中西医结合治疗顽固性心力衰竭患者的应用研究

目的探讨参松养心胶囊与重组人脑钠利肽在顽固性心力衰竭（以下简称心衰）患者中的联合应用价值。方法选取2013 年1 月-2014 年12 月南阳医学高等专科学校第一附属医院收治的顽固性心衰患者86例，分为治疗组和对照组各43 例。对照组采用重组人脑利钠肽的临床药物治疗，治疗组在对照组治疗的基础之上加用参松养心胶囊的药物联合治疗，分别比较两组顽固性心衰患者的临床治疗效果。结果与对照组相比，治疗组临床治疗的总有效率（93.02%）提升，而无效率则（6.98%）减少，经过统计学处理，差异均具有统计学意义（p <0.05）；治疗组左室收缩末期内径（LVESD）（32.43±4.05）mm、左室舒张末期内径（LVEDD）（47.39±4.09）mm、左室收缩末期容积（LVESV）（66.03±12.09）ml、左室舒张末期容积（LVEDV）（86.41±13.52）ml 均减少，而左室射血分数LVEF（48.64±6.98）%提高，经过统计学处理，差异均具有统计学意义（p <0.05）；治疗组心肌肌钙蛋白I（cTnI）（0.29±0.10）μg/L、超敏C 反应蛋白（hs-CRP）（9.65±3.21）mg/L、N 末端B 型利钠肽原（NT-proBNP）（389.47±113.70）ng/L均降低，经过统计学处理，差异均具有统计学意义（p <0.05）。结论参松养心胶囊与重组人脑钠利肽在顽固性心衰患者的联合治疗过程中，能够积极改善心功能指标，并有效调节神经内分泌因子，从根本上提高临床疗效。

Application study of integrative medicine in treatment of refractory heart failure

Objective To probe into the combined application value of Shensong Yangxin capsules combined with recombinant human brain natriuretic peptide in patients with refractory heart failure. Methods From January 2013 to December 2014, 86 patients with refractory heart failure were selected in our hospital. The patients were divided into treatment group and control group with 43 cases in each group. The refractory heart failure patients in the control group were treated with recombinant human brain natriuretic peptide as clinical drug therapy. Those patients in the treatment group were treated with recombinant human brain natriuretic peptide combined with Shensong Yangxin capsules as clinical drug therapy. The clinical treatment effect was analyzed and compared between the two groups. Results Compared with the control group, the total effective rate was significantly increased (93.02%), the ineffective rate was significantly decreased (6.98%) in the treatment group (p < 0.05). Compared with the control group, the left ventricular end systolic diameter, left ventricular end diastolic diameter, left ventricular end systolic volume and left ventricular end diastolic volume were significantly reduced, while the left ventricular ejection fraction was significantly increased in the treatment group (p < 0.05). Compared with the control group, the cardiac troponin I (cTnI), hypersensitive C-reactive protein (hs-CRP), N-terminal B-type natriuretic peptide prosoma (NTproBNP) were significantly reduced in the treatment group (p < 0.05). Conclusions Shensong Yangxin capsules combined with recombinant human brain natriuretic peptide could actively improve cardiac function, and effectively regulate neuroendocrine factors, and fundamentally improve the clinical efficacy for patients with refractory heart failure.