益心舒胶囊治疗扩张型心肌病并慢性心力衰竭患者的疗效观察

目的评价益心舒胶囊治疗扩张型心肌病并慢性心力衰竭（DCM-CHF）患者的临床疗效。方法将120例DCM-CHF患者随机分为益心舒胶囊治疗组（A组,60例）和对照组（B组,60例）,两组均采用标准的抗慢性心力衰竭药物治疗,包括利尿剂、洋地黄、血管紧张素转换酶抑制剂（ACEI）和血管紧张素II受体阻滞剂（ARB）、β受体阻滞剂及抗血小板聚集药等基础治疗。A组患者在标准的抗慢性心力衰竭药物治疗基础上加用益心舒胶囊（1.2g,每日3次口服）。对患者治疗前及治疗3月后进行心功能分级评定,采用6min步行距离评估患者的活动能力、利用心脏超声评价心脏射血分数、对患者进行生活质量评分,并对患者因心衰急性加重而住院治疗的入院率进行比较。结果经3月治疗后,两组患者的总有效率无统计学差异,但治疗组患者略高于对照组（81%vs 75.4%,P〉0.05）。两组患者治疗后心功能、活动能力、生活质量评分、心脏射血分数均较治疗前有明显改善,但加用益心舒胶囊治疗组患者的6min步行距离（530.6±105.8 vs 487.5±110.6,P〈0.05）及生活质量评分（11.5±12.4vs 21.5±12.4,P〈0.05）明显优于对照组,加用益心舒胶囊治疗组患者因心衰而住院的比率低于对照组（6.9%vs 14%,P〈0.05）。两组安全性指标比较无统计学差异。结论在标准的抗慢性心力衰竭药物治疗基础上加用益心舒胶囊有助于改善扩张型心肌病并慢性心力衰竭患者的活动能力,提高生活质量。

Efficacy of Yixinshu Capsule on Patients with Dilated Cardiomyopathy and Chronic Congestive Heart Failure

Objective To evaluate the efficacy of Yixinshu Capsule on patients with dilated cardiomyopathy and chronic congestive heart failure.Methods 120 cases of patients with dilated cardiomyopathy and chronic congestive heart failure were divided randomly into 2groups：Treatment Group（n=60）,treated with routine anti-heart failure therapy（including diuretic agent,digitalis,angiotensin converting enzyme inhibitor,angiotensin II receptor blocker,β receptor blocker and platelet aggregation inhibitor） alone,and Treatment Group（n=60）,treated with routine treatment plus Yixinshu capsule（1.2g/time,orally,3 times per day） for three months.The cardiac function was evaluated with NYHA functional class and left ventricular ejection fraction（LVEF）measured with ultrasonic cardiogram,exercise capacity was assessed with 6 minute walk test（6MWT）,quality of life were evaluated using the Minnesota Living with Heart Failure Questionnaire（MLHFQ）.Results After 3 months of therapy,the total effective rate in treatment group was superior to that in control group, but without significant difference（81%,75.4%,χ2=15.48,P〈0.05）.The cardiac function,exercise activity,scores of MLHFQ,LVEF were improved in the two groups,but the exercise capacity and the quality of life of the treatment group of patients were better than that of the control group（6MWT：530.6±105.8 vs 487.5±110.6,P〈0.05;MLHFQ：11.5±12.4 vs 21.5±12.4,P〈0.05）.There were more patients in control group who needed to be in hospital than that in treatment group（6.9% vs 14%,P〈0.05）.Conclusion On the basis of routine antiheart failure therapy,Yixinshu capsule makes for improving the exercise capacity and quality of life of patients with dilated cardiomyopathy combined with chronic congestive heart failure.