芪苈强心胶囊治疗慢性心力衰竭的效果及对神经内分泌激素和心室重构的影响

Effect of Astragalus Membranaceus Heart Capsule in the Treatment of Chronic Heart Failure and Its Effect on Neuroendocrine Hormones and Ventricular Remodeling

目的探讨芪苈强心胶囊治疗慢性心力衰竭(CHF)的效果及对神经内分泌激素和心室重构的影响.方法选取2020年1月—2021年1月宜春市人民医院收治的110例CHF患者为研究对象,随机分为常规组(n=55)和中药组(n=55).常规组进行常规抗CHF治疗,中药组在常规组基础上加用芪苈强心胶囊,两组均连续治疗12个月.比较两组治疗效果,神经内分泌激素水平和超声心动图.结果中药组治疗总有效率为87.27%,高于常规组的69.09%,差异有统计学意义(P<0.05).治疗后,中药组血浆N末端脑钠肽前体、血管紧张素Ⅱ和内皮素-1水平均低于常规组,组间差异有统计学意义(P<0.05).治疗后,中药组左心室舒张末期内径、左心室收缩末期内径均短于常规组,左心室舒张末期容积、左心室收缩末期容积均小于常规组,左心室射血分数高于常规组,组间差异有统计学意义(P<0.05).两组不良反应发生率比较,组间差异无统计学意义(P>0.05).结论芪苈强心胶囊能提高CHF的治疗效果,调节神经内分泌激素水平和改善心室重构,且安全性较高.

Objective To investigate the effect of Astragalus membranaceus heart capsules in the treatment of chronic heart failure(CHF)and the effect on neuroendocrine hormones and ventricular remodeling.Methods 110 patients with CHF admitted to Yichun People's Hospital from January 2020 to January 2021 were selected for the study and randomly divided into the conventional group(n=55)and the traditional Chinese medicine group(n=55).The conventional group underwent conventional anti-CHF treatment,and the Chinese medicine group added Astragalus membranaceus heart capsule to the conventional group,and both groups were treated continuously for 12 months.The treatment effect,neuroendocrine hormone level and echocardiogram were compared between the two groups.Results The total effective rate of treatment in the Chinese medicine group was 87.27%,which was higher than 69.09%in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the plasma N-terminal brain natriuretic peptide precursor,angiotensin II and endothelin-1 levels in the Chinese medicine group were lower than those in the conventional group,and the differences between the groups were statistically significant(P<0.05).After treatment,the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter in the Chinese medicine group were shorter than those in the conventional group,the left ventricular end-diastolic volume and left ventricular end-systolic volume were smaller than those in the conventional group,and the left ventricular ejection fraction was higher than that in the conventional group,and the differences between the groups were statistically significant(P<0.05).There was no statistically significant difference between the two groups when comparing the incidence of adverse reactions(P>0.05).Conclusion Astragalus membranaceus heart capsule can improve the therapeutic effect of CHF,regulate neuroendocrine hormone levels and improve ventricular remodeling,with a high safety profile.