芪参益气滴丸治疗慢性心力衰竭疗效评价
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摘要
目的评价芪参益气滴丸用于慢性心力衰竭患者的临床疗效。方法入选20016年1月-2017年12月在我院门诊及住院的慢性心力衰竭(CHF)患者186例,年龄46~79(平均68.3±13.6)岁,随机分为芪参益气滴丸治疗组95例,对照组91例。入选患者在治疗原发病的基础上,均接受标准心衰治疗,治疗组加用芪参益气滴丸0.5,3次/d,疗程12周。主要评价两组治疗前后临床疗效、左室舒张末径、左室射血分数(EF)、血浆NT-proBNP检测及6 min步行试验的变化。结果治疗组总有效率88.4%,血浆NT-proBNP水平明显降低,左室舒张末径减小、LVEF增加,6 min步行距离增加,均显著优于对照组,达到统计学差异(P <0.01或P <0.05)。结论应用芪参益气滴丸治疗后,CHF患者临床症状、心功能指标及活动耐力明显改善,生活质量提高。
Objective To investigate the clinical efficacy of Qishen Yiqi gutta pills in the treatment of chronic heart failure(CHF). Methods CHF patients(n = 186), 46 to 79(average 68.3±13.6) years old, were chosen from outpatient and inpatient in our hospital from Jan. 2016 to Dec. 2017, and then randomly divided into Qishen Yiqi Gutta Pills treatment group(n = 95) and control group(n = 91). The selected patients were treated for standard heart failure. The treatment group added Qishen Yiqi gutta pills(0.5 g) once 0.5 g and 3 times a day for 12 weeks. The changes of left ventricular diastolic diameter, left ventricular ejection fraction(EF), plasma NT-proBNP and 6 min walking test were compared between two groups before and after treatment. Results The total effective rate was 88.4 % in treatment group. the plasma NT-proBNP level decreased significantly, the left ventricular diastolic diameter decreased, the LVEF increased, and the 6 min walking distance increased, all of which were significantly better than the control group. The difference was statistically significant(P < 0.01 or P < 0.05). Conclusion The efficacy of Qishen Yiqi gutta pills is significant in CHF patients, which can improve heart function, activity endurance and quality of life.
Objective To investigate the clinical efficacy of Qishen Yiqi gutta pills in the treatment of chronic heart failure(CHF). Methods CHF patients(n = 186), 46 to 79(average 68.3±13.6) years old, were chosen from outpatient and inpatient in our hospital from Jan. 2016 to Dec. 2017, and then randomly divided into Qishen Yiqi Gutta Pills treatment group(n = 95) and control group(n = 91). The selected patients were treated for standard heart failure. The treatment group added Qishen Yiqi gutta pills(0.5 g) once 0.5 g and 3 times a day for 12 weeks. The changes of left ventricular diastolic diameter, left ventricular ejection fraction(EF), plasma NT-proBNP and 6 min walking test were compared between two groups before and after treatment. Results The total effective rate was 88.4 % in treatment group. the plasma NT-proBNP level decreased significantly, the left ventricular diastolic diameter decreased, the LVEF increased, and the 6 min walking distance increased, all of which were significantly better than the control group. The difference was statistically significant(P < 0.01 or P < 0.05). Conclusion The efficacy of Qishen Yiqi gutta pills is significant in CHF patients, which can improve heart function, activity endurance and quality of life.
引文
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[10]黄健莹,梁健健,陈振宇.黄芪皂苷对慢性心衰大鼠心室重塑及血浆脑钠肽水平的影响[J].广东药学院学报,2014,30(4):479-481.
[11]蒋洪强,张金国,谭洪勇.黄芪甲苷对慢性心力衰竭大鼠心肌纤维化和结缔组织生长因子表达的影响[J].中国循环杂志,2016,31(2):165-169.
[12]张智萃,郭利平.芪参益气滴丸临床应用及实验研究[J].吉林中医药,2012,32(5):514-518.
[13]李国林,姜雪,王霞.黄芪注射液治疗慢性心力衰竭[J].长春中医药大学学报,2014,30(12):280-282.
[14]Tong JY,Xu YJ,Bian YP,et al.Effect and mechanism of Qishen Yiqi Pills on adriamycin-induced cardiomyopathy in mice[J].Chin J Nat Med,2013,11(5):514-518.
[15]高妮娜,李丽.黄芪调节免疫功能的应用研究[J].长春中医药大学学报,2008,24(6):671-671.
[16]曲凤,邢冬梅,郑文科,等.芪参益气滴丸治疗缺血性心力衰竭的系统评价[J].中国实验方剂学杂志,2014,20(3):213-218.
[17]Li YC,Liu YY,Hu BH,et al.Attenuating effect of posttreatment with QiShen YiQi Pills on myocardial fibrosis in rat cardiac hypertrophy[J].Clin Hemorheol Microcirc,2012,51(3):177-191.
[18]张晓群,张红斌.曲美他嗪联合芪参益气滴丸治疗慢性心力衰竭的临床疗效及对血浆BNP、AngII、ALD水平的影响[J].中国循证心血管医学杂志,2017,9(6):705-708.
[19]田野,顾健霞.芪参益气滴丸治疗冠心病心力衰竭的Meta分析.中国中医急症,2016,25(9):1725-1727.
[20]张晓颖,魏万林,束长城,等.芪参益气滴丸对肾性高血压大鼠心肌钙调节蛋白激酶Ⅱ的影响[J].中华医学杂志,2013,93(6):469-473.
[21]张长江,李元红.血浆NT-proBNP联合6 min步行试验法在慢性心力衰竭诊断中的应用价值[J].中西医结合心脑血管病杂志,2016,14(2):178-179.
[22]邵正斌,戴小华,毛静远,等.芪参益气滴丸对慢性心力衰竭患者心功能及超敏C-反应蛋白的影响[J].中国实验方剂学杂志,2015(15):152-155.
[2]陈灏珠.内科学[M].8版.北京:人民卫生出版社,2013:166-169.
[3]郑立文,刘晨.芪苈强心胶囊对老年慢性心力衰竭患者心功能和NT-proBNP的影响[J].中国老年学杂志,2013,33(15):3739-3740.
[4]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].中华心血管病杂志,2014,42(2):98-122.
[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.
[6]Sirico D,Salzano A,Arcopinto M,et al.Anti remodeling therapy:new strategies and future perspective in post ischemic heart failure part E[J].Monaldi Arch Chest Dis,2014,82(4):195-201.
[7]Straburzyńska-Migaj E,Nessler J,Gruchala M,et al.Sacubitril/valsartan for treatment of chronic heart failure with reduced ejection fraction.Can all patients benefit?A position statement paper of experts of the Heart Failure Working Group of the Polish Cardiac Society[J].Kardiol Pol,2017,75(3):286-293.
[8]冠心病中医临床研究联盟,中国中西医结合学会心血管疾病专业委员会,中华中医药学会心病分会,等.慢性心力衰竭中医诊疗专家共识[J].中医杂志,2014,55(14):1258-1260.
[9]李彬,王永霞,朱明军.慢性心力衰竭的中医药治疗与思考[J].中华中医药杂志,2014,29(6):1913-1915.
[10]黄健莹,梁健健,陈振宇.黄芪皂苷对慢性心衰大鼠心室重塑及血浆脑钠肽水平的影响[J].广东药学院学报,2014,30(4):479-481.
[11]蒋洪强,张金国,谭洪勇.黄芪甲苷对慢性心力衰竭大鼠心肌纤维化和结缔组织生长因子表达的影响[J].中国循环杂志,2016,31(2):165-169.
[12]张智萃,郭利平.芪参益气滴丸临床应用及实验研究[J].吉林中医药,2012,32(5):514-518.
[13]李国林,姜雪,王霞.黄芪注射液治疗慢性心力衰竭[J].长春中医药大学学报,2014,30(12):280-282.
[14]Tong JY,Xu YJ,Bian YP,et al.Effect and mechanism of Qishen Yiqi Pills on adriamycin-induced cardiomyopathy in mice[J].Chin J Nat Med,2013,11(5):514-518.
[15]高妮娜,李丽.黄芪调节免疫功能的应用研究[J].长春中医药大学学报,2008,24(6):671-671.
[16]曲凤,邢冬梅,郑文科,等.芪参益气滴丸治疗缺血性心力衰竭的系统评价[J].中国实验方剂学杂志,2014,20(3):213-218.
[17]Li YC,Liu YY,Hu BH,et al.Attenuating effect of posttreatment with QiShen YiQi Pills on myocardial fibrosis in rat cardiac hypertrophy[J].Clin Hemorheol Microcirc,2012,51(3):177-191.
[18]张晓群,张红斌.曲美他嗪联合芪参益气滴丸治疗慢性心力衰竭的临床疗效及对血浆BNP、AngII、ALD水平的影响[J].中国循证心血管医学杂志,2017,9(6):705-708.
[19]田野,顾健霞.芪参益气滴丸治疗冠心病心力衰竭的Meta分析.中国中医急症,2016,25(9):1725-1727.
[20]张晓颖,魏万林,束长城,等.芪参益气滴丸对肾性高血压大鼠心肌钙调节蛋白激酶Ⅱ的影响[J].中华医学杂志,2013,93(6):469-473.
[21]张长江,李元红.血浆NT-proBNP联合6 min步行试验法在慢性心力衰竭诊断中的应用价值[J].中西医结合心脑血管病杂志,2016,14(2):178-179.
[22]邵正斌,戴小华,毛静远,等.芪参益气滴丸对慢性心力衰竭患者心功能及超敏C-反应蛋白的影响[J].中国实验方剂学杂志,2015(15):152-155.