丹参注射液和维生素C治疗支气管肺炎合并心力衰竭的疗效观察

Observation on therapeutic efficacy of salvia miltiorrhiza injection and vitamin C on broncho pnenmonia complicated by heart failure

目的：探讨抗心力衰竭（心衰）治疗中保护心肌能量代谢的意义。方法：将１６２例支气管肺炎并心衰患儿，随机分成治疗组与对照组各８１例。对照组应用吸氧、镇静、抗感染及强心剂（西地兰饱和量法）和血管扩张剂治疗。治疗组在以上综合治疗的（１／５西地兰饱和量）基础上，应用大剂量丹参注射液和维生素Ｃ。丹参注射液每次５ｍｌ～１０ｍｌ，维生素Ｃ２００ｍｇ·ｋｇ－１／ｄ～２５０ｍｇ·ｋｇ－１／ｄ。结果：治疗组显效４２例（５１．９％），有效３９例（４８．１％），总有效率１００．０％。对照组显效１８例（２２．２％），有效４８例（５９．３％），无效１５例，总有效率８１．５％，２组比较，Ｐ＜０．０１。２组呼吸频率、心率和肝肿大恢复正常的时间分别为（１．４±０．１）日比（５．１±０．４）日，（１．７±０．２）日比（４．６±０．３）日，（１．３±０．１）日比（７．６±０．７）日，２组疗效比较有极显著性差异（Ｐ均＜０．００１）。结论：清除氧自由基是纠正心肌能量不足的关键，也是抗心衰治疗的前提。丹参注射液与维生素Ｃ协同保护心肌能量代谢，可增加洋地黄制剂的疗效，避免其毒副作用。

Objective:To explore the significance of protecting myocardial energy metabolism and antiheart failure (HF) during therapy.Methods:One hundred and sixtytwo cases of brancho pneumonia complicated by HF were divided randomly into treatment group (81 cases) and control group(81 cases).The control group was treated with oxygen,sedative,antiinfection and cardiotonic (cedilan,saturated dose) and vasodilator,while the treatment group was treated with salvia miltiorrhiza injection and vitamin C on the basis of complex therapy(1/5 saturated does of cedilan);the dose of salvia miltiorrhiza injection was 5 ml～10 ml,the dose of vitamin C was 200 mg·kg -1 /d～250 mg·kg -1 /d.Results:In treatment group,42 cases (51 9%) were improved obviously,39 cases (48 1%) were improved,the total effective rate was 100 0%;in control group,18 cases (22 2%) were improved obviously,48 cases (59 3%) were improved,15 cases were no changed,the total effective rate was 81 5%,there have obvious difference between 2 groups ( P <0 01).The reinstatement time of respiratory rate,heart rate and hepatomegalia were (1 4±0 1) days vs. (5 1±0 4)days,(1 7±0 2) days vs. (4 6±0 3) days and (1 3±0 1) days vs (7 6±0 7) days in treatment group and control group respectively,there have obvious diference of therapeutic efficacy between 2 groups (all P <0 001).Conclusions:Clearance of oxygen free radical is the key of correcting myocardial energy metabolism insufficiency,it is also the basis of treating heart failure.Salvia miltiorrhiza injection combined vitamin C to protecting myocardial energy metabolism can promote the therapeutic efficacy of digitalis and decrease sideeffect,therefore,to protecting myocardial energy metabolism is the key of treating heart failure.