF、SV、CO水平均较治疗前升高（P<0.05），且观察组3项指标均高于对照组（P<0.05）。治疗后，2组SDNN、RMSSD、PNN50水平均较治疗前升高（P<0.05），且观察组上述3...

Observation on Curative Effect of Yixin Decoction on Chronic Heart Failure and ItsEffect on Renin-Angiotensin-Aldosterone System

Abstract：Objective：To observe the clinical effect of Yixin Decoction on chronic heart failure (CHF) andits effect on renin- angiotensin- aldosterone system (RAAS). Methods： A total of 116 CHF patients wereincluded and divided into the observation group and the control group according to the random number tablemethod， with 58 cases in each group. The control group was given routine western medicine fortreatment，and the observation group was additionally treated with Yixin Decoction based on the treatmentof the control group. After 8 weeks of treatment，the clinical effects were evaluated；the levels of indexesof heart function，including left ventricular ejection fraction (LVEF)，stroke volume (SV) and cardiac output(CO)， indexes of heart rate variability (HRV)， including standard deviation of NN intervals (SDNN) within4 hours， root mean square of successive differences (RMSSD) between adjacent R- R intervals within24 hours and proportion of number of times adjacent NN intervals differing by more than 50 ms (PNN50) oftotal sinus beats，and RAAS indexes，including angiotensin-Ⅱ(Ang-Ⅱ)，aldosterone (ALD) and plasmarenin activity (PRA) before and after treatment were compared between the two groups. Results： Aftertreatment，the total effective rate was 93.10% in the observation group and 77.59% in the control group，the difference being significant (P＜0.05). After treatment，the levels of LVEF，SV and CO in both groupswere increased when compared with those before treatment (P＜0.05)，and the above three levels in theobservation group were higher than those in the control group (P＜0.05). After treatment， the levels ofSDNN，RMSSD and PNN50 in both groups were increased when compared with those before treatment(P＜0.05)，and the above threelevels in the observation group were higher than those in the control group(P＜0.05). After treatment， the levels of Ang- II， ALD and PRA in both groups were decreased whencompared with those before treatment (P＜0.05)， and the above 3 levels in the observation group werelower than those in the control group (P＜0.05). Conclusion：The therapy of Yixin Decoction combined withroutine western medicine has a significant curative effect on CHF， which can effectively decrease theRAAS activity of patients，improve the HRV and enhance the heart function.