盐酸曲美他嗪联合血塞通滴丸治疗慢性心力衰竭的临床观察

Evaluation on effects of Trimetazidine combined with Xuesaitong dropping pills on chronic heart failure

目的:观察盐酸曲美他嗪联合血塞通滴丸治疗慢性收缩性心力衰竭的临床疗效。方法:62例心功能Ⅲ级以上的心力衰竭患者随机分为对照组31例和治疗组31例,若收缩压高于100mmHg,两组则常规给予B受体阻滞剂、ACEI类(或ARB类)、利尿剂,根据病情加用地高辛以及对原发病的治疗;治疗组除上述常规用药外加用盐酸曲美他嗪20mg,每天3次口服,血塞通滴丸10粒,每天3次口服,治疗8周,通过观察超声心动图的指标以及临床症状改善的情况评价心功能的影响。结果:治疗组临床显效25例(80.6%),有效3例(9.7%),无效3例(9.7%),总有效率为90.3%。对照组临床显效10例(32%),有效12例(39%),无效9例(29%),总有效率为71%。2组之间总有效率存在显著性差异(P<0.01)。2组治疗期间均未出现明显不良反应,用药安全。治疗组治疗前后左室舒张末内径(LVEDV)显著减小(P<0.05),左室射血分数(LVEF)显著上升(P<0.05)。结论:盐酸曲美他嗪联合血塞通滴丸能够改善患者的心功能,是一种安全、有效的治疗方案。

Objective:To evaluate the safety and efficacy of trimetazidine combined with simvastatinon on chronic heart failure.Methods:62 patients with heart failure(cardiac function classification was over three grade)were randomly divided into two groups.Patients whose systolic blood pressure were over 100mmHg,were treated withβ-blockers or calcium antagonists,isosorbide mononitrate,anticoagulant,anti-platelet drugs and other conventional therapy in control group(n=31).The others were treated with trimetazidine 20 mg three times a day and simvastatin 10 mg except conventional therapy in treatment group(n=31).8 weeks later heart functions were investigated based on EF and LVEDV of UCG.Meanwhile,Clinical efficacy was evaluated based on improvement of cardiac function classification.Results:For treatment group,the total effective rate 90.3%,markedly effective rate 、 effective rate and ineffective rate was(n=25),(n=3)and(n=3)respectively;For other group,the total effective rate71%,markedly effective rate 、effective rate and ineffective rate was(n=10),(n=12)and(n=9)respectively.There was significantly different on the total effective rate between the two groups(P<0.01).Ejection fraction of Left ventricular obviously increased and left ventricular end diastolic diameter decreased between before and after treatment in treatment group(P<0.01).There were not any obvious adverse drug reaction in the two groups.Conclusion:Trimetazidine combined with Xuesaitong dropping pills on the basis of conventional therapy on heart failure is more effective and safe therapy.