芪苈强心胶囊联合重组人脑利钠肽治疗扩张型心肌病心力衰竭的临床研究

目的探讨芪苈强心胶囊联合重组人脑利钠肽治疗扩张型心肌病心力衰竭的临床疗效。方法选取2014年12月—2016年11月在延安市人民医院住院的扩张型心肌病心力衰竭患者85例,随机分为对照组(42例)和治疗组(43例)。对照组静脉泵入冻干重组人脑利钠肽1.5μg/kg,1 h后按7.5 ng/(kg·min~(-1))持续泵入,72 h后给予常规治疗。治疗组患者在对照组治疗基础上口服芪苈强心胶囊,4粒/次,3次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组治疗前后临床指标、心功能指标、B型脑钠肽(BNP)、高敏C反应蛋白(hs-CRP)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为78.57%、90.69%,两组比较差异具有统计学意义(P0.05)。治疗后,两组心率、左室舒张末期内径(LVEDd)、收缩末期内径(LVESD)、BNP、hs-CRP水平均显著降低,6 min步行距离、左心室射血分数(LVEF)显著升高,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组心率、LVEDd、LVESD、BNP、hs-CRP水平低于对照组,6 min步行距离、LVEF高于对照组,两组比较差异具有统计学意义(P0.05)。结论芪苈强心胶囊联合重组人脑利钠肽治疗扩张型心肌病心力衰竭患者具有较好的临床疗效,可显著改善患者的临床症状和心功能指标,降低BNP、hs-CRP水平,具有一定的临床推广应用价值。

Clinical study on Qili Qiangxin Capsules combined with recombinant human brain natriuretic peptide in treatment of dilated cardiomyopathy with heart failure

Objective To observe the clinical efficacy of Qili Qiangxin Capsules combined with recombinant human brain natriuretic peptide in treatment of dilated cardiomyopathy with heart failure. Methods Patients (85 cases) with dilated cardiomyopathy with heart failure in Yan'an People's Hospital from December 2014 to November 2016 were randomly divided into control (42 cases) and treatment (43 cases) groups. Patients in the control group were intravenous pumping with Lyophilized Recombinant Human Brain Natriuretic Peptide1.5 μg/kg, then 7.5 ng/(kg·min?1) continuously pump after 1 h, and they were given routine treatment after 72 h. Patients in the treatment group were po administered with Qili Qiangxin Capsules on the basis of the control group,4 grains/time,three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of clinical indicators, cardiac function indexes, BNP, and hs-CRP in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 78.57% and 90.69%, respectively, and there were differences between two groups (P <0.05). After treatment, heart rate, LVEDd, LVESD, BNP, and hs-CRP levels were significantly reduced, but 6 min walking distance and LVEF were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, heart rate, LVEDd, LVESD, BNP, and hs- CRP in the treatment group were lower than those in the control group, but 6 min walking distance and LVEF were higher than those in the control group, and there was difference between two groups (P < 0.05). Conclusion Qili Qiangxin Capsules combined with recombinant human brain natriuretic peptide has a significant effect in treatment of dilated cardiomyopathy with heart failure, and can significantly improve the clinical symptoms and cardiac function indexes of patients, also can reduce the levels of BNP and hs-CRP, which has a certain clinical application value.