充血性心力衰竭的中医药研究进展

中医药在治疗心衰方面有着毒副作用小、疗效好持久等难以替代的优势,近些年随着实验、临床研究不断深入及中药新剂型的出现,大大丰富了中医药疗心衰的手段。     

葛根素联合卡托普利治疗对充血性心力衰竭患者心功能的影响

目的观察葛根素联合卡托普利治疗充血性心力衰竭(CHF)的临床疗效。方法将90例CHF患者随机分为两组,对照组采用常规治疗,治疗组在对照组常规治疗的基础上加用葛根素注射液300mg静脉滴注,同时口服卡托普利25mg,一日3次。观察两组用药前后心率(HR)变化,用超声显像仪检测两组射血分数(LVEF)、每搏量(SV)、心排血量(CO)。结果治疗组总有效率为88.9%,对照组总有效率为68.9%,两组比较,差异有统计学意义(P0.05)。治疗组治疗后SV、CO、LVEF明显升高,HR明显降低,两组比较,差异有统计学意义(P0.05)。结论葛根素联合卡托普利治疗充血性心力衰竭可明显改善患者心功能。     

Effects of KATP channel openers diazoxide and pinacidil in coronary-perfused atria and ventricles from failing and non-failing human hearts

This study compared the effects of ATP-regulated potassium channel (K_ATP) openers, diazoxide and pinacidil, on diseased and normal human atria and ventricles. We optically mapped the endocardium of coronary-perfused right (n = 11) or left (n = 2) posterior atrial-ventricular free wall preparations from human hearts with congestive heart failure (CHF, n = 8) and non-failing human hearts without (NF, n = 3) or with (INF, n = 2) infarction. We also analyzed the mRNA expression of the K_ATP targets K_ir6.1, K_ir6.2, SUR1, and SUR2 in the left atria and ventricles of NF (n = 8) and CHF (n = 4) hearts. In both CHF and INF hearts, diazoxide significantly decreased action potential durations (APDs) in atria (by − 21 ± 3% and − 27 ± 13%, p < 0.01) and ventricles (by − 28 ± 7% and − 28 ± 4%, p < 0.01). Diazoxide did not change APD (0 ± 5%) in NF atria. Pinacidil significantly decreased APDs in both atria (− 46 to −80%, p < 0.01) and ventricles (− 65 to − 93%, p < 0.01) in all hearts studied. The effect of pinacidil on APD was significantly higher than that of diazoxide in both atria and ventricles of all groups (p < 0.05). During pinacidil perfusion, burst pacing induced flutter/fibrillation in all atrial and ventricular preparations with dominant frequencies of 14.4 ± 6.1 Hz and 17.5 ± 5.1 Hz, respectively. Glibenclamide (10 μM) terminated these arrhythmias and restored APDs to control values. Relative mRNA expression levels of K_ATP targets were correlated to functional observations. Remodeling in response to CHF and/or previous infarct potentiated diazoxide-induced APD shortening. The activation of atrial and ventricular K_ATP channels enhances arrhythmogenicity, suggesting that such activation may contribute to reentrant arrhythmias in ischemic hearts.     

比索洛尔与地高辛合用对慢性心衰患者的影响

目的研究比索洛尔与地高辛合用对慢性心力衰竭（CHF）的疗效。方法100例CHF患者随机分为观察组和对照组,每组50例。对照组以常规抗心力衰竭药和地高辛0．25mg治疗;观察组在常规抗心力衰竭药基础上予地高辛0．125mg和比索洛尔1．25mg治疗。两组疗程均为4个月,观察两组有效率与左室射血分数（LVEF）。结果观察组治疗总有效率达96％,对照组治疗总有效率为80％,两组比较差异有统计学意义（P〈0．05）。结论小剂量比索洛尔与小剂量地高辛合用是治疗CHF有效药物。     

心衰慢性病管理的中西医研究进展

慢性心衰作为现代医学中最难攻克的难题之一,是心血管疾病的重要致死原因,在全球医疗支出中占据着极大的比例,慢性心力衰竭病人的诊治进行系统的管理可有效的改善患者生活质量,削减医疗开支。慢性心衰的疾病管理的开展已取得一定成效,但以中医特色思想为理念的管理模式,目前国内只有较少中医医院在开展探索性实践,该文综述中西医结合慢性心衰疾病研究的必要性及其国内外研究的进展。     

穴位注射治疗慢性充血性心力衰竭31例疗效观察

目的：观察穴位注射治疗慢性充血性心力衰竭（CHF）的临床疗效。方法：将62例CHF患者随机分为治疗组与对照组,每组各31例,两组均予西医常规治疗,治疗组加用穴位注射,疗程均为14d;比较治疗前后两组临床症状、体征及心功能。结果：治疗组疗效优于对照组。结论：在常规西医治疗基础上加用穴位注射治疗CHF疗效满意。