补益强心片对慢性心力衰竭患者心功能和生活质量的影响

Influences of Buyi Qiangxin Tablets on Cardiac Function and Life Quality of Chronic Heart Failuture Patients

目的:探讨补益强心片对慢性心力衰竭(CHF)患者心功能和生活质量的影响。方法:将68例CHF患者随机按住院前后分为对照组和观察组各34例。两组均参照"慢性心力衰竭诊断治疗指南"给予心衰一般治疗和西药常规治疗。观察组加用补益强心片,1.2 g/次,3次/d。疗程4周。评价治疗前后美国纽约心脏病协会(NYHA)心功能分级和6 min步行实验(6 MWT),记录Lee氏心衰计分,采用超声心动图测定心室射血分数(LVEF)和心输出量(CO),以明尼苏达心衰生活质量调查表评估生活质量,检测血浆脑钠素前体末端(NT-proBNP)和抗利尿激素(ADH)水平。结果:观察组Lee氏心衰疗效总有效率为91.17%,优于对照组的73.52%(P<0.05);观察组心功能分级疗效总有效率为88.23%,优于对照组的67.64%(P<0.05);观察组治疗后Lee氏心衰积分和生活质量评分均较治疗前下降,并低于对照组(P<0.01);两组治疗后6 MWT均比治疗前增加,观察组增加更为显著(P<0.01);治疗后两组LVEF和CO均上升,观察组高于对照组(P<0.01);观察组治疗后血浆NT-proBNP和ADH水平均比治疗前下降,并低于对照组(P<0.01)。结论:补益强心片能改善CHF患者心功能分级,提高LVEF和CO,增加患者6MWT,提高患者生活质量,其作用机制可能与降低患者血浆NT-proBNP和ADH水平有关。

Objective ： To study the influences of Buyi Qiangxin tablet on cardiac function and life quality of the chronic heart failure （CHF） patients. Method： Sixty-eight cases of patients with CHF were randomly divided into control group （34 cases） and observation group （34 cases） according to before and after entering the hospital. The patients of both groups took general treatment of cardiac failure and conventional western medical treatment according to the guide of the diagnosis and treatment of chronic heart failure. The patients in observation group took Buyi Qiangxin tablets, 1.2 g/time, 3 times/day, the treatment course is 4 weeks. The New York Heart Association （NYHA） cardiac heart grading and 6 minutes walk test （6 MWT） were evaluated before and after treatment, recording Lee g heart failure. Left ventricular ejection fraction （LVEF） and cardiac output （CO） were tested using echocardiography. The life quality was evaluated by Minnesota life quality of heart failure questionnaires, detecting the plasma NT-proBNP and antidiuretic hormone （ADH） level. Result： The total curative effect of Leeg heart failure of the observation group was 91.17% , which is higher than that of the control group （73.52% , P 〈 0.05）. The total curative effect of cardiac function of observation was 88.23% , superior to 67.64% in the control group （P 〈 0.05）. After the treatment, the Lee＇s heart failure points and life quality scores of observation group decreased and were lower than the control group （P 〈 O. O1 ）. The 6MWT of both groups increased and the increasing in observation group was more significantly （P 〈 0.01 ）. The LVEF and CO of both groups increased after the treatment, the observation group was higher than control group （P 〈 0.01 ）. The levels of plasma NT-proBNP and ADH decreased and observation group was less than the control group （P 〈 0. O1 ）. Conclusion： Buyi Qiangxin tablets can improve cardiac function grading of CHF patients, increasing LVEF, CO, 6 MWT and life quality of patients. Its mechanism may be related to decreasing NT-proBNP and ADH of patients.