养心汤改善比索洛尔治疗慢性充血性心力衰竭耐受性28例临床分析

Effect of Yangxin Decoction on Improving of Drug Tolerance of Bisoprolol for Treat ment of Chronic Congestive Heart Failure:An Analysis of 28 Cases

目的:观察养心汤对比索洛尔治疗慢性充血性心力衰竭耐受性的影响。方法:选择对比索洛尔治疗剂量下出现的不适症状(头晕、乏力、心悸等)难耐受的慢性充血性心力衰竭患者56例,按就诊时间先后顺序分为2组各28例。对照组以比索洛尔减量治疗,观察组在比索洛尔剂量不变的基础上加用养心汤治疗,2组疗程均为3月。观察2组治疗前后不适症状改善情况、心脏血流动力学指标[左室舒张末期内径(LVED)、左室收缩末期内径(LVES)、左室射血分数(LVEF)]、静息心率及静息血压。结果:症状总有效率观察组为96.4%,对照组为71.4%,2组比较,差异有显著性意义(P<0.05)。治疗后观察组LVEF升高,LVED、LVES降低,与对照组比较,差异均有显著性意义(P<0.05)。治疗后观察组静息心率较对照组低,2组比较,差异有显著性意义(P<0.05)。治疗后2组血压值均较治疗前有不同程度的升高,差异均有显著性意义(P<0.05);但2组间比较,差异无显著性意义(P>0.05)。结论:养心汤能明显改善比索洛尔治疗慢性充血性心力衰竭引起的不适症状,改善患者LVEF、LVED、LVES值,提高了患者服用比索洛尔的耐受性。

Objective： To observe the effect of self-made prescription Yangxin decoction on the drug tolerance of Bisopro- Iol for treatment of chronic congestive heart failure. Methods： Fifty-six chronic congestive heart failure patients which had complaints such as dizziness, fatigue and palpitation during the treatment with Bisoprolol at therapeutic dose were equally randomized into observation group and control group according to the visit sequence. The control group was given reduction dose of bisoprolol tablets, and the treatment group was given the same therapeutic dose of bisoprolol tablets combined with Yangxin decoction. Three months constituted one treatment course. Before and after treatment, the relief of complaints, hemodynamic indexes such as left ventricular end diastolic diameter （LVEDD）, left ventricular end systolic diameter（LVESD） and left ventricular ejection fraction （LVEF）, resting heart rate and resting blood pressure were observed in both groups. Re- sults： The total effective rate was 96.4% in the observation group and was 71.4% in the control group, the difference being significant （P 〈 0.05）. After treatment, LVEF was increased, LVEDD and LVESD were decreased, and resting heart rate was lowered in the observation group （P 〈 0.05 compared with those in the control group）. Resting blood pressure was increased in both groups after treatment （P 〈 0.05 compared with those before treatment）, the difference between the two groups were insignificant （P〉 0.05）. Conclusion： Self-made prescription Yangxin decoction could obviously improve the tolerance of bisoprolol in the treatment of chronic congestive heart failure through relieving the complaints and improving LVEF, LVEDD and LVESD.