养心氏片联合左卡尼汀治疗舒张性心力衰竭的临床研究
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摘要
目的探讨养心氏片联合左卡尼汀注射液治疗舒张性心力衰竭的临床疗效。方法选取2015年7月—2018年5月十堰市太和医院收治的96例舒张性心力衰竭患者作为研究对象,随机将患者分为对照组(48例)和治疗组(48例)。对照组缓慢注射左卡尼汀注射液,2.0 g加入到50 mL生理盐水中,3次/d。治疗组在对照组的基础上口服养心氏片,3片/次,3次/d。两组患者均连续治疗1周。观察两组患者的临床疗效,同时比较两组治疗前后的6 min步行距离(6 MWT)、生活质量评分、心功能指标和血清细胞因子水平。结果治疗后,治疗组的总有效率为97.9%,显著高于对照组的87.5%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组6 MWT显著升高,生活质量评分显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组6 MWT显著高于对照组,生活质量评分显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组E值、二尖瓣前向血流E峰与A峰比值(E/A)均显著升高,A值、左心室等容舒张时间(IVRT)、E峰加速时间(ACTe)和E峰减速时间(Dcte)均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组E、E/A显著高于对照组,A、IVRT、ACTe、DCTe显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清N-末端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hs-CRP)水平均显著降低,基质金属蛋白酶抑制剂-1(TIMP-1)显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组血清NT-ProBNP、hs-CRP水平均显著低于对照组,TIMP-1显著高于对照组,两组比较差异具有统计学意义(P<0.05)。结论养心氏片联合左卡尼汀注射液治疗舒张性心力衰竭具有较好的临床疗效,可有效改善患者的左心室舒张功能,改善血清细胞因子水平,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Yangxinshi Tablets combined with Levocarnitine Injection in treatment of diastolic heart failure. Methods Patients(96 cases) with diastolic heart failure in Shiyan Taihe Hospital from July 2015 to May 2018 were randomly divided into control(48 cases) and treatment(48 cases) groups. Patients in the control group were iv administered with Levocarnitine Injection, 2.0 g added into normal saline 50 mL, three times daily. Patients in the treatment group were po administered with Yangxinshi Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 1 week. After treatment, the clinical efficacy was evaluated, and the 6 MWT, quality of life scores, cardiac function indexes, and serum cytokine levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the treatment group was 97.9%, which was significantly higher than 87.5% in the control group, and there were differences between two groups(P <0.05). After treatment, 6 MWT in the two groups were significantly increased, but quality of life scores was significantly decreased,and there were differences in the same group(P < 0.05). After treatment, 6 MWT in the treatment group was higher than those in the control group, but quality of life score was lower than those in the control group, and there were differences between two groups(P <0.05). After treatment, E and E/A in the two groups were significantly increased, but A, IVRT, ACTe, and DCTe were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, E and E/A in the treatment group were higher than those in the control group, but A, IVRT, ACTe, and DCTe were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, NT-ProBNP and hs-CRP levels in the two groups were significantly decreased, but TIMP-1 levels were significantly increased, and there were differences in the same group(P < 0.05). After treatment, NT-ProBNP and hs-CRP levels in the treatment group were lower than those in the control group, but TIMP-1 levels were higher than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Yangxinshi Tablets combined with Levocarnitine Injection has a good clinical effect in treatment of diastolic heart failure, can effectively improve the left ventricular diastolic function of patients, and improve the levels of serum cytokines, which has a certain clinical application value.
Objective To investigate the clinical effect of Yangxinshi Tablets combined with Levocarnitine Injection in treatment of diastolic heart failure. Methods Patients(96 cases) with diastolic heart failure in Shiyan Taihe Hospital from July 2015 to May 2018 were randomly divided into control(48 cases) and treatment(48 cases) groups. Patients in the control group were iv administered with Levocarnitine Injection, 2.0 g added into normal saline 50 mL, three times daily. Patients in the treatment group were po administered with Yangxinshi Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 1 week. After treatment, the clinical efficacy was evaluated, and the 6 MWT, quality of life scores, cardiac function indexes, and serum cytokine levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the treatment group was 97.9%, which was significantly higher than 87.5% in the control group, and there were differences between two groups(P <0.05). After treatment, 6 MWT in the two groups were significantly increased, but quality of life scores was significantly decreased,and there were differences in the same group(P < 0.05). After treatment, 6 MWT in the treatment group was higher than those in the control group, but quality of life score was lower than those in the control group, and there were differences between two groups(P <0.05). After treatment, E and E/A in the two groups were significantly increased, but A, IVRT, ACTe, and DCTe were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, E and E/A in the treatment group were higher than those in the control group, but A, IVRT, ACTe, and DCTe were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, NT-ProBNP and hs-CRP levels in the two groups were significantly decreased, but TIMP-1 levels were significantly increased, and there were differences in the same group(P < 0.05). After treatment, NT-ProBNP and hs-CRP levels in the treatment group were lower than those in the control group, but TIMP-1 levels were higher than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Yangxinshi Tablets combined with Levocarnitine Injection has a good clinical effect in treatment of diastolic heart failure, can effectively improve the left ventricular diastolic function of patients, and improve the levels of serum cytokines, which has a certain clinical application value.
引文
[1]周鹍,逯金金,林谦.舒张性心力衰竭研究进展[J].中西医结合心脑血管病杂志,2015,13(1):20-22.
[2]邹艳惠,张亮,王鑫,等.左卡尼汀注射液治疗舒张性心力衰竭的临床疗效观察[J].中国医药导刊,2013,15(6):1015-1016.
[3]黄敏,李宏浩,张相年.养心氏片治疗舒张性心力衰竭的临床研究[J].中西医结合心脑血管病杂志,2009,7(2):135-136.
[4]朱文玲.内科疾病诊断与疗效标准[M].上海:上海中医药大学出版社,2006:3.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:77-84.
[6]奚悦文,范维琥.明尼苏达心力衰竭生活质量调查表适用性的评价[J].上海医学,2004,27(4):222-225.
[7]刘春霞.舒张性心力衰竭的发病机制和治疗进展[J].心血管病学进展,2013,34(2):254-257.
[8]余梅玫,孟令毅.左卡尼汀治疗慢性心力衰竭的疗效分析[J].安徽医药,2014,18(4):744-745.
[9]王垒,刘慧,李允,等.托拉塞米联合左卡尼汀治疗慢性心力衰竭急性加重期的临床研究[J].现代药物与临床,2018:33(1):79-83.
[10]陈安妮,高越,赵亚红,等.养心氏片药理作用机制与临床研究进展[J].解放军药学学报,2017,33(2):172-175,182.
[11]盘锋.养心氏片辅助治疗舒张性心力衰竭80例疗效观察[J].中医临床研究,2014,6(18):39-41.
[12]蔺曜,牟博勇,曾朝富,等.左卡尼汀治疗慢性心力衰竭的临床疗效观察[J].实用心脑肺血管病杂志,2013,21(3):17-18.
[13]张为,鲁卫星.养心氏片治疗冠心病慢性心力衰竭气虚血瘀证临床研究[J].辽宁中医药大学学报,2010,12(3):115-118.
[14]李秋菊,朱剑,何明,等.血浆NT-proBNP在舒张性心力衰竭中的意义[J].浙江中医药大学学报,2010,34(5):670-671.
[15]原永明,王慧,尹良平,等.慢性心力衰竭患者BNP、hs-CRP水平检测的临床意义[J].检验医学,2015,30(6):591-592.
[16]李晓峰,韩玉刚,贾文美.慢性心衰患者血清MMP-1、TIMP-1变化的临床意义[J].山东医药,2006,46(34):45-46.
[2]邹艳惠,张亮,王鑫,等.左卡尼汀注射液治疗舒张性心力衰竭的临床疗效观察[J].中国医药导刊,2013,15(6):1015-1016.
[3]黄敏,李宏浩,张相年.养心氏片治疗舒张性心力衰竭的临床研究[J].中西医结合心脑血管病杂志,2009,7(2):135-136.
[4]朱文玲.内科疾病诊断与疗效标准[M].上海:上海中医药大学出版社,2006:3.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:77-84.
[6]奚悦文,范维琥.明尼苏达心力衰竭生活质量调查表适用性的评价[J].上海医学,2004,27(4):222-225.
[7]刘春霞.舒张性心力衰竭的发病机制和治疗进展[J].心血管病学进展,2013,34(2):254-257.
[8]余梅玫,孟令毅.左卡尼汀治疗慢性心力衰竭的疗效分析[J].安徽医药,2014,18(4):744-745.
[9]王垒,刘慧,李允,等.托拉塞米联合左卡尼汀治疗慢性心力衰竭急性加重期的临床研究[J].现代药物与临床,2018:33(1):79-83.
[10]陈安妮,高越,赵亚红,等.养心氏片药理作用机制与临床研究进展[J].解放军药学学报,2017,33(2):172-175,182.
[11]盘锋.养心氏片辅助治疗舒张性心力衰竭80例疗效观察[J].中医临床研究,2014,6(18):39-41.
[12]蔺曜,牟博勇,曾朝富,等.左卡尼汀治疗慢性心力衰竭的临床疗效观察[J].实用心脑肺血管病杂志,2013,21(3):17-18.
[13]张为,鲁卫星.养心氏片治疗冠心病慢性心力衰竭气虚血瘀证临床研究[J].辽宁中医药大学学报,2010,12(3):115-118.
[14]李秋菊,朱剑,何明,等.血浆NT-proBNP在舒张性心力衰竭中的意义[J].浙江中医药大学学报,2010,34(5):670-671.
[15]原永明,王慧,尹良平,等.慢性心力衰竭患者BNP、hs-CRP水平检测的临床意义[J].检验医学,2015,30(6):591-592.
[16]李晓峰,韩玉刚,贾文美.慢性心衰患者血清MMP-1、TIMP-1变化的临床意义[J].山东医药,2006,46(34):45-46.