沙库巴曲缬沙坦钠联合芪参益气滴丸治疗慢性心衰的疗效观察
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摘要
目的:观察沙库巴曲缬沙坦钠联合芪参益气滴丸治疗慢性心衰(CHF)的疗效。方法:选择我院2017-06—2018-02诊治的CHF患者84例,采用随机盲法分为两组,每组42例。对照组采用常规疗法并给予沙库巴曲缬沙坦钠(50mg/次,2次/天)治疗,观察组在对照组基础上联合芪参益气滴丸(2-3丸/次,3次/天)治疗,疗程均为3个月。分析两组患者治疗前后临床生命体征(心率、血压)、心功能疗效、心动图参数[(左心室舒张末期与收缩末期血容量,EDV,ESV),射血分数(EF)、每搏输出量(SV)、心输出量(CO)]及B型利钠肽前体(pro-BNP)、C反应蛋白(CRP)指标变化。结果:观察组心功能显效率及总有效率均高于对照组(均P<0.05)。治疗前,两组患者的心率、血压、脉搏、ESV、EDV、CO、EF、SV、pro-BNP及CRP水平无统计学差异(均P>0.05);治疗后,两组患者以上指标均明显改善,且观察组各指标改善效果明显优于对照组(均P<0.05)。结论:沙库巴曲缬沙坦钠联合芪参益气滴丸治疗CHF患者可有效改善心功能与临床生命体征,降低pro-BNP及CRP水平,较沙库巴曲缬沙坦钠单用疗效更好。
Objective: To analyze the curative effect of sacubitril valsartan sodium combined with Qishen Yiqi Dropping Pill in the treatment of chronic heart failure(CHF). Method: 84 patients with CHF enrolled in our hospital from June 2017 to February 2018 were randomly divided into two groups(n=42). The patients in the control group were treated with conventional therapy and treated with sacubitril valsartan sodium. The observation group was treated with Qishen Yiqi Dropping Pill on the basis of the control group. The clinical vital signs(heart rate, blood pressure), cardiac function and cardiac parameters(left ventricular end-diastolic and end-systolic blood volume, EDV, ESV), ejection fraction(EF), stroke volume(SV), cardiac output(CO) and B-type natriuretic peptide(pro-BNP), C Response protein(CRP) were detected. Results: The markedly effective rate and the total effective rate of cardiac function were higher than that of the control group(P<0.05). There were no significant differences in heart rate, blood pressure, pulse, ESV, EDV, CO, EF, SV, pro-BNP and CRP between the two groups before treatment(P>0.05). After treatment, the above indicators of both groups were significantly improved, but the improvement effect of the above indicators in the observation group was significantly better than that of the control group(all P<0.05). Conclusion: The treatment of patients with CHF with sacubitril valsartan sodium combined with Qishen Yiqi Dropping Pill can effectively improve cardiac function and clinical vital signs, reduce pro-BNP and CRP levels,which has a good prognosis.
Objective: To analyze the curative effect of sacubitril valsartan sodium combined with Qishen Yiqi Dropping Pill in the treatment of chronic heart failure(CHF). Method: 84 patients with CHF enrolled in our hospital from June 2017 to February 2018 were randomly divided into two groups(n=42). The patients in the control group were treated with conventional therapy and treated with sacubitril valsartan sodium. The observation group was treated with Qishen Yiqi Dropping Pill on the basis of the control group. The clinical vital signs(heart rate, blood pressure), cardiac function and cardiac parameters(left ventricular end-diastolic and end-systolic blood volume, EDV, ESV), ejection fraction(EF), stroke volume(SV), cardiac output(CO) and B-type natriuretic peptide(pro-BNP), C Response protein(CRP) were detected. Results: The markedly effective rate and the total effective rate of cardiac function were higher than that of the control group(P<0.05). There were no significant differences in heart rate, blood pressure, pulse, ESV, EDV, CO, EF, SV, pro-BNP and CRP between the two groups before treatment(P>0.05). After treatment, the above indicators of both groups were significantly improved, but the improvement effect of the above indicators in the observation group was significantly better than that of the control group(all P<0.05). Conclusion: The treatment of patients with CHF with sacubitril valsartan sodium combined with Qishen Yiqi Dropping Pill can effectively improve cardiac function and clinical vital signs, reduce pro-BNP and CRP levels,which has a good prognosis.
引文
1 董洪玲, 王中鲁, 张亮,等. 慢性心力衰竭的治疗进展[J]. 中国循证心血管医学杂志, 2017, 9(2):246-248.
2 黎励文, 李明敏. 慢性心力衰竭的治疗进展[J]. 中华老年心脑血管病杂志, 2016, 18(7):673-675.
3 陈可冀, 吴宗贵, 朱明军,等. 慢性心力衰竭中西医结合诊疗专家共识[J]. 心脑血管病防治, 2016, 16(5):225-232.
4 赵明昕, 于霞, 张晓非,等. 瑞舒伐他汀钙片联合芪参益气滴丸治疗慢性心力衰竭的临床观察[J]. 中国药房, 2017, 28(8):1 098-1 101.
5 王喆. 《中国心力衰竭诊断和治疗指南2014》解读[J]. 中国临床医生杂志, 2016, 44(5):14-16.
6 Nahler MPG. New York heart association classification (NYHA)[M]. New York:Springer Vienna, 2009:121.
7 郑刚.心力衰竭发病机制研究新进展[J].中华老年心脑血管病杂志,2018,20(4):428-431.
8 张骞, 刘小慧, 董建增. 慢性心力衰竭药物治疗进展[J]. 中国实用内科杂志, 2016, 36(4):272-276.
9 孙孟华, 卢景晶, 门素珍,等. 心力衰竭药物治疗的相关免疫学机制[J]. 国际免疫学杂志, 2016, 39(6):591-594.
10 Vecchis RD, Cantatrione C, Mazzei D, et al. The impact exerted on clinical outcomes of patients with chronic heart failure by aldosterone receptor antagonists: A meta-analysis of randomized controlled trials[J]. J Clin Med Res, 2017, 9(2):130-142.
11 Fu S, Ping P, Wang F, et al. Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure[J]. J Bio Eng, 2018, 12(1):2-101.
12 Ruiz-Hurtado G, Ruilope LM. Advantages of sacubitril/valsartan beyond blood pressure control in arterial hypertension[J]. European Heart Journal, 2017, 38(44):3 318-3 320.
13 Prenner SB, Shah SJ, Yancy CW. Role of angiotensin receptor-neprilysin inhibition in heart failure[J]. Curr Atheroscler Rep, 2016, 18(8):48-57.
14 Voors AA, Mauro G, Liu L CY, et al. Renal effects of the angiotensin receptor neprilysin inhibitor LCZ696 in patients with heart failure and preserved ejection fraction[J]. Eur J Heart Failure, 2015, 17(5):510-517.
15 王星, 陈康寅, 贾忠伟,等. 芪参益气滴丸对慢性心力衰竭患者的临床疗效分析[J]. 现代生物医学进展, 2016, 16(21):4 089-4 092.
16 余希文, 何长国, 宋磊,等. 芪参益气滴丸联合参麦注射液对慢性心力衰竭病人汗出症状、心功能及BNP的影响[J]. 中西医结合心脑血管病杂志, 2017, 15(5):584-587.
17 孔志明.芪参益气滴丸联合瑞舒伐他汀对慢性心力衰竭患者B型脑钠肽及相关细胞因子的影响[J].宁夏医科大学学报,2018,40(2):192-195.
18 解娜,刘景委,尚花娣,等.hs-CRP、cystatin C、NT-proBNP在慢性心力衰竭发展过程中的意义[J].广东医学,2016,37(12):1 839-1 842.
19 叶婷, 张宇, 张梦,等. 中医药治疗慢性心力衰竭药理机制研究进展[J]. 中西医结合心脑血管病杂志, 2016, 14(8):841-843.
20 刘胜强, 陈进业, 刘发俊,等. 芪参益气滴丸对慢性心力衰竭病人心率变异性及心功能的影响[J]. 中西医结合心脑血管病杂志, 2016, 14(19):2 221-2 223.
21 刘亚洋, 李鹤, 朱源生. 芪参益气滴丸对冠心病慢性心力衰竭病人心功能、免疫功能及micro RNA155水平的影响[J]. 中西医结合心脑血管病杂志, 2017, 15(11):1 342-1 344.微循环学杂志2019年第29卷第1期临床研究 ?
2 黎励文, 李明敏. 慢性心力衰竭的治疗进展[J]. 中华老年心脑血管病杂志, 2016, 18(7):673-675.
3 陈可冀, 吴宗贵, 朱明军,等. 慢性心力衰竭中西医结合诊疗专家共识[J]. 心脑血管病防治, 2016, 16(5):225-232.
4 赵明昕, 于霞, 张晓非,等. 瑞舒伐他汀钙片联合芪参益气滴丸治疗慢性心力衰竭的临床观察[J]. 中国药房, 2017, 28(8):1 098-1 101.
5 王喆. 《中国心力衰竭诊断和治疗指南2014》解读[J]. 中国临床医生杂志, 2016, 44(5):14-16.
6 Nahler MPG. New York heart association classification (NYHA)[M]. New York:Springer Vienna, 2009:121.
7 郑刚.心力衰竭发病机制研究新进展[J].中华老年心脑血管病杂志,2018,20(4):428-431.
8 张骞, 刘小慧, 董建增. 慢性心力衰竭药物治疗进展[J]. 中国实用内科杂志, 2016, 36(4):272-276.
9 孙孟华, 卢景晶, 门素珍,等. 心力衰竭药物治疗的相关免疫学机制[J]. 国际免疫学杂志, 2016, 39(6):591-594.
10 Vecchis RD, Cantatrione C, Mazzei D, et al. The impact exerted on clinical outcomes of patients with chronic heart failure by aldosterone receptor antagonists: A meta-analysis of randomized controlled trials[J]. J Clin Med Res, 2017, 9(2):130-142.
11 Fu S, Ping P, Wang F, et al. Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure[J]. J Bio Eng, 2018, 12(1):2-101.
12 Ruiz-Hurtado G, Ruilope LM. Advantages of sacubitril/valsartan beyond blood pressure control in arterial hypertension[J]. European Heart Journal, 2017, 38(44):3 318-3 320.
13 Prenner SB, Shah SJ, Yancy CW. Role of angiotensin receptor-neprilysin inhibition in heart failure[J]. Curr Atheroscler Rep, 2016, 18(8):48-57.
14 Voors AA, Mauro G, Liu L CY, et al. Renal effects of the angiotensin receptor neprilysin inhibitor LCZ696 in patients with heart failure and preserved ejection fraction[J]. Eur J Heart Failure, 2015, 17(5):510-517.
15 王星, 陈康寅, 贾忠伟,等. 芪参益气滴丸对慢性心力衰竭患者的临床疗效分析[J]. 现代生物医学进展, 2016, 16(21):4 089-4 092.
16 余希文, 何长国, 宋磊,等. 芪参益气滴丸联合参麦注射液对慢性心力衰竭病人汗出症状、心功能及BNP的影响[J]. 中西医结合心脑血管病杂志, 2017, 15(5):584-587.
17 孔志明.芪参益气滴丸联合瑞舒伐他汀对慢性心力衰竭患者B型脑钠肽及相关细胞因子的影响[J].宁夏医科大学学报,2018,40(2):192-195.
18 解娜,刘景委,尚花娣,等.hs-CRP、cystatin C、NT-proBNP在慢性心力衰竭发展过程中的意义[J].广东医学,2016,37(12):1 839-1 842.
19 叶婷, 张宇, 张梦,等. 中医药治疗慢性心力衰竭药理机制研究进展[J]. 中西医结合心脑血管病杂志, 2016, 14(8):841-843.
20 刘胜强, 陈进业, 刘发俊,等. 芪参益气滴丸对慢性心力衰竭病人心率变异性及心功能的影响[J]. 中西医结合心脑血管病杂志, 2016, 14(19):2 221-2 223.
21 刘亚洋, 李鹤, 朱源生. 芪参益气滴丸对冠心病慢性心力衰竭病人心功能、免疫功能及micro RNA155水平的影响[J]. 中西医结合心脑血管病杂志, 2017, 15(11):1 342-1 344.微循环学杂志2019年第29卷第1期临床研究 ?