CAJ | 학술논문

目的：探讨补肾通脉汤对慢性心力衰竭患者血浆肾素活性（PRA）、脑钠肽（BNP）和血管紧张素Ⅱ（AngⅡ）的影响。方法选取2011年1月至2013年12月山东省日照市中医医院心血管病科慢性心力衰竭患者100例，采用随机数字表法将患者分为两组，每组50例，对照组给予西医常规疗法，治疗组在对照组基础上加用补肾通脉汤治疗，均治疗8周。实验室检测治疗前后PRA、BNP、和AngⅡ，超声心动图评价治疗前后心功能。结果治疗组PRA、BNP、AngⅡ均较治疗前显著降低（t值分别为2.990、4.030、4.401，P均＜0.05）。治疗组治疗后PRA、BNP、AngⅡ显著低于对照组（t值分别为2.622、2.863、3.809，P均＜0.05）。两组超声心动图检测的左心室收缩末期直径（LVESD）、左心室舒张末期直径（LVEDD）和左心室射血分数（LVEF）均显著改善（治疗组t值分别为9.167、11.030、13.273，P均＜0.01；对照组分别为5.189、7.626、6.906，P均＜0.01）；治疗组LVESD、LVEDD、LVEF改善显著优于对照组，差异均有统计学意义（t＝4.037、2.701、7.458，P均＜0.01）。结论补肾通脉汤可有效降低慢性心衰患者PRA以及血浆BNP、AngⅡ水平，改善心功能。
목적：탐토보신통맥탕대만성심력쇠갈환자혈장신소활성（PRA）、뇌납태（BNP）화혈관긴장소Ⅱ（AngⅡ）적영향。방법선취2011년1월지2013년12월산동성일조시중의의원심혈관병과만성심력쇠갈환자100례，채용수궤수자표법장환자분위량조，매조50례，대조조급여서의상규요법，치료조재대조조기출상가용보신통맥탕치료，균치료8주。실험실검측치료전후PRA、BNP、화AngⅡ，초성심동도평개치료전후심공능。결과치료조PRA、BNP、AngⅡ균교치료전현저강저（t치분별위2.990、4.030、4.401，P균＜0.05）。치료조치료후PRA、BNP、AngⅡ현저저우대조조（t치분별위2.622、2.863、3.809，P균＜0.05）。량조초성심동도검측적좌심실수축말기직경（LVESD）、좌심실서장말기직경（LVEDD）화좌심실사혈분수（LVEF）균현저개선（치료조t치분별위9.167、11.030、13.273，P균＜0.01；대조조분별위5.189、7.626、6.906，P균＜0.01）；치료조LVESD、LVEDD、LVEF개선현저우우대조조，차이균유통계학의의（t＝4.037、2.701、7.458，P균＜0.01）。결론보신통맥탕가유효강저만성심쇠환자PRA이급혈장BNP、AngⅡ수평，개선심공능。
Objective To investigate the effect of Bushen-Tongmai decoction on plasma renin activity (PRA), plasma levels of brain natriuretic peptide (BNP) and angiotensinⅡ(AngⅡ) in patients with chronic heart failure. Methods A total of 100 patients with chronic heart failure from January 2011 to December 2013 were randomly divided into a control group and a treatment group, with 50 patients in each group. The patients in the control and treatment groups received conventional treatment and Bushen-Tongmai decoction plus conventional treatment for 8 weeks, respectively. Laboratory measurements including PRA, BNP and AngⅡwere performed before and after treatment.Cardiac function was measured before and after treatment with echocardiography. Results The PRA , plasma levels of BNP and AngⅡ after treatment in the treatment group were significantly decreased than before treatment (treatment group:t=2.990, 4.030, 4.401, all P<0.01);after treatment, there was significant difference in PRA, BNP and AngⅡbetween the treatment group and the control group(t=2.622, 2.863, 3.809, all P<0.05). Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) by echocardiography in both groups were significantly improved (treatment group:t=9.167, 11.030, 13.273, all P<0.01;control group:t=5.189, 7.626, 6.906, all P<0.01). Improvements of LVESD, LVEDD and LVEF in the treatment group were grater than those in the control group (t=4.037, 2.701, 7.458, all P<0.01). Conclusion Bushen-Tongmai decoction can effectively decrease PRA , plasma levels of BNP, AngⅡ, and improve cardiac function in patients with chronic heart failure.