基于“肝心同治”探讨软肝化纤汤治疗冠心病合并抑郁的临床疗效

林志强；赵福成；韩艳茹；任伟华；贾奎

文章摘要

林志强；赵福成；韩艳茹；任伟华；贾奎.基于“肝心同治”探讨软肝化纤汤治疗冠心病合并抑郁的临床疗效[J].中医药信息,2024,41(6):55-59

基于“肝心同治”探讨软肝化纤汤治疗冠心病合并抑郁的临床疗效

Clinical Efficacy of Ruangan Huaxian Decoction in Treating Coronary Heart Disease Complicated with Depression Based on the Principle of "Treating Liver and Heart Simultaneously"

投稿时间：2023-12-01 录用日期：2024-01-08

DOI：10.19656/j.cnki.1002-2406.20240610

中文关键词: 冠心病抑郁软肝化纤汤血清脑源性神经营养因子胃促生长素

英文关键词: Coronary heart disease Depression Ruangan Huaxian Decoction Brain-derived neurotrophic factor Ghrelin

基金项目:河南省中医药青苗人才培养项目（210999904）

作者	单位
林志强；赵福成；韩艳茹；任伟华；贾奎

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中文摘要:

目的：基于“肝心同治”理论探讨软肝化纤汤对冠心病合并抑郁患者的临床疗效。方法：选取符合纳入标准的冠心病合并抑郁患者123例，依据随机数字表随机分为对照组62例和治疗组61例。对照组给予常规西医治疗，治疗组在对照组的基础上口服软肝化纤汤治疗，两组均治疗8周。比较两组患者的临床有效率，治疗前后中医证候评分、汉密顿抑郁量表（HAMD）评分、血脂水平，血浆肾素、醛固酮、超敏C反应蛋白（hs-CRP）及清脑源性神经营养因子（BDNF）和胃促生长素（ghrelin）水平。结果：治疗组的心绞痛和抑郁临床有效率均高于对照组（P <0.05）；两组患者治疗后总胆固醇（TC）、甘油三酯（TG）和低密度脂蛋白（LDL-C）水平均明显降低，其中治疗组TG、LDL-C明显低于对照组（P <0.05）；两组患者治疗后血浆肾素水平升高（P <0.05）,hs-CRP含量显著下降（P <0.05），且治疗组hs-CRP含量低于对照组（P <0.05）；两组患者治疗后血浆BDNF、ghrelin含量均明显增高（P <0.05），且治疗组高于对照组（P <0.05）。结论：软肝化纤汤可显著改善抑郁、心绞痛等临床症状，其机制与抑制炎症因子、对抗肾素-血管紧张素-醛固酮系统（RAAS）过度活化、改善血管内皮损伤及降低交感神经兴奋性有关。

英文摘要:

Objective: Based on the theory of "treating liver and heart simultaneously",this study aimed to explore the clinical efficacy of Ruangan Huaxian Decoction(RHD) in patients with coronary heart disease complicated by depression. Methods: A total of 123 patients with coronary heart disease complicated by depression who met the inclusion criteria were selected and randomly divided into a control group of 62 cases and a treatment group of 61 cases using a random number table. The control group received routine Western medicine treatment, while the treatment group received the same plus oral administration of RHD. Both groups were treated for 8 weeks. The clinical efficacy, TCM syndrome score, Hamilton Depression Scale(HAMD) score, blood lipid levels, plasma renin, aldosterone, high-sensitivity C-reactive protein(hs-CRP), brain-derived neurotrophic factor(BDNF), and ghrelin levels were compared before and after treatment in both groups. Results: The clinical efficacy of angina and depression in the treatment group was higher than that in the control group(P < 0. 05). After treatment, the levels of total cholesterol(TC), triglycerides(TG), and low-density lipoprotein cholesterol(LDL-C) in both groups decreased significantly, with TG and LDL-C levels in the treatment group being significantly lower than those in the control group(P < 0. 05). Plasma renin levels increased(P < 0. 05), and hs-CRP levels decreased significantly(P < 0. 05) after treatment in both groups, with the hs-CRP levels in the treatment group being lower than those in the control group(P < 0. 05). Plasma BDNF and ghrelin levels increased significantly(P < 0. 05) after treatment in both groups, with levels in the treatment group being higher than those in the control group(P < 0. 05). Conclusion: Ruangan Huaxian Decoction can significantly improve clinical symptoms such as depression and angina, and its mechanism may be related to the inhibition of inflammatory factors, counteraction against excessive activation of the renin-angiotensin-aldosterone system(RAAS), improvement of vascular endothelial damage, and reduction of sympathetic nervous system excitability.

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