厄贝沙坦氢氯噻嗪联合金匮肾气丸治疗高血压慢性心力衰竭患者的临床效果及对NLRP3/NF-κB通路的影响

doi:10.3969/j.issn.1671-7171.2023.08.030

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摘要【目的】探讨厄贝沙坦氢氯噻嗪联合金匮肾气丸治疗高血压慢性心力衰竭(CHF)患者的临床效果及对核苷酸结合寡聚化结构域样受体家族3(NLRP3)/核因子-κB(NF-κB)通路的影响。【方法】选择2019年5月至2022年5月本院收治的106例高血压CHF患者,根据随机数字表法将其分为观察组(厄贝沙坦氢氯噻嗪联合金匮肾气丸治疗)和对照组(厄贝沙坦氢氯噻嗪治疗),每组53例。比较两组疗效、中医证候积分、血压水平、心功能[B型脑钠肽(BNP)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)]、NLRP3/NF-κB通路指标[NLRP3、NF-κB、白介素-1β(IL-1β)、白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)]及安全性。【结果】观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后胸闷心悸、难以平卧、下肢水肿、心悸目眩、头晕耳鸣、少气懒言、倦怠乏力中医证候积分低于对照组(P<0.05);观察组治疗后收缩压、舒张压低于对照组(P<0.05);观察组治疗后BNP、LVEDD、LVESD低于对照组,LVEF高于对照组(P<0.05);观察组治疗后NLRP3、NF-κB、IL-1β、IL-18、TNF-α低于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。【结论】厄贝沙坦氢氯噻嗪联合金匮肾气丸治疗高血压CHF,能有效改善患者临床症状和体征,降低血压水平,提高心功能,抑制NLRP3/NF-κB通路激活,安全可靠。

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	王文静

关键词 ：高血压/并发症, 心力衰竭/并发症, 氢氯噻嗪/药理学, 厄贝沙坦/药理学, NLR家族,热蛋白结构域包含蛋白3/药物作用

Abstract：【Objective】To investigate the clinical efficacy of irbesartan hydrochlorothiazide combined with the Jingui Shenqi Pill in the treatment of hypertensive chronic heart failure (CHF) and its impact on the nucleotide binding oligomerization domain-like receptor protein 3 (NLRP3)/nuclear factor B (NF-κB) pathway. 【Methods】A total of 106 hypertensive CHF patients admitted to our hospital from May 2019 to May 2022 were randomly divided into an observation group (treated with irbesartan hydrochlorothiazide combined with the Jingui Shenqi Pill) and a control group (treated with irbesartan hydrochlorothiazide) using a random number table method,with 53 patients in each group. We compared the efficacy,traditional Chinese medicine syndrome scores,blood pressure levels,cardiac function [B-type brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD)],NLRP3/NF-κB pathway [NLRP3,NF-κB,interleukin-1 (IL-1β),interleukin-18 (IL-18),tumor necrosis factor-α(TNF-α)],and safety between two groups. 【Results】The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant (P<0.05); After treatment,the observation group had lower scores of traditional Chinese medicine syndromes such as chest tightness,palpitations,difficulty lying flat,lower limb edema,palpitations,dizziness,tinnitus,lack of qi and lazy speech,fatigue and fatigue compared to the control group (P<0.05); After treatment,the systolic and diastolic blood pressure in the observation group were lower than those in the control group (P<0.05); After treatment,BNP,LVEDD,and LVESD in the observation group were lower than those in the Western medicine group,while LVEF was higher than that in the control group (P<0.05); After treatment,the NLRP3,NF-κB,IL-1β,IL-18,and TNF-α levels in the observation group were lower than those in the control group (P<0.05); There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group (P>0.05). 【Conclusions】The combination of Irbesartan Hydrochlorothiazide and the Jinkui Shenqi Pill in the treatment of hypertensive CHF can effectively improve clinical symptoms and signs,lower blood pressure levels,improve cardiac function,inhibit NLRP3/NF-κB pathway activation,and is safe and reliable.

Key words： Hypertension/CO Heart Failure/CO Hydrochlorothiazide/PD Irbesartan/PD NLR Family,Pyrin Domain-Containing 3 Protein/DE

收稿日期: 2023-02-01

中图分类号:

R541.3

引用本文:

王文静. 厄贝沙坦氢氯噻嗪联合金匮肾气丸治疗高血压慢性心力衰竭患者的临床效果及对NLRP3/NF-κB通路的影响[J]. 医学临床研究, 2023, 40(8): 1225-1228.
WANG Wen-jing. Effect of Irbesartan Hydrochlorothiazide Combined with Jinkui Shenqi Pill on Hypertensive CHF and its Influence on NLRP3/NF-κB Pathway. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1225-1228.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.08.030 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I8/1225

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