二丁酰环磷腺苷钙联合芪苈强心胶囊治疗慢性心力衰竭患者的疗效观察
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摘要
目的探讨二丁酰环磷腺苷钙联合芪苈强心胶囊治疗慢性心力衰竭的疗效和安全性。方法选取120例慢性心力衰竭患者,随机分为观察组(常规治疗+二丁酰环磷腺苷钙和芪苈强心胶囊)和对照组(常规治疗)。比较2组的临床疗效、心率、心功能分级、6 min步行距离(6MWD)、明尼苏达心力衰竭生活质量(QOL)评分、左室舒张末期内径(LVED)、左心室射血分数(LVEF)、N末端脑钠肽原(NT-proBNP)、不良反应等指标。结果治疗4周后,观察组总有效率显著高于对照组(P<0.05),2组患者的血浆NT-proBNP水平均显著降低,但观察组显著低于对照组(P<0.05)。观察组心率、LVEF、LVED、6MWD、心功能以及QOL等方面的改善均显著优于对照组(P<0.05)。2组的不良反应发生情况比较,差异无统计学意义(P>0.05)。结论在常规治疗基础上加用二丁酰环磷腺苷钙及芪苈强心胶囊治疗慢性心力衰竭安全有效,可显著降低NT-proBNP水平,改善患者症状,提升心功能,提高生活质量。
Objective To explore the efficiency and safety of calcium dibutyryladenosine cyclophosphate combined with Qili Qiangxin Capsules in treating patients with chronic heart failure.Methods A total of 120 patients with chronic heart failure were selected and randomly divided into observation group(calcium dibutyacyladenosine cyclophosphate plus Qili Qiangxin Capsules plus standard treatments) and control group(standard treatments).The clinical efficacy,heart rate,cardiac function classification,6-minute walking distance(6 MWD),quality of life by Minnesota heart failure(QOL),left ventricular end-diastolic diameter(LVED),left ventricular ejection fraction(LVEF),N-terminal brain natriuretic peptide(NT-proBNP),and adverse reactions were compared between the two groups.Results After 4 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05),the plasma NT-proBNP level in both groups significantly decreased,and the plasma NT-proBNP level in observation group was significantly lower than that in the control group(P<0.05).The improvements of heart rate,LVEF,LVED,6 MWD,cardiac function and QOL in the observation group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion On the basis of routine treatment,calcium dibutyryladenosine cyclophosphate combined with Qili Qiangxin Capsules is safe and effective in the treatment of patients with chronic heart failure,which can significantly reduce the level of NT-proBNP,improve the symptoms and cardiac function of patients,and improve the quality of life.
Objective To explore the efficiency and safety of calcium dibutyryladenosine cyclophosphate combined with Qili Qiangxin Capsules in treating patients with chronic heart failure.Methods A total of 120 patients with chronic heart failure were selected and randomly divided into observation group(calcium dibutyacyladenosine cyclophosphate plus Qili Qiangxin Capsules plus standard treatments) and control group(standard treatments).The clinical efficacy,heart rate,cardiac function classification,6-minute walking distance(6 MWD),quality of life by Minnesota heart failure(QOL),left ventricular end-diastolic diameter(LVED),left ventricular ejection fraction(LVEF),N-terminal brain natriuretic peptide(NT-proBNP),and adverse reactions were compared between the two groups.Results After 4 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05),the plasma NT-proBNP level in both groups significantly decreased,and the plasma NT-proBNP level in observation group was significantly lower than that in the control group(P<0.05).The improvements of heart rate,LVEF,LVED,6 MWD,cardiac function and QOL in the observation group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion On the basis of routine treatment,calcium dibutyryladenosine cyclophosphate combined with Qili Qiangxin Capsules is safe and effective in the treatment of patients with chronic heart failure,which can significantly reduce the level of NT-proBNP,improve the symptoms and cardiac function of patients,and improve the quality of life.
引文
[1]周京敏,崔晓通,葛均波.中国心力衰竭的流行病学概况[J].中华心血管病杂志,2015,43(12):1018-1021.
[2]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中国实用乡村医生杂志,2014,42(24):3-10.
[3]李新军,齐书英.二丁酰环磷腺苷钙联合生脉、黄芪注射液治疗慢性心力衰竭的临床效果[J].临床误诊误治,2015,28(6):60-62.
[4]马利平,秦延军.二丁酰环磷腺苷钙联合参附注射液治疗慢性心力衰竭疗效观察[J].河北医学,2015,37(2):196-198.
[5]蒋瑞侠.二丁酰环磷腺苷钙治疗扩张型心肌病心力衰竭的疗效观察[J].河南医学研究,2015,24(8):103-104.
[6]李翔.二丁酰环磷腺苷钙对75例冠心病心力衰竭患者左心室泵血功能的影响[J].上海医药,2013,34(17):22-24.
[7]曾晓渝,范才平,万晓妍.二丁酰环磷腺苷钙联合用药研究概况[J].世界最新医学信息文摘,2017,17(44):106-122.
[8]苏冠华,孙雨霏,卢永昕.心力衰竭的能量代谢重构及其治疗[J].国际心血管病杂志,2012,39(2):65-67.
[9]陈曙霞.心先安的药理学效应及临床应用[J].中国心血管病杂志,1997,2(4):283-285.
[10]邓艾民.环磷腺苷葡胺对心力衰竭患者BNP及心功能的疗效[J].心血管康复医学杂志,2016,25(3):317-320.
[11]张仲君.环磷腺苷葡胺联合厄贝沙坦对老年心力衰竭患者心功能、血浆NT-proBNP浓度的影响[J].中国老年学杂志,2010,30(24):3808-3809.
[12]Wilson T W H,Huang Y M.Cardiotonic Modulation in Heart Failure Insights from Traditional Chinese Medicine[J].J Am Coll Cardiol,2013,62(12):1073-1074.
[13]Tong X,Lu R,Wan Y et al.Effects of Qili Qiangxin capsules on NT-proBNP level and cardiac function in silicosis patients[J].Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi,2014,32(9):697-699.
[14]Li X,Zhang J,Huang J,et al.A multicenter,randomized,double-blind,parallel-group,placebo-controlled study of the effects of qili qiangxin capsules in patients with chronic heart failure[J].J Am Coll Cardiol,2013,62:1065-1072.
[15]何穗智,刘素芳,吴伟康,等.芪苈强心胶囊治疗慢性心力衰竭的安全性及有效性的系统评价[J].临床心血管病杂志,2013,29(8):605-608.
[16]Sun J,Zhang K,Xiong W J,et al.Clinical effects of a standardized Chinese herbal remedy,Qili Qiangxin,as an adjuvant treatment in heart failure:systematic review and metaanalysis[J].BMC Complement Altern Med,2016,11(16):201-208.
[17]Liu Y,Ouyang Y,Li S,et al.Determination of twelve active compounds in Qili Qiangxin capsules by UPLC-MS[J].Zhongguo Zhong Yao Za Zhi,2014,39(10):1822-1825.
[18]Zeng Q C,Wu Z L,Huang Y L,et al.Effects of Qili Qiangxin capsule on renal aquaporin-2 expression in rats with chronic heart failure[J].European Heart Journal Supplements,2015,17(Supplement C):C42-C48.
[19]He Y,Du B,Fan H,et al.Beneficial Effects of Qili Qiangxin Capsule on Lung Structural Remodeling in Ischemic Heart Failure via TGF-β1/Smad3 Pathway[J].Evid Based Complement Alternat Med,2015,2015:298631-298638.
[20]Cui X,Zhang J,Li Y,et al.Effects of Qili Qiangxin Capsule on AQP2,V2R,and AT1R in Rats with Chronic Heart Failure[J].Evid Based Complement Alternat Med,2015,2015:639450-639457.
[2]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中国实用乡村医生杂志,2014,42(24):3-10.
[3]李新军,齐书英.二丁酰环磷腺苷钙联合生脉、黄芪注射液治疗慢性心力衰竭的临床效果[J].临床误诊误治,2015,28(6):60-62.
[4]马利平,秦延军.二丁酰环磷腺苷钙联合参附注射液治疗慢性心力衰竭疗效观察[J].河北医学,2015,37(2):196-198.
[5]蒋瑞侠.二丁酰环磷腺苷钙治疗扩张型心肌病心力衰竭的疗效观察[J].河南医学研究,2015,24(8):103-104.
[6]李翔.二丁酰环磷腺苷钙对75例冠心病心力衰竭患者左心室泵血功能的影响[J].上海医药,2013,34(17):22-24.
[7]曾晓渝,范才平,万晓妍.二丁酰环磷腺苷钙联合用药研究概况[J].世界最新医学信息文摘,2017,17(44):106-122.
[8]苏冠华,孙雨霏,卢永昕.心力衰竭的能量代谢重构及其治疗[J].国际心血管病杂志,2012,39(2):65-67.
[9]陈曙霞.心先安的药理学效应及临床应用[J].中国心血管病杂志,1997,2(4):283-285.
[10]邓艾民.环磷腺苷葡胺对心力衰竭患者BNP及心功能的疗效[J].心血管康复医学杂志,2016,25(3):317-320.
[11]张仲君.环磷腺苷葡胺联合厄贝沙坦对老年心力衰竭患者心功能、血浆NT-proBNP浓度的影响[J].中国老年学杂志,2010,30(24):3808-3809.
[12]Wilson T W H,Huang Y M.Cardiotonic Modulation in Heart Failure Insights from Traditional Chinese Medicine[J].J Am Coll Cardiol,2013,62(12):1073-1074.
[13]Tong X,Lu R,Wan Y et al.Effects of Qili Qiangxin capsules on NT-proBNP level and cardiac function in silicosis patients[J].Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi,2014,32(9):697-699.
[14]Li X,Zhang J,Huang J,et al.A multicenter,randomized,double-blind,parallel-group,placebo-controlled study of the effects of qili qiangxin capsules in patients with chronic heart failure[J].J Am Coll Cardiol,2013,62:1065-1072.
[15]何穗智,刘素芳,吴伟康,等.芪苈强心胶囊治疗慢性心力衰竭的安全性及有效性的系统评价[J].临床心血管病杂志,2013,29(8):605-608.
[16]Sun J,Zhang K,Xiong W J,et al.Clinical effects of a standardized Chinese herbal remedy,Qili Qiangxin,as an adjuvant treatment in heart failure:systematic review and metaanalysis[J].BMC Complement Altern Med,2016,11(16):201-208.
[17]Liu Y,Ouyang Y,Li S,et al.Determination of twelve active compounds in Qili Qiangxin capsules by UPLC-MS[J].Zhongguo Zhong Yao Za Zhi,2014,39(10):1822-1825.
[18]Zeng Q C,Wu Z L,Huang Y L,et al.Effects of Qili Qiangxin capsule on renal aquaporin-2 expression in rats with chronic heart failure[J].European Heart Journal Supplements,2015,17(Supplement C):C42-C48.
[19]He Y,Du B,Fan H,et al.Beneficial Effects of Qili Qiangxin Capsule on Lung Structural Remodeling in Ischemic Heart Failure via TGF-β1/Smad3 Pathway[J].Evid Based Complement Alternat Med,2015,2015:298631-298638.
[20]Cui X,Zhang J,Li Y,et al.Effects of Qili Qiangxin Capsule on AQP2,V2R,and AT1R in Rats with Chronic Heart Failure[J].Evid Based Complement Alternat Med,2015,2015:639450-639457.