通心络胶囊联合依那普利治疗扩张型心肌病的临床研究

目的探讨通心络胶囊联合依那普利治疗扩张型心肌病的临床效果。方法选取2015年10月—2018年10月辽宁省人民医院收治的88例扩张型心肌病患者,随机分成对照组和治疗组,每组各44例。对照组口服马来酸依那普利片,起始剂量2.5 mg/次,2次/d;而后每隔1周增加2.5 mg/次,直至维持剂量10 mg/次,2次/d。治疗组在对照组基础上饭后口服通心络胶囊,3粒/次,3次/d。两组均连续治疗8周。观察两组的临床疗效,比较两组治疗前后主要症状积分、超声心动图指标、血清学指标的变化情况。结果治疗后,对照组和治疗组的总有效率分别是75.0%、90.9%,两组比较差异具有统计学意义(P0.05)。治疗后,两组心悸积分、气短积分、疲倦乏力积分、面肢浮肿积分、胸闷(痛)积分均较治疗前显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组这些症状积分均显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组左室射血分数(LVEF)、左室短轴缩短率(LVFS)、左室心输出量(LVCO)值均显著增高,而左心室舒张末内径(LVEDd)均显著减小,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组LVEF、LVFS、LVCO值高于对照组,而LVEDd值低于对照组,两组比较差异具有统计学意义。治疗后,两组肌钙蛋白I(cTnI)、B型利钠肽(BNP)、内皮素(ET)、一氧化氮(NO)、C反应蛋白(CRP)水平较治疗前显著下降,而超氧化物歧化酶(SOD)水平均显著上升,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组cTnI、BNP、ET、NO、CRP水平低于对照组,而SOD水平高于对照组,两组比较差异具有统计学意义(P0.05)。结论通心络胶囊联合依那普利治疗扩张型心肌病具有较好的临床疗效,能明显改善患者症状,保护心功能,减轻炎性损伤,具有一定的临床推广应用价值。

Clinical study on Tongxinluo Capsules combined with enalapril in treatment of dilated cardiomyopathy

Objective To investigate the clinical effect of Tongxinluo Capsules combined with enalapril in treatment of dilated cardiomyopathy.Methods Patients (88 cases) with dilated cardiomyopathy in Liaoning People''s Hospital from October 2015 to October 2018 were randomly divided into control (44 cases) and treatment (44 cases) groups. Patients in the control group were po administered with Enalapril Maleate Tablets, the initial dosage was 2.5 mg/time and twice daily. Then the dosage was increased by 2.5 mg/time every other week until the maintenance dosage was 10 mg/time and twice daily. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the changes of main symptom integral, echocardiographic parameters, and serological indicators in two groups before and after treatment were compared.Results After treatment, the clinical efficacy in the control and treatment groups were 75.0% and 90.9%, respectively, and there were differences between two groups (P<0.05). After treatment, the scores of palpitation, breath shortness, tired weakness, surface limb edema, and chest tightness (pain) in two groups were significantly lower than those before treatment, and the difference was statistically significant in the same group (P<0.05), and these symptoms integrals in the treatment group were significantly lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, LVEF, LVFS, and LVCO in the two groups were significantly increased, but LVEDd was significantly decreased, and there were differences in the same group (P<0.05). After treatment, LVEF, LVFS, and LVCO in the treatment group were higher than those in the control group, but LVEDd was significantly lower than that in the control group, and there were differences between two groups (P<0.05). After treatment, cTnI, BNP, ET, NO, and CRP in the two groups were significantly decreased, but SOD was significantly increased, and there were differences in the same group (P<0.05). After treatment, cTnI, BNP, ET, NO, and CRP in the treatment group were lower than those in the control group, but SOD was significantly higher than that in the control group, and there were differences between two groups (P<0.05).Conclusion Tongxinluo Capsules combined with enalapril has significant effect in treatment of dilated cardiomyopathy, and can significantly improve the symptoms, and protect cardiac function, and can also reduce inflammatory injury, which has a certain clinical application value.