【摘要】 目的 观察扶阳活血汤对慢性心力衰竭（chronic heart failure,CHF）患者氧化应激及心室功能重构的影响。方法 选择2022年1月—2023年12月安徽中医药大学附属太和中医院收治的CHF患者100例，采用计算机生成随机序列进行简单随机分组，分为对照组与观察组，每组50例。对照组予常规西药治疗，观察组予以西药联合扶阳活血汤治疗。两组均治疗8周。观察并比较两组患者治疗后临床疗效、治疗前后心室重构功能[心房收缩期A峰与左心室舒张早期E峰最大流速比值（early diastolic peak velocity/atrial systolic peak velocity,VE/VA）、收缩末期内径（left ventricular end-systolic dimension,LVDs）、舒张末期内径（left ventricular end-diastolic dimension,LVDd）、左心室舒张末期容积（left ventricular end-diastolic volume,LVEDV）、收缩末期容积（left ventricular end-systolic volume,LVESV）、左心室射血分数（left ventricular ejection fraction,LVEF）]、中医证候积分、运动耐受能力[6分钟步行试验（6-minute walk test,6MWT）]、氧化应激指标[血清前列腺素（prostaglandin,PG）、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、超氧化物歧化酶（superoxide dismutase,SOD）、过氧化氢酶（catalase,CAT）]水平。结果 治疗后，观察组临床疗效总有效率96.00%(48/50)高于对照组72.00%(36/50)，差异有统计学意义（P<0.05）。治疗后，两组患者VE/VA比值和LVEF与治疗前比较均有所升高，LVDs、LVDd、LVEDV、LVESV水平均有所降低，差异有统计学意义（P<0.05）；且观察组VE/VA比值和LVEF较对照组明显升高，LVDs、LVDd、LVEDV、LVESV较对照组明显降低，差异有统计学意义（P<0.05）。治疗后两组患者中医证候积分均较治疗前降低、6MWT距离增加，差异有统计学意义（P<0.05）；且治疗后观察组中医证候积分较对照组明显降低、6MWT距离较对照组明显增加，差异有统计学意义（P<0.05）。治疗后两组患者血清PG、MMP-9水平均较治疗前降低，SOD、CAT水平均较治疗前升高，差异有统计学意义（P<0.05）；且治疗后观察组血清PG、MMP-9水平较对照组明显降低，SOD、CAT水平则较对照组明显升高，差异有统计学意义（P<0.05）。两组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论 扶阳活血汤能够提升CHF患者临床治疗效果，抑制心室重构及氧化应激状态，降低中医证候积分，提升运动耐力和心功能。更多还原

【Abstract】 Objective To investigate the effects of Fuyang Huoxue Decoction on oxidative stress and ventricular functional remodeling in patients with chronic heart failure(CHF). Methods A total of 100 patients with CHF admitted to Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese Medicine from January 2022 to December 2023 were enrolled and divided into a control group and an observation group by computer-generated random sequence,with 50 cases in each group. The control group was treated with conventional western medicine,while the observation group received conventional western medicine combined with Fuyang Huoxue Decoction. The treatment course lasted for 8 weeks in both groups. The two groups were observed and compared in terms of clinical efficacy,pre-and post-treatment ventricular functional remodeling indicators [early diastolic peak velocity/atrial systolic peak velocity(VE/VA),left ventricular end-systolic dimension(LVDs),left ventricular end-diastolic dimension(LVDd),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF)],traditional Chinese Medicine(TCM) syndrome scores,exercise tolerance [6-minute walk test(6 MWT)],and oxidative stress indicators [serum prostaglandin(PG),matrix metalloproteinase-9(MMP-9),superoxide dismutase(SOD),and catalase(CAT)]. Results After treatment,the total clinical effective rate of the observation group was 96. 00%(48/50),which was significantly higher than 72. 00%(36/50) of the control group(P<0. 05). After treatment,the VE/VA ratio and LVEF were elevated,while LVDs,LVDd,LVEDV,and LVESV were reduced in both groups(P<0. 05). In addition,the observation group showed higher VE/VA and LVEF and lower LVDs,LVDd,LVEDV,and LVESV than the control group. TCM syndrome scores decreased,and 6 MWT distance increased in both groups after treatment(P<0. 05),and the observation group had lower TCM syndrome scores and longer 6 MWT distance than the control group(P<0. 05). After treatment,serum PG and MMP-9 levels were significantly reduced,whereas SOD and CAT levels were markedly elevated in both groups(P<0. 05),and the observation group showed lower PG and MMP-9 levels and higher SOD and CAT levels than the control group(P<0. 05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0. 05). Conclusion Fuyang Huoxue Decoction can improve clinical curative effect,inhibit ventricular remodeling and oxidative stress,reduce TCM syndrome scores,and enhance exercise tolerance and cardiac function in CHF patients.更多还原