【摘要】 目的：探讨芪参姜汤干预对慢性心力衰竭患者血管内皮生长因子（VEGF）、非对称性二甲基精氨酸（ADMA）、可溶性生长刺激表达基因2蛋白（sST2）、N-末端脑钠肽前体（NT-proBNP）、关键生物指标水平的影响，并分析其潜在机制，以期为优化慢性心力衰竭的综合治疗方案提供依据。方法：选取于本院就诊且符合纳入标准的慢性心力衰竭患者92例，随机分为对照组与观察组，每组各46例。两组患者均接受标准化基础治疗，观察组在此基础上联合芪参姜汤治疗，疗程12周。分别于治疗前、治疗12周后检测患者血清NT-proBNP、ADMA、VEGF、sST2、心脏彩超指标、心功能指标，对指标变化幅度进行组间比较，重点评估血管生成能力、内皮功能及炎性重构状态的改善情况。结果：治疗后，两组患者的血清NT-proBNP水平较治疗前均下降（P<0.001），且观察组治疗后的血清NT-proBNP水平低于对照组（t=2.530,P=0.014）；治疗后，观察组患者的血清ADMA水平低于对照组（t=2.319,P=0.024）；两组患者治疗后的血清VEGF水平较治疗前均升高（P<0.001），且观察组治疗后的血清VEGF水平高于对照组（t=2.052,P=0.044）；两组患者治疗后的血清sST2水平较治疗前均降低（P<0.001），且观察组治疗后的血清sST2水平低于对照组（t=2.270,P=0.026）；治疗后，观察组患者的左室射血分数（LVEF）、左心室收缩末期内径（LVESD）及左室短轴缩短率（FS）均较治疗前改善（P<0.05）。结论：芪参姜汤可通过多靶点协同调节VEGF血管新生通路、ADMA内皮功能轴及sST2炎症信号网络，改善慢性心力衰竭患者的血管生成障碍。更多还原

【Abstract】 Objective: To investigate the effects of qishenjiang decoction on vascular endothelial growth factor(VEGF), asymmetric dimethylarginine(ADMA), soluble suppression of tumorigenicity 2(s ST2), and N-terminal pro-B-type natriuretic peptide(NT-pro BNP), and key biomarkers in patients with chronic heart failure, and to explore the potential mechanisms,thereby providing evidence for optimizing comprehensive treatment strategies for chronic heart failure.Methods: A total of 92 patients with chronic heart failure who visited our hospital and met the inclusion criteria were enrolled and randomly assigned to the control group and the observation group,with 46 patients in each group. Both groups received standardized conventional therapy. In addition,the observation group was treated with qishenjiang decoction for 12 weeks. Serum NT-proBNP, ADMA, VEGF, and sST2 levels, as well as echocardiographic parameters and cardiac function indicators of the patients were measured before treatment and after 12 weeks of treatment. Changes in these indicators were compared between the two groups, with emphasis on improvements in angiogenic capacity,endothelial function, and inflammatory remodeling status.Results: After treatment, the serum NT-proBNP levels of patients decreased in both groups compared with baseline(P<0. 001), and the post-treatment NT-proBNP level in the observation group was lower than that in the control group(t=2. 530, P=0. 014). After treatment, serum ADMA levels of patients in the observation group were lower than those in the control group(t=2. 319, P=0. 024). Serum VEGF levels of patients increased in both groups after treatment compared with baseline(P<0. 001), and the posttreatment VEGF level in the observation group was higher than that in the control group(t=2. 052, P=0. 044). Serum sST2 levels of patients decreased in both groups after treatment compared with baseline(P<0. 001), and the post-treatment sST2 level in the observation group was lower than that in the control group(t=2. 270, P=0. 026). After treatment, patients in the observation group showed significant improvements in left ventricular ejection fraction(LVEF), left ventricular end-systolic diameter(LVESD), and fractional shortening(FS) compared with baseline(P<0. 05).Conclusion: Qishenjiang decoction may improve angiogenesis impairment in patients with chronic heart failure through multi-target synergistic regulation of the VEGF-mediated angiogenic pathway, the ADMA-related endothelial function axis, and the sST2-associated inflammatory signaling network.更多还原