Objective:To reveal the underlying relationships between Chinese medicine(CM)syndromes and ultrafiltration(UF)in the treatment of heart failure based on a metabonomic approach.Methods:Seventeen acute decompensated heart failure(ADHF)patients were enrolled,and their CM syndromes before and after UF were collected.In addition,their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis.Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples.Partial least-squares to latent structure-discriminant analyses were used for data analysis.Results:An obvious difference was observed preand post-treatment.A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine,1-methylhistidine,phytosphingosine,O-decanoyl-R-carnitine,etc.were screened out,showing a significant change after UF.The major adjusted m etabolic pathways were purine metabolism,histidine metabolism,leucine and isoleucine metabolism,arginine and proline metabolism,carnitine shuttle,sphingolipid metabolism and phospholipid metabolism.Conclusions:Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.
目的:评估八段锦干预心力衰竭的疗效及安全性。方法:搜索中国知网数据库、中国生物医学文献数据库、万方数据库以及维普中文全文数据库;PubMed、Cochrane Library、web of science、EMBASE。检索时间为建库至2019年2月28日。对纳入的随机对照试验(RCT)用Cochrane手册进行偏倚风险评估,用Rev Man 5.3软件进行Meta分析。结果:纳入6篇文献,7个随机对照研究,共计543例心力衰竭患者。与对照组比较,观察组MLHFQ减少[MD=10.88,95%CI=(8.22,13.54)],6分钟步行试验(6MWT)提高[MD=107.81,95%CI=(75.83,139.78)],左心室射血分数(LVEF)提高[MD=3.62,95%CI=(2.04,5.19)],B型利钠肽(BNP)降低[MD=73.32,95%CI=(45.12,101.53)],临床疗效[OR=4.00,95%CI=(1.35,11.83)],中医证候评分[OR=4.57,95%CI=(2.03,10.31)]。结论:八段锦可改善心力衰竭患者的心功能,用于稳定期的康复治疗。
目的系统评价中医药干预利尿剂抵抗的心力衰竭(心衰)病人的疗效和安全性。方法计算机检索Pubmed、中国生物医学文献数据库(Web版)、中文生物医学期刊数据库(Web版)CMCC、VIP中文科技期刊数据库(Web版)、CNKI中国期刊全文数据库(Web版)、万方数据库,检索策略:中医药(Traditional Chinese Medical Science,TCM)、利尿剂抵抗(diuretic resistant)、中西医结合(Combine Traditional Chinese and Western Medicine)、顽固性心衰(Intractable heart failure)。结果共纳入5篇随机对照或半随机对照试验总共356例,其中治疗组179例,对照组177例,对纳入的临床疗效有效率合并效应量的检验,PP分析结果:RR(random)=1.38,95%CI(1.23,1.55),差异有统计学意义(P<0.000 01);ITT分析结果:RR(fixed)=1.42,95%CI(1.26,1.61),差异有统计学意义(P<0.000 01)。结论中医药干预能够改善利尿剂抵抗心衰病人的心功能,其疗效优于常规治疗,并且安全性好,但临床研究较少及文献报道质量较低。
