阿托伐他汀片联合益心舒胶囊治疗冠心病慢性心力衰竭的疗效观察

目的观察阿托伐他汀片联合益心舒胶囊治疗冠心病慢性心力衰竭的临床疗效。方法2010年7月-2012年7月在首都医科大学附属北京安贞医院治疗的93例冠心病慢性心力衰竭患者随机分为治疗组（45例）和对照组（48例）。对照组进行常规治疗包括应用利尿剂、血管紧张素转换酶抑制剂、洋地黄、硝酸酯类和D受体阻滞剂等药物的基础上加用阿托伐他汀片10mg，每晚1次。治疗组口服益心舒胶囊3粒／次，3次／d，其他同对照组，两组均持续治疗6个月。疗程结束后，评价两组的临床疗效及不良反应；采用ELISA法测定治疗前后血浆N末端B型利钠肽原（NT-proBNP）的水平；采用彩色多普勒超声测量治疗前后左心室射血分数（LVEF）及左室舒张末内径（LVEDd）的变化。结果治疗组和对照组的总有效率分别为91．1％、72．9％，两组比较差异有统计学意义（P〈0．05）。治疗后两组患者的LVEF均较治疗前有所增加，治疗组LVEF水平明显高于对照组，且差异有统计学意义（P〈0．05）；治疗后，两组患者的NT-proBNP水平均较治疗前明显下降，且治疗组明显低于对照组（P〈0．05）；两组患者治疗后的LVEDd水平均具有降低趋势，但两组比较差异无统计学意义。结论阿托伐他汀片联合益心舒胶囊治疗冠心病心力衰竭具有良好的治疗作用，疗效确切，值得临床应用。

Curative observation of Atorvastatin Tablet combined with Yixinshu Capsule for treatment of heart failure caused by coronary heart disease

Objective To explore the clinical efficacy of Atorvastatin Tablet combined with Yixinshu Capsule for the treatment of heart failure caused by coronary heart disease. Methods Patients （93 cases） who suffered from the heart failure caused by coronary heart disease in the Beijing Anzhen Hospital of the Capital University of Medical Sciences from July 2010 to July 2012 were randomly divided into treatment （45 cases） and control （48 cases） groups. The patients in the control group were treated with atorvastatin 10 mg once daily after the conventional treatment such as diuretics, angiotensin converting enzyme inhibitor, digitalis, nitrates, and β-blockers. The patients in the treatment group were additionally given Yixinshu Capsule, three capsules each time, three times daily, other treatment was the same as the control group. After the treatment for 6 months, the clinical efficacy and adverse reactions were observed and the ELISA was employed to determine the N-terminal pro-B-type natriuretic peptide （NT-proBNP） level before and after the treatment and color duplex ultrasonography was applied to measure the left ventricular ejection fraction （LVEF） and left ventricular end-diastolic diameter （LVEDd） before and after the treatment to evaluate the improvement of cardiac function. Results The efficiency for the patients both in the treatment and control groups was 91.1% and 72.9% with the significant difference （P〈0.05）. The LVEF level before the treatment was significantly higher than that after the treatment in the two groups （P〈0.05）. After the treatment, the NT-proBNP level in the patients of the two groups was obviously improved with significantly difference （P〈0.05）.The LVEDd level was lower after the treatment in the two groups. However, no significant difference was found. Conclusion Atorvastatin Tablet combined with Yixinshu Capsule has a accurate curative effect on the patients with heart failure caused by coronary heart disease, which could be used in clinical treatment.