中文摘要：

目的观察参竹心康汤对慢性心衰患者心功能与胰岛素抵抗和血管内皮依赖性舒张功能的影响。方法将91例慢性心衰患者随机分为治疗组（46例）与对照组（45例）。对照组以西医常规治疗，治疗组在此基础上加服参竹心康汤。检测空腹血糖和空腹胰岛素，计算胰岛素敏感指数（ISI）、胰岛素抵抗评估指数（IR），采用高分辨率超声技术检测肱动脉内皮依赖血管舒张功能、左室射血分数（LVEF）、二尖瓣舒张早期流速峰值（EPFV）、二尖瓣舒张晚期流速峰值（APFV）及二者之比（E／A），用药治疗1个月，观察治疗前后指标变化。结果两组间心衰疗效及中医证候疗效差异有统计学意义（P〈0．05）；Lee心衰积分和中医证候积分两组治疗前后差异有统计学意义（P〈0．01），治疗后两组间比较，治疗组改善优于对照组（P〈0．05）；ISI和IR治疗组治疗前后差异有统计学意义（P〈0．05或P〈0．01），IR对照组治疗前后有统计学意义（P〈0．05），治疗后两组间比较，ISI与IR变化均有统计学意义（P〈0．05），治疗组改善优于对照组；肱动脉反应性充血内径（D1）及内皮依赖血管扩张反应（FMD）治疗组治疗前后相比差异有统计学意义（P〈0．05），而治疗后两组间比较，治疗组改善优于对照组（P〈0．01）；LVEF和E／A两组治疗前后差异有统计学意义（Pc=0．01）；而治疗后两组间比较，治疗组LVEF、EjA改善优于对照组（P〈0．05）。结论参竹心康汤可提高慢性心衰患者的临床疗效，改善胰岛素抵抗及肱动脉血管内皮依赖舒张功能。

英文摘要：

Objective To observe the effect of Shenzhu Xinkang decoction（SXD） on heart function, insulin resistance （ISI）, and endothelium - dependent vasodilation function in patients with chronic heart failure. Methods Ninety - one patients with chronic heart failure were enrolled and randomly divided into treatment group （n--46） and control group （n=45）. All patients were managed with conventional western medicine therapy,the patients in treatment group were administered hy SXD. The indexes of the patients were observed pre- and post- treatment. ISI,insulin resistance index,which were calculated by detecting bloodfasting sugar （BFS）, the levels of fasting insulin,endothelium- dependent vasodilation function of brachial artery, left ventricular ejection fraction （LVEF）, early peak filing velocity （EPFV）,atrial peak filing velocity （APFV） or the ratio between EPFV and APFV （E/A） were detected. Results There were differences in effect of heart failure,Lee＇s cardiac risk index, Chinese medicine symptom curative effect, and the improvement in TCM syndrome in two groups （P〈0.05 or P〈0. 017. The Lee＇s cardiac risk index and Chinese medicine symptom curative effect in the treatment group was superior to that in the control group （P〈0.05）. There was statistical significance different in the index of ISI and IR in treatment group （P〈0.05 or P%0.01）. The indexes of ISI and IR was statistical different between the two groups （P〈0.05）. The brachial artery diameter at reactive hyperemia and endothelium- dependent vascular relaxation reactivity was significanctly difference between pre- and posttreatment in treatment group （P%0.01）. The indexes of LVEF, EPFV, and E/A were significant difference between two groups （P%0.01）. Conclusion SXD was useful for treatment of chronic heart failure, and to improve insulin resistance and endothelium - dependent vasodilation function.