参附注射液联合多巴胺治疗慢性心力衰竭合并低血压的疗效观察

目的观察参附注射液联合多巴胺治疗慢性心力衰竭合并低血压的疗效。方法将68例慢性心力衰竭合并低血压患者随机分为对照组38例和治疗组30例。两组除未给ACEI／ARB、β2-肾上腺素受体阻断剂及硝酸盐类药物外，均给予常规抗心力衰竭＋多巴胺升压治疗。治疗组在常规抗心力衰竭＋多巴胺治疗基础上，加参附注射液静滴。结果治疗组升压、稳压作用的总有效率明显高于对照组，差异有统计学意义（P〈0．05）。治疗后，反映心功能的左室射血分数（EF）、每搏量（SV）、每分排血量（CO）两组均增加，治疗组改善更明显（P〈0．05）；反映心力衰竭疗效的指标脑钠肽（BNP）两组均下降（P〈0．05），治疗组下降较对照组明显（P〈0．05）；反映炎性反应的C反应蛋白（CRP）仅治疗组下降（P〈O．05）。多巴胺的累积量治疗组较对照组明显减少（P〈0．05），且心律失常发生率低（P〈0．05）；开始使用ACEI／ARB、Br肾上腺素受体阻断剂的间隔时间、住CCU的时间治疗组较对照组明显缩短（P〈0，05）。治疗后对照组心率明显增快（P〈0．05），而治疗组则变化不明显（P=0．65）。结论参附注射液联合多巴胺治疗慢性心力衰竭合并低血压，优势互补，升压、稳压作用显著，减少了多巴胺的用量，缩短了住CCU时间，为后续治疗（使用ACEI／ARB、8厂肾上腺素受体阻断剂、硝酸盐类药物及可能的血管重建）创造了条件，提高临床疗效，改善了预后，值得在临床上推广。

The clinical efficacy of Shenfu injection combine with Dopamine in treatment of chronic heart failure with hypotension

Objective To observe the clinical efficacy of combination therapy（Shenfu Injection Combined with Dopamine） in treatment of chronic heart failure with hypotension. Methods 68 cases of patients with chronic heart failure and hypotensimi were randomly divided into two groups, and both of groups did not administer ACEI/ ARB, Beta 2-adrenergic receptor blockers, nitrate drugs. Control group was given Dopamine treatment, the treatment group was given with Shenfu Injection combined with Dopamine. The total effective rate, blood press, heart rate, cumulative dose of dopamine, intervals of starting ACEI/ARB, Beta 2-adrenergic receptor blockers, cardiac arrhythmia incidence, the days in the CCU after treatment and level of LVEF, SV, CO, BNP, CRP, liver and kidney function renal function were compared before and after treatment. Results The blood pressure of the treating group was more higher and stable than that of control group. The total effective rate of the control group was significantly lower than the treatment group （P〈0.05）. The days in the CCU and intervals of starting ACEI/ ARB, Beta 2-adrenergic receptor blockers in the treatment group was shorter than that of the control group （P〈 0.05）. Echocardiographic indices（EF, SV, CO） were significantly increased（P〈0.05） and level of BNP decreased more markedly in the treating group than that of the control group （P〈0.05）, but CRP only decreased in the treatment group （P〈0.05）. Cardiac arrhythmia incidence in the treating group was more lower than that of the control group（P〈0.05 ）. Heart rate in the control group was more increased than before treatment（P〈0.05 ）, but in the treatment group there was no significance than before treatment （P=0.65）. Conclusion Shenfu injection combined with dopamine in the treatment of chronic heart failure with hypotension shows complementary advantages in elevating and stablizing blood press, significantly reducing the dose of dopamine, and improving the clinical outcomes, it is worth in clinical practice.