生脉饮联合琥珀酸美托洛尔治疗老年慢性充血性心力衰竭的临床研究

目的探讨生脉饮联合琥珀酸美托洛尔治疗老年慢性充血性心力衰竭的可行性。方法回顾性分析2007年12月至2011年12月汉中市人民医院收治的120例老年慢性充血性心力衰竭患者的临床资料,将其按照随机数表法分为琥珀酸美托洛尔缓释片组与加用生脉饮组两组,琥珀酸美托洛尔缓释片组(n=60)给予琥珀酸美托洛尔缓释片,从小剂量12 mg开始,每日1次,早饭后服用,至第6日时递增1次剂量,每次增量5.90 mg,仍每日口服1次,可耐受最大量为190 mg/d;加用生脉饮组(n=60)在此基础上加用生脉饮,每次10 mL,每日2次。琥珀酸美托洛尔缓释片对比两组治疗的临床疗效及指标。结果 1加用生脉饮组治疗的总有效率96.7%(58/60)]显著地优于琥珀酸美托洛尔缓释片组81.7%(49/60)](P<0.05);2加用生脉饮组较琥珀酸美托洛尔缓释片组治疗后的左心室射血分数(47.6±9.7)%vs(41.4±8.3)%]、左心室舒张期末内径(52.8±6.7)mm vs(61.9±5.6)mm]、心率(81.5±7.8)次/min vs(93.2±10.6)次/min]、室性期前收缩(33.9±3.8)次/min vs(44.0±3.9)次/min]以及房性期前收缩(44.3±3.9)次/min vs(38.0±3.7)次/min],具有统计学差异(P<0.05)。结论将生脉饮联合琥珀酸美托洛尔治疗老年慢性充血性心力衰竭,其临床效果尤佳,建议临床推广应用。

Clinical Study of Shengmai Decoction Combined with Metoprolol in Treating Elderly Patients with Chronic Congestive Heart Failure

Objective To investigate the feasibility of Shengmai decoction combined with metoprolol in treating elderly patients with chronic congestive heart failure. Methods The clinical data of 120 eases of senile patients with chronic congestive heart failure admitted in Hanzhoung City People＇s Hospital from Dec. 2007 to Dec. 2011 were retrospectively analyzed ,and aeeording to the random number table, the eases were divided into metoprolol group（ treated with metoprolol sueeinate sustained-release tablets） and the eombination group （ treated with metoprelol combined with Shengmai decoction）. Patients in the metoprolol group （ n = 60 ） were given metoprolol suecinate sustained-release tablets, began from 12mg at a time, 1 time/day, taken after breakfast,an increment of 5.90 mg wereas added every sixth day, still orally 1 time/day, to the maximum tolerated dose of 190 mg/d;patients in the combination group （n = 60） were given extra Shengmai decoction, 10 mL each time,2 times/day. The clinical curative effeet and related indexes of the two groups were compared. Results ①The total effective rate of the combination group was 96.7 % （ 58/60 ）, significandy higher than 81.7% （49/60） of the metoprolol group, the difference was statistically significant （P 〈 0.05 ） ; ②The left ventrieular ejection fractions of the combination group and the metoprolol group after treat- ment were （47.6 ± 9.7） % vs （41.4 ± 8.3 ） % ], left ventrieular end diastolic diameters were （ 52.8 ±6.7） mmvs（61.9 ±5.6） mini,heart rateswere（81.5 ±7.8） BPM vs （93.2±10. 6）BPM],room extrasystole frequencies were （33.9 ±3.8） BPM vs （44.0 ±3.9） BPM] and atrial extrasystoles frequencies were （44.3 ±3.9 ） BPM vs （ 38.0 ±3.7 ） BPM ], all with significant statistical differences （ P 〈 0.05 ）. Conclusion The clinical effect of Shengmai decoction eombined with metoprolol in treating elderly patients with chronic congestive heart failure is remarkable, therefore, should be w