参附注射液及不同给药方式治疗重症难治性心力衰竭的临床观察

The Clinical Observation of the Effects of Shenfu Injection and Different Ways of Drug Delivery on Severe and Refractory Heart Failure

目的观察参附注射液及不同给药方式治疗重症难治性心力衰竭的临床疗效。方法将90例重症难治性心力衰竭患者按随机数字表法随机分为对照组、静滴参附组及泵入参附组各30例。对照组予西医常规治疗,静滴参附组在对照组的基础上加用常规静脉滴注参附注射液,泵入参附组在对照组的基础上加用微量泵持续泵入参附注射液,3组疗程均为14 d。结果治疗后3组心率(HR)、左室射血分数(LEVF)、每分钟心输出量(CO)及血浆钠尿肽(BNP)的改善程度均优于治疗前(P<0.01)。组间比较,静滴与泵入参附组对HR、LEVF、CO及BNP的改善程度均优于对照组(P<0.05或P<0.01),泵入参附组优于静滴参附组(P<0.05);泵入参附组、静滴参附组证候疗效总有效率分别为96.67%,83.33%,均高于对照组的60.00%(P<0.05或P<0.01);泵入参附组与静滴参附组比较,差异有统计学意义(P<0.05);泵入参附组、静滴参附组综合疗效总有效率分别为93.33%,70.00%,均高于对照组的53.33%(P<0.05或P<0.01);泵入参附组与静滴参附组比较,差异有统计学意义(P<0.05)。结论参附注射液是治疗重症难治性心力衰竭安全有效的中药制剂。

Objective： To observe the clinical effects of Shenfu injection and different ways of drug delivery on severe and refractory heart failure. Methods： 90 patients with severe and refractory heart failure,staying in ICU of our hospital from January 2012 to March 2015 ,were randomly divided into the control group,the infusion group of Shenfu injection and the pumping group of Shenfu injection,30 cases in each group. The control group was treated with conventional western medicine. The infusion group of Shenfu injection was treated with conventional intravenous injection of Shenfu based on the treatment of the control group. The pumping group of Shenfu injec- tion was treated with micro pumping of Shenfu injection based on the treatment of the control group. The course of treatment lasted for 14 d. Results： After treatment, the improvement of HR, LEVF, CO and BNP of all groups was better than that before treatment （P〈 0.01）,the pumping group and the infusion group better than the control group （P〈 0.05 or P〈 0.01 ）,and the pumping group better than the infusion group （P〈0.05）. The total efficacy of the pumping group was 96.67%,the infusion group 83.33%,both higher than that of the control group 60.00%（P〈 0.01 or P〈 0.05）,with statistical significance （P〈 0.05）. The comprehensive efficacy of the pumping group was 93.33% ,the infusion group 70.00% ,both of which were higher than the control group 53.33% （P 〈 0.01 or P 〈 0.05 ）. The differences between groups was statistically significant （P〈 0.05 or P〈 0.01 ）. Conclusion： Shenfu in- jection treatment on severe and refractory heart failure is a safe and effective traditional Chinese medicine ,worthy of promotion.