参附注射液联合比索洛尔治疗慢性心力衰竭的临床研究

目的探讨参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭的临床疗效。方法选取2015年9月—2016年8月在成都体育学院附属体育医院收治的慢性心力衰竭患者106例作为研究对象,根据随机数字表法将患者分为对照组和治疗组,每组各53例。对照组口服富马酸比索洛尔片,5 mg/次,1次/d。治疗组在对照组治疗的基础上静脉滴注参附注射液,30 m L加入到5%葡萄糖注射液中,300 m L/次,1次/d。两组均连续治疗4周。观察两组患者的临床疗效,比较两组的明尼苏达心力衰竭生活质量量表(MLHFQ)评分、6 min步行试验(6WMT)、心功能指标和血清学指标。结果治疗后,对照组和治疗组的总有效率分别为71.70%、94.34%,两组比较差异有统计学意义(P0.05)。治疗后,两组MLHFQ评分明显降低,6WMT距离均显著增加,同组治疗前后比较差异有统计学意义(P0.05);且治疗组治疗后MLHFQ评分和6WMT距离显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)显著降低,左心室射血分数(LVEF)显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组治疗后心功能指标明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清N末端脑钠肽(NT-pro BNP)、同型半胱氨酸(HCY)、血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组血清学指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论参附注射液联合富马酸比索洛尔片治疗慢性心力衰竭患者的疗效显著,能够改善患者的生活质量,提高运动耐量,有效防治心肌损害的进一步加重,且安全可靠,具有一定的临床推广应用价值。

Clinical study on Shenfu Injection combined with bisoprolol in treatment of chronic heart failure

Objective To investigate the clinical efficacy of Shenfu Injection combined with Bisoprolol Fumarate Tablets in treatment of chronic heart failure. Methods Patients (106 cases) with chronic heart failure in the Sports Hospital Attached to CDSU from September 2015 to August 2016 were randomly divided into control and treatment groups, and each group had 53 cases. Patients in the control group were po administered with Bisoprolol Fumarate Tablets, 5 mg/time, once daily. Patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group, 30 mL added into 5% glucose solution, 300 mL/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and MLHFQ scores, 6WMT, cardiac function indexes, and the serological indexes in two group were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.70% and 94.34%, respectively, and there was difference between two groups (P < 0.05). After treatment, the MLHFQ scores in two groups were significantly decreased, but the distance of 6WMT in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And MLHFQ scores and distance of 6WMT in the treatment group was significantly better than that in the control group, with significant difference between two groups (P < 0.05). After treatment, LVEDD and LVESD in two groups were significantly decreased, but LVEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group,with significant difference between two groups (P < 0.05). After treatment, NT-proBNP, HCY, CRP, and IL-6 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the serological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shenfu Injection combined with Bisoprolol Fumarate Tablets has clinical curative effect in treatment of chronic heart failure, can effectively improve the quality of life and the exercise tolerance of patients, prevent the further aggravation of myocardial injury, with good safety, which has a certain clinical application value.