地高辛片联合益气复脉治疗慢性心力衰竭的疗效观察

目的观察地高辛片联合益气复脉治疗慢性心力衰竭的临床疗效。方法选取于2012年12月-2013年12月来上海市东方医院诊疗的慢性心力衰竭患者64例,随机分为对照组（29例）和治疗组（35例）。对照组在一般基础治疗的基础上口服地高辛片0.125 mg/次,1次/d。治疗组在对照组基础上加用注射用益气复脉（冻干）3.9 g加入5%葡萄糖注射液或0.9%氯化钠注射液250 mL静脉点滴,1次/d。两组均治疗14 d。治疗结束后对两组患者的临床疗效、N-末端脑钠肽前体（NT-proBNP）和心功能指标进行比较分析。结果治疗后,治疗组和对照组的总有效率分别为97.14%、89.66%,两组比较差异有统计学意义（P〈0.05）。两组治疗后血浆NT-proBNP水平均较治疗前有所降低,治疗前后差异有统计学意义（P〈0.05）。治疗后,治疗组血浆NT-proBNP水平明显低于对照组,两组比较差异有统计学意义（P〈0.05）。治疗后,两组心功能指标左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）均较治疗前明显降低,心室射血分数（LVEF）、舒张早期/舒张晚期二尖瓣血流速度（E/A）及心输出量（CO）均较治疗前明显升高（P〈0.05、0.01）;但治疗组对改善患者LVEDD、LVESD、LVEF、E/A及CO方面明显优于对照组,两组比较差异有统计学意义（P〈0.05,0.01）。结论在地高辛治疗基础上加用益气复脉治疗慢性心力衰竭可较好的改善患者的临床症状和心功能状况,对患者肝肾功能未产生明显不良反应,值得临床推广应用。

Clinical observation of Digaoxin Tablet combined with Yiqi Fumai in treatment of chronic heart failure

Objective To evaluate the clinical efficacy of Digaoxin Tablet combined with Yiqi Fumai in the treatment of chronic heart failure. Methods Sixty-four hospitalized patients with chronic heart failure were randomly divided into treament （n = 29） and control （n = 35） groups. The Digaoxin Tablet was given to the patients in both groups, 0.125 rag/d, 14 d for a period of treatment. And Yiqi Fumai Injection was given additionally to patients in the treatment group, 3.9 g Yiqi Fumai added in 250 mL of normal saline or 5% glucose injection for iv drippiing, once daily. The treatment cycle was 14 d. After the treatment, the clinical efficacy, NT-proBNP level and cardiac function indices were analyzed. Result After treatment, the effective rates in the treat and control groups were 97.14% and 89.66%, respectively, with obvious differences （P 〈 0.05）. Compared with those before treatment, the reduce of NT-proBNP in the treatment group was more significantly than that of the control group （P 〈 0.05）, and the left ventricular enddistolic diameter （LVEDD）, left ventricular and systolic diameter （LVESD）, left ventricular ejection fraction （LVEF）, cardiac output （CO）, and ratio of early diastolic transmitral inflow velocity to late diastolic transmitral inflow velocity （E/A） were improved obviously in both groups. However, these indices in the treatment group were better improved than those in the control group （P 〈 0.05, 0.01）. Conclusion The Digaoxin Tablet therapy combined with traditional Chinese medicine Yiqi Fumai for the treatment of chronic heart failure can better improve the clinical symptoms, cardiac function, and quality of life of the patients with chronic heart failure with no significant impact on liver and kidney functions. Yiqi Fumai is worthy of clinical application.