心可舒片对冠心病慢性心力衰竭患者症状缓解期食欲减退干预的研究

Intervention Experiment of Xinkeshu Pian on Anorexia at Symptoms Remission of Coronary Heart Disease Patients with Chronic Heart Failure

目的观察心可舒片是否对冠心病慢性心力衰竭患者症状缓解期食欲减退、血清胃动素和胃泌素浓度有干预,并探讨其机制。方法选取98例冠心病合并慢性心力衰竭的住院病例为研究对象。随机将其分为观察组50例,对照组48例。在常规治疗的基础上,观察组加服心可舒片4片,每日3次;对照组加服单硝酸异山梨酯片10mg,每日3次。观测两组患者从入院到心衰主要症状(胸闷、心慌、呼吸困难、浮肿等)缓解时所需天数以及上述两个时间点的左室射血分数、食欲减退患者人数、血清胃动素和胃泌素浓度,并进行分析。结果观察组与对照组从入院到心衰主要症状缓解时所需天数分别为(4.5±2.1)d和(4.4±1.9)d;左室射血分数分别为(56.3±23.1)%和(58.4±24.2)%,差异不具有统计学意义(P>0.05)。到心衰主要症状缓解时,两组患者的食欲减退人数均较入院时减少,其中观察组较对照组减少较多,差异具有统计学意义(P<0.05)。到心衰主要症状缓解时,两组患者的血清胃动素和胃泌素浓度均较入院时增高,且观察组较对照组增高更明显,差异有统计学意义(P<0.01)。结论心可舒较单硝酸异山梨酯对冠心病慢性心力衰竭患者症状缓解期食欲减退更具干预作用,且促胃动素和胃泌素的分泌更加明显。

Objective To observe the effect of Xinkeshu P/an on anorexia, serum motilin and gastrin at symptom remission among coronary heart disease （CHD） patients with chronic heart failure. Methods 98 of CHD inpatients complicated with chronic heart failure were selected and divided into 2 groups： observation group （n =50） and control group （n =48）. On the basis of conventional treatment, the observation group took Xinkeshu P/an, 4 tablets, 3 times per day; while the control group took isosorbide dinitrate, 10 mg, 3 times per day. Remission of symptoms, changes of serum motilin and gastrin were observed and compared between two groups. Results The number of days from admission to remission of heart failure was （4.5 ±2.1） d in observation group and （4.4±1.9） d in the control, the left ventrieular ejection fraction was （56.3±23.1） % in the observation and （58.4±24.2）% in the control, the differences were no statistics significant （P〉0.05）. When remission of heart failure symptoms, the ratios of anorexia in both group decreased and it was lower in the observation group than in the control （P〈0.05）; and the levels of motilin and gastrin increased and it was higher in the observation group （P〈0.01）. Conclusion The Xinkeshu Plan has better effect on the remission of main symptoms of heart failure than isosorbide dinitrate dose, and more obvious on the secretion level of motilin and gastrin.