芪苈强心胶囊在AECOPD并心力衰竭中临床观察

Clinical observation of Qiliqiangxin capsule on AECOPD with heart failure

目的综合评价传统西药加芪苈强心胶囊对慢性阻塞性肺疾病急性发作期（AECOPD）合并心力衰竭患者的临床疗效。方法选取我院2011年1月～2012年10月符合入选条件的AECOPD合并心力衰竭患者82例，所有患者随机分成观察组（n=41）和对照组（n=41），其中对照组采用常规西药治疗，而观察组在此基础上加用芪苈强心胶囊，观察两组患者临床症状改善情况，以及心功能分级、LVEF（左室射血分数）、血浆NT-proBNP、血清TNF-α、IL-6及IL-8水平的改善情况。结果观察组总有效率为85．4％，显著高于对照组总有效率68．3％（P〈0．05）；两组治疗后NT-proBNP、LVEF水平均较治疗前有明显改善（P〈0．05），且观察组的改善情况明显优于对照组（P〈0．05）；两组治疗后血清TNF-α、IL-6、IL-8水平均较治疗前有明显改善（P〈0．05），治疗组TNF-α、IL-8的改善程度明显优于对照组（P〈0．05）。结论常规西药与芪苈强心胶囊联合治疗，不仅能改善患者的心功能，降低NT-proBNP，还能够有效降低各炎性因子水平，抑制气道、肺实质的炎症反应，有效提高临床疗效。

Objective To evaluate clinical effects of traditional western medicines plus Qiliqiangxin capsule on chronic obstructive pulmonary disease in acute exacerbation stage （AECOPD） with heart failure. Methods 82 cases of AECOPD with heart failure which were diagnosed in the first affiliated hospital of Henan University from Jan 2011 to Oct 2012 were involved in this study; these patients were divided into two groups randomly and evenly： Control group （n=41） was treated with traditional western medicines, while observation group （n=41） was treated with traditional western medicines plus Qiliqiangxin capsule. Improvement of clinical symptoms, cardiac functional grading, LVEF （left ventricular ejection fraction）, and expressions of NT- proBNP, TNF- α, IL-6, IL-8 were observed in two groups. Results The total effective rate of observation group was 85.4%, while control group was 68.3%, and two groups showed significant differences （P 〈 0.05）. The expressions of NT-proBNP and LVEF were both improved in two groups, and improvements in observation group were significantly higher than control group. Besides, expressions of TNF- α, IL-6, IL-8 were also improved after the patients received these 2 different treatments mentioned above, furthermore, the expression of TNF- α, IL-6 and IL-8 in observation group were significantly superior to control group. Conclusion The treatment of traditional western medicines combined with Qiliqiangxin capsule can not only improve heart function, decrease expression of NT-proBNP, but also effectively decrease expression of inflammatory factors, inhibit inflammation reaction in airway and lung parenchyma. In general, traditional western medicines plus Qiliqiangxin capsule can effectively improve clinical efficacy.