保心合剂对慢性心力衰竭患者血浆脑钠肽及心功能的影响

Effect of Baoxinheji(保心合剂) on plasma brain natrium peptide and cardiac function in patients with chronic heart failure

目的观察保心合剂对慢性心力衰竭患者的临床疗效以及对心功能、脑钠肽(BNP)的影响。方法将60例慢性心力衰竭患者随机分为治疗组和对照组,每组30例。对照组单纯使用西药治疗;治疗组在使用西药的基础上加服保心合剂,疗程4周。观察治疗前后疗效、心功能改善情况,并检测血浆BNP含量。结果治疗组总有效率明显优于对照组(86.7%比70.0%,P<0.05)。两组均可改善左室舒缩功能,其中治疗组在改善左室射血分数(LVEF,0.626±0.157比0.502±0.128)、每搏量〔SV,(59.80±12.90)m l比(52.20±16.55)m l〕方面与对照组比较差异有统计学意义(P均<0.05)。两组治疗后血浆BNP水平均较治疗前显著降低〔对照组(243.3±30.4)ng/L比(579.8±48.1)ng/L,治疗组(228.6±47.8)ng/L比(560.8±55.2)ng/L,P均<0.05〕;治疗组治疗后虽较对照组明显降低,但两组比较差异无统计学意义(P>0.05)。结论BNP可以作为判断心力衰竭严重程度的指标之一;保心合剂治疗慢性心力衰竭疗效确切,值得进一步推广。

Objective To observe the clinical therapeutic effect of Baoxinheji （保心合剂） and its influence on cardiac function and plasma brain natrium peptide （BNP） in patients with chronic congestive heart failure. Methods Sixty patients of chronic congestive heart failure were randomly divided into two groups： the control group （only treated with western medicine for 4 weeks, n=30） and the treatment group （treated with Baoxinheji as well as western medicine for 4 weeks, n=30）. The curative effect, cardiac function and plasma level of BNP in all the patients were observed before and after the treatment. Results The total therapeutic effective rate in treatment group was better than that in control group （86.7% vs. 70.0%, P〈0. 05）. After treatment, the systolic and diastolic function of the left ventricle in both groups could be improved, and there were significant differences in left ventricular ejection fraction （LVEF, 0. 626±0. 157 vs. 0.502±0.128） and stroke volume [SV,（59.80±12.90） ml vs. （52.20±16.55）ml] between the two groups （both P〈 0.05）. After treatment, the plasma BNP levels were significantly decreased in both groups [the control group： （243.3±30.4）ng/L vs. （579.8±48.1） ng/L, the treatment group：（228. 6±47. 8） ng/L vs. （560.84±55.2） ng/L, both P〈0. 05]; BNP level after treatment in the treatment group was lower than that in the control group, but there was no obvious difference between the two groups （P〉0.05）. Conclusion BNP can be regarded as one of the indexes for the diagnosis of severe degree of the patients with chronic congestive heart failure; Baoxinheji has a definite effect on the patients and can be used extensively.