芪苈强心胶囊治疗老年慢性心肾综合征的临床研究

Study on Qili Qiangxin Capsule treating Chronic Cardio- renal Syndrome in Senile Patients

目的:观察芪苈强心胶囊对老年心肾综合征患者的临床疗效。方法:选取2010年2月至2013年2月在我科住院的老年心肾综合征患者76例,随机分为常规治疗组(对照组)和芪苈强心胶囊治疗组(实验组),每组38例。对照组按心力衰竭指南给予常规治疗,实验组在常规治疗的基础上加用芪苈强心胶囊,每日3次,每次4粒。共观察12周,观察治疗前后两组患者的心功能分级、左室射血分数(LVEF)值、左室舒张末期内径(LVDd)、脑钠肽(NBP)以及血肌酐(Scr)和肾小球滤过率(GFR)等指标。结果:1)两组临床疗效比较:对照组显效10例,有效17例,总有效率71.1%;实验组显效15例,有效20例,总有效率92.1%。实验组总有效率明显优于对照组(P<0.05)。2)与治疗前比较,两组患者治疗12周后LVEF均有不同程度提高(P<0.05,P<0.01),LVDd和NBP有所下降(P<0.05,P<0.01);与对照组比较,实验组各项心功能指标改善更显著(P<0.05)。3)与治疗前比较,两组Scr均下降(P<0.05,P<0.01),GFR明显提高(P<0.05),实验组疗效更显著(P<0.05)。结论:芪苈强心胶囊能明显改善老年慢性心肾综合征患者的心肾功能,提高生活质量,无不良反应发生。

Objective： To investigate the effect of Qili Qiangxin capsule on senile patients with cardio- renal syndrome（ CRS）. Meth- ods： A total of 76 elder patients with diagnosis of CRS in our department in last 2 years were divided into control group and treatment group randomly,each group had 38 cases. The control group received regular therapy according to guideline of heart failure（ AHA, 2011）. The patients of treatment group took the medicine of Qili Qiangxin capsule on the basis of routine therapy,and the recommended dosage was 4 capsules every 8 hours for 12 weeks. Observation index include NYHA- FC,LVEF,LVDd,NBP,Scr,and GFR. Re- sults： 1） Comparison of clinical effect： The total effective rate was 71. 1% in control group and 92. 1% in treatment group,and the difference was significant（ P 0. 05）; 2） LVEF increased significantly in each group after 12 weeks treatment,while LVDd and NBP reduced. The improvement was more significant in treatment group. 3） The level of Scr reduced and GFR increased significantly in treat- ment group than those in control group. Conclusion： Qili Qiangxin capsule could improve the cardiac and renal function and quality of life in elder patients with CRS without adverse reaction.