参脉注射液联合重组人脑钠利肽治疗顽固性心衰随机平行对照研究

Randomized Cotrolled Study of Treating Refractory Heart Failure By Shenmai Injection plus Recombinant Human Brain Natriuretic Peptide

[目的]观察参脉注射液联合重组人脑钠利肽治疗顽固性心衰疗效。[方法]使用随机平行对照方法,将30例住院患者按随机数字表随机分为两组,对照组15例,限盐、吸氧和休息、积极去除诱因(抗感染,纠正酸碱失衡和电解质紊乱等)、抗心衰治疗(包括充分利尿,扩张血管ACET或ARB,地高辛等)。rhBNP治疗:负荷剂量1.5μg/mL静脉推注后,以0.0075μg/(kg.min)持续静脉泵入维持24h,2次/周,2周为1疗程。治疗组15例,西药治疗同对照组,参脉注射液50mL+5%GS/NS200mL静滴,1次/d。观测临床症状、一般指标、左心室功能、血液生化、B型利钠肽。2周为1疗程,连续治疗1疗程,判定疗效。[结果]治疗组,显效9例,有效5例,无效1例,总有效率93.33%。对照组显效3例,有效6例,无效6例,总有效率60.00%,治疗组疗效优于对照组(P<0.05)。心功能、BNP指标均有改善(P<0.01,P<0.05),治疗组优于对照组(P<0.01)。[结论]参脉注射液联合重组人脑钠利肽治疗各种顽固性心功能不全,临床症状、血液动力学均有改善,副作用少,安全,值得推广应用。

[ Objective] Shenmai injection of recombinant human brain natriuretic peptide treatment of in- tractable heart failure efficacy. [ Methods ] using randomized controlled methods, 30 cases of hospitalized pa- tients were randomly divided into two groups by random number table, Control group of 15 cases of salt restric- tion, oxygen and rest, active removal of incentives （ anti - infection, to correct the pH imbalances and electro- lyte disturbances） , anti - heart failure therapy （ including diuretic, expansion of blood vessels ACET or ARB, Digoxin）. rhBNP treatment ： after a loading dose of 1.5txg/mL, intravenous injection, into to 0. 0075 p^g/（ kg ~ min） continuous intravenous infusion to maintain 24h, 2 times / week, 2 weeks of a course of treatment. Treatment group, 15 cases of western medicine with the control group, the Shenmai Injection 50mL ＋5% GS/ NS200mL - infusion, 1/d. Observation of clinical symptoms, the general index, left ventricular function, blood biochemistry, B - type natriuretic peptide. Two weeks of a course of treatment, continuous treatment of a course of treatment to determine efficacy. [ Results] in treatment group, obvious effects occurred in 9 cases ,5 cases were effective, 1 case of ineffectiveness, and the tatol effective rate was 93.33 %. The control group, obvi- ous effects occurred in 3 cases, 6 cases were effective, 6 case of ineffectiveness, the total efficiency of 60. 00%. Treatment group than the control group （ P 〈 0.05 ）. Cardiac function, BNP indicators have im- proved （ P 〈 0.01, P 〈 0.05 ）, treatment group than the control group （ P 〈 0.01 ）. [ Conclusion ] Shenmai in- jection of recombinant human brain natriuretic peptide treatment of various intractable heart function insuffi- ciency, clinical symptoms, hemodynamics are improved, fewer side effects, safety should be widely applied.