鹿红颗粒干预心肌梗死后心功能不全的临床研究

Clinical Observation on Luhong Granules in Intervening Heart Dysfunction after Myocardial Infarction

目的观察鹿红颗粒对心肌梗死(MI)后阳虚血瘀证心功能不全患者的心功能及心室重构的影响。方法 60例确诊为MI后心功能不全且中医辨证为阳虚血瘀证的患者随机分为对照组与干预组,各30例。对照组给予标准西药治疗,干预组在对照组治疗基础上加用鹿红颗粒,观察周期3个月。观察用药前后两组患者的中医临床症状,检测指标:血浆B型脑钠肽(BNP)、血浆血管紧张素Ⅱ(AngⅡ)、血浆去甲肾上腺素(NE)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、左室射血分数(LVEF)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)。结果两组用药前后NE和BNP有统计学意义(P<0.01);两组用药前后BNP差值比较有统计学意义(P<0.01),两组治疗前后AngⅡ无统计学意义(P>0.05)。干预组治疗前后LVESD有统计学意义(P<0.05);两组用药前后LVESD差值比较有统计学意义(P<0.05),其他指标均无统计学意义(P>0.05)。干预组用药后中医临床症状有效率优于对照组(P<0.01)。结论在标准西药治疗基础上加载鹿红颗粒治疗能够改善MI后心功能不全患者BNP、LVEF、LVESD及中医临床症状,疗效优于单纯标准西药治疗。

Objective To investigate the effects of Luhong granules（LHG） on heart function and ventricular remodeling in patients with heart dysfunction after myocardial infarction and yang deficiency and blood stasis syndrome. Methods Sixty patients with heart dys- function after myocardial infarction and yang deficiency and blood stasis syndrome were randomly divided into two groups,The con- trol group（ n = 30） treated with routine treatment and the treatment group（ n = 30）treated with LHG on the basis of routine treatment for 3 months. Before and after treatment,the symptoms of traditional Chinese medicine, B- type natriuretic peptide（BNP）, angioten- sin H （Ang Ⅱ ）, norepinephrine（NE）, left ventricular（LV）end diastolic dimension （LVEDD）, LV end -systolic dimension（LVESD）, LV ejection fraction （LVEF）, inter- ventricular septal thickness （IVST）, LV posterior wall thickness （LVPWT） were observed. Results After treatment, NE and BNP levels in two groups had very more significant improvement（ P ~0. 01）. BNP level in treatment group was higher than that in the control group （ P 〈0. 01）. There were no difference in AngH between two groups before and after treat- ment（ P 〉0. 05）. LVESD had significant improvement in the treatment group after treatment （ P 〈0. 05） ; Difference value of LVESD in treatment group was more improved than in the control group （ P 〈0. 05）. The effective rate of the symptoms of traditional Chi- nese medicine were 93. 4% in treatment group, 13. 3% in control group （ P 〈0. 05）. Conclusion LHG plus routine treatment can improve the BNP,LVEF,LVESD and clinical symptoms in patients with heart dysfunction after myocardial infarction and yang defi- ciency and blood stasis syndrome.