磷酸肌酸钠联合麝香保心丸对慢性心力衰竭患者心功能和心室重构的影响
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摘要
目的探讨磷酸肌酸钠联合麝香保心丸对慢性心力衰竭(chronic heart failure, CHF)患者的心功能和心室重构的影响。方法 108例CHF患者随机分为观察组和对照组各54例,观察组采用磷酸肌酸钠联合麝香保心丸治疗,对照组采用磷酸肌酸钠治疗。比较2组临床疗效、心功能指标、心室重构指标、神经内分泌因子及不良反应发生率。结果观察组治疗总有效率(90.7%)及治疗后左室射血分数[(41.25±6.63)%]、左心室内径缩短率[(25.13±3.49)%]明显高于对照组[70.4%、(37.76±4.06)%、(21.04±3.27)%](P>0.05),治疗后左心室舒张末期内径[(45.62±7.23)mm]、左心室收缩末期内径[(37.25±5.48)mm]、左心室后壁厚度[(9.71±1.64)mm]、室间隔收缩末期厚度[(11.36±1.58)mm]、左心室质量指数[(100.85±13.47)g/m~2]、氨基末端B型钠尿肽前体[(226.74±36.59)ng/L]、血管紧张素Ⅱ[(53.27±7.44)ng/L]、内皮素-1[(25.87±5.02)mg/L]明显低于对照组[(51.34±6.58)mm、(41.36±4.32)mm、(10.78±1.73)mm、(12.07±1.62)mm、(114.38±12.96)g/m~2、(319.92±34.47)ng/L、(82.16±10.27)ng/L、(41.29±5.12)mg/L](P<0.05),不良反应发生率(5.6%)与对照组(7.4%)比较差异无统计学意义(P>0.05)。结论磷酸肌酸钠联合麝香保心丸可有效改善CHF患者心功能,调节神经内分泌因子,促进病情恢复。
Objective To investigate the effect of creatine phosphate combined with Shexiang Baoxin Pill on cardiac function and ventricular remodeling in patients with chronic heart failure(CHF). Methods Totally 108 patients with CHF were randomly divided into observation group(n=54) treated with creatine phosphate combined with Shexiang Baoxin pills and control group(n=54) treated with creatine phosphate only. The clinical efficacy, cardiac function indexes, ventricular remodeling indexes, neuroendocrine factors and adverse reaction incidence were compared between two groups. Results The total effective rate(90.7%), left ventricular ejection fraction((41.25±6.63)%) and left ventricular fractional shortening((25.13±3.49)%) in observation group were significantly higher than those in control group(70.4%,(37.76±4.06)%,(21.04±3.27)%)(P<0.05), while left ventricular end-diastolic dimension((45.62±7.23) mm), left ventricular end-systolic dimension((37.25±5.48) mm), left ventricular posterior wall thickness((9.71±1.64) mm), interventricular septal end-systolic thickness((11.36±1.58) mm), left ventricular mass index((100.85±13.47) g/m~2), N-terminal pro-B type natriuretic peptide((226.74±36.59) ng/L), angiotensin Ⅱ((53.27±7.44) ng/L) and endothelin-1((25.87±5.02) mg/L) in observation group were significantly lower than those in control group((51.34±6.58) mm,(41.36±4.32) mm,(10.78±1.73) mm,(12.07±1.62) mm,(114.38±12.96) g/m~2,(319.92±34.47) ng/L,(82.16±10.27) ng/L,(41.29±5.12) mg/L) after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions between observation group(5.6%) and control group(7.4%)(P>0.05). Conclusion Creatine phosphate combined with Shexiang Baoxin Pill can effectively improve the cardiac function, regulate the neuroendocrine factors and promote the recovery of CHF.
Objective To investigate the effect of creatine phosphate combined with Shexiang Baoxin Pill on cardiac function and ventricular remodeling in patients with chronic heart failure(CHF). Methods Totally 108 patients with CHF were randomly divided into observation group(n=54) treated with creatine phosphate combined with Shexiang Baoxin pills and control group(n=54) treated with creatine phosphate only. The clinical efficacy, cardiac function indexes, ventricular remodeling indexes, neuroendocrine factors and adverse reaction incidence were compared between two groups. Results The total effective rate(90.7%), left ventricular ejection fraction((41.25±6.63)%) and left ventricular fractional shortening((25.13±3.49)%) in observation group were significantly higher than those in control group(70.4%,(37.76±4.06)%,(21.04±3.27)%)(P<0.05), while left ventricular end-diastolic dimension((45.62±7.23) mm), left ventricular end-systolic dimension((37.25±5.48) mm), left ventricular posterior wall thickness((9.71±1.64) mm), interventricular septal end-systolic thickness((11.36±1.58) mm), left ventricular mass index((100.85±13.47) g/m~2), N-terminal pro-B type natriuretic peptide((226.74±36.59) ng/L), angiotensin Ⅱ((53.27±7.44) ng/L) and endothelin-1((25.87±5.02) mg/L) in observation group were significantly lower than those in control group((51.34±6.58) mm,(41.36±4.32) mm,(10.78±1.73) mm,(12.07±1.62) mm,(114.38±12.96) g/m~2,(319.92±34.47) ng/L,(82.16±10.27) ng/L,(41.29±5.12) mg/L) after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions between observation group(5.6%) and control group(7.4%)(P>0.05). Conclusion Creatine phosphate combined with Shexiang Baoxin Pill can effectively improve the cardiac function, regulate the neuroendocrine factors and promote the recovery of CHF.
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.
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[3] 李慧婷,薛恩忠.心脉隆注射液联合磷酸肌酸钠治疗慢性心力衰竭的临床研究[J].现代药物与临床,2017,32(11):2116-2119.
[4] 安宜沛,邹旭,姚耿圳,等.麝香保心丸辅助治疗慢性心力衰竭疗效的Meta分析[J].中医杂志,2015,56(8):662-666.
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[8] 刁克,逯艺,郭德刚.磷酸肌酸钠联合丹参多酚酸盐治疗冠心病心绞痛的疗效观察[J].现代药物与临床,2017,32(3):419-422.
[9] 田帅,张利宣,马子健,等.慢性心力衰竭患者应用磷酸肌酸钠治疗对心功能和NT-proBNP的影响[J].河北医药,2016,38(14):2173-2175.
[10] 胡开宇,韩志华,张金伟.麝香保心丸联合卡维地洛治疗缺血性心脏病心力衰竭的疗效观察[J].现代药物与临床,2016,31(3):294-297.
[11] 李蓉,吴泰蓉,朱灿宏,等.麝香保心丸治疗冠心病慢性心力衰竭患者临床疗效观察[J].中西医结合心脑血管病杂志,2015,21(15):1704-1706.
[12] 张鹏,艾力曼·马合木提,孙娟.心肌能量代谢与慢性心力衰竭心室重构关系及心肌能量代谢药物应用的研究进展[J].中华实用诊断与治疗杂志,2018,24(1):94-97.
[13] 王天娇,周琳,刘一航,等.评估心力衰竭预后相关指标的研究进展[J].中国循证心血管医学杂志,2017,9(3):374-376.
[2] 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.
[3] 李慧婷,薛恩忠.心脉隆注射液联合磷酸肌酸钠治疗慢性心力衰竭的临床研究[J].现代药物与临床,2017,32(11):2116-2119.
[4] 安宜沛,邹旭,姚耿圳,等.麝香保心丸辅助治疗慢性心力衰竭疗效的Meta分析[J].中医杂志,2015,56(8):662-666.
[5] 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.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(2):1076-1095.
[6] 中国中西医结合学会心血管疾病专业委员会,中国医师协会中西医结合医师分会心血管病学专家委员会.慢性心力衰竭中西医结合诊疗专家共识[J].中国中西医结合杂志,2016,36(2):133-141.
[7] 孟立平,郭航远,蒋承建.慢性心力衰竭药物治疗研究进展[J].中国全科医学,2015,18(23):2870-2872.
[8] 刁克,逯艺,郭德刚.磷酸肌酸钠联合丹参多酚酸盐治疗冠心病心绞痛的疗效观察[J].现代药物与临床,2017,32(3):419-422.
[9] 田帅,张利宣,马子健,等.慢性心力衰竭患者应用磷酸肌酸钠治疗对心功能和NT-proBNP的影响[J].河北医药,2016,38(14):2173-2175.
[10] 胡开宇,韩志华,张金伟.麝香保心丸联合卡维地洛治疗缺血性心脏病心力衰竭的疗效观察[J].现代药物与临床,2016,31(3):294-297.
[11] 李蓉,吴泰蓉,朱灿宏,等.麝香保心丸治疗冠心病慢性心力衰竭患者临床疗效观察[J].中西医结合心脑血管病杂志,2015,21(15):1704-1706.
[12] 张鹏,艾力曼·马合木提,孙娟.心肌能量代谢与慢性心力衰竭心室重构关系及心肌能量代谢药物应用的研究进展[J].中华实用诊断与治疗杂志,2018,24(1):94-97.
[13] 王天娇,周琳,刘一航,等.评估心力衰竭预后相关指标的研究进展[J].中国循证心血管医学杂志,2017,9(3):374-376.