伊伐布雷定联合芪苈强心胶囊治疗老年缺血性心肌病的临床疗效及对炎症因子水平的影响

Clinical efficacy of ivabradine combined with Qiliqiangxin capsule in the treatment of elderly patients with ischemic cardiomyopathy and its effect on the level of inflammatory factors

目的:探讨伊伐布雷定联合芪苈强心胶囊治疗老年缺血性心肌病的临床疗效及对患者炎症因子水平的影响。方法:选取我院2015年3月~2018年11月老年缺血性心肌病患者42例,随机分为对照组(21例)和观察组(21例),在常规治疗基础上,对照组予以芪苈强心胶囊治疗,观察组予以伊伐布雷定联合芪苈强心胶囊治疗,记录两组患者治疗2周前后24 h心率、血压、6 min步行试验(6MWT)距离、左心室射血分数(LVEF)、氨基末端前脑钠肽(NT-proBNP)及血清炎症因子(hs-CRP、TNF-α、IL-6)水平,比较两组患者不良反应发生情况、3个月内再住院率及病死率。结果:两组患者治疗前后血压比较无统计学差异(P>0.05);治疗2周后,与对照组相比,观察组24 h心率明显降低、6MWT距离明显上升、心功能指标NT-ProBNP、LVEF显著改善,差异有统计学意义(P<0.05);治疗后观察组血清炎症因子(hs-CRP、TNF-α、IL-6)水平明显低于对照组(P<0.05);两组药品不良反应发生情况无明显差异(P>0.05);随访3个月内,观察组再住院率及病死率均显著低于对照组(P<0.05)。结论:伊伐布雷定联合芪苈强心胶囊治疗老年缺血性心肌病临床疗效显著,可改善患者心功能,降低血清炎症因子水平,临床值得推广。

Objective:To investigate the clinical efficacy of ivabradine combined with Qiliqiangxin capsule,a traditional Chinese medicine,in the treatment of elderly patients with ischemic cardiomyopathy and its effect on the level of inflammatory factors.Methods:Forty-two elderly patients with ischemic cardiomyopathy in our hospital from March 2015 to November 2018 were randomly divided into control group(n=21)and combined treatment group(n=21).On the basis of routine treatment,control group was treated with Qiliqiangxin Capsule,while combined treatment group was treated with Ivabradine combined with Qiliqiangxin Capsule.The average heart rate of 24 h,blood pressure,6-minute walking test distance,left ventricular ejection fraction(LVEF),NT-proBNP and serum inflammatory factors(hs-CRP,TNF-α,IL-6)were recorded before and 2 weeks after treatment.The incidence of adverse reactions,re-hospitalization rate and mortality rate within 3 months were compared between the two groups.Results:There was no significant difference in blood pressure between the two groups before and after treatment(P>0.05).After 2 weeks of treatment,compared with that respectively in control group,the average heart rate of 24 h of combined treatment group decreased significantly,the 6-minute walking distance increased significantly,and the cardiac function indices NTproBNP and LVEF improved significantly(all P<0.05);and the levels of serum inflammatory factors(hs-CRP,TNF-α,and IL-6)in combined treatment group were significantly lower than those in control group(all P<0.05).There was no significant difference in adverse drug reactions between the two groups(P>0.05).After 3 months of follow-up,the re-hospitalization rate and fatality rate in combined treatment group were significantly lower than those in control group(P<0.05).Conclusion:Ivabradine combined with Qiliqiangxin Capsule is effective in the treatment of elderly ischemic cardiomyopathy.It can improve patients’cardiac function and reduce the levels of serum inflammatory factors.