中药联合曲美他嗪治疗冠心病心力衰竭临床研究

Clinical Research on the Treatment of Heart Failure Caused by Coronary Heart Disease with Traditional Chinese Medicine Combined with Trimetazidine

目的：探讨中药联合曲美他嗪与单用曲美他嗪治疗冠心病心力衰竭的临床疗效,为临床治疗提供参考价值。方法：选取我院2013年9月~2014年5月期间因冠心病心力衰竭需治疗患者130例,随机分为2组,每组65例,分别予以中药联合曲美他嗪（观察组）和曲美他嗪（对照组）,比较两组治疗后各项指标变化情况、心功能疗效以及治疗前后生活质量情况。结果：观察组治疗后SBP高于对照组,DBP低于对照组,HR少于对照组,LVEF高于对照组,LVESD和LVEDD低于对照组,6min步行距离大于对照组,差异具有统计学意义（P〈0.05）;观察组治疗后显效率和总有效率高于对照组,差异具有统计学意义（P〈0.05）;在进行临床治疗前,两组患者生活质量评价的各项数值均无显著差异（P〉0.05）,具有可比性;经1个疗程治疗后,两组患者各维度评分均较治疗前有显著增高,差异具有统计学意义（P〈0.05）;经1个疗程治疗后,观察组患者生活质量评分细则里面的生理职能、身体疼痛、活力、社会功能得分等治疗得分均显著地高于对照组患者,差异具有统计学意义（P〈0.05）。结论：中药联合曲美他嗪应用于冠心病心力衰竭的临床治疗,其临床疗效、各项指标和生活质量等各方面均显著优于单纯使用曲美他嗪,值得临床广泛应用和深入研究。

Objective： To study the clinical effect of treating heart failure caused by coronary heart disease respectively with tradi- tional Chinese medicine combined with trimetazidine and single trimetazidine, so as to provide a reference for the clinical treat- ment. Method： 130 cases of patients that should be treated be- cause of heart failure caused by coronary heart disease from September 2013 to May 2014 in our hospital were selected and randomly divided into 2 groups with 65 cases for each group, andthey were respectively given traditional Chinese medicine com- bined with trimetazidine （the observation group） and trimetazidine （the control group）, and the change of various indexes, the effect of heart function and the quality of life of the two groups before and after the treatment were compared. Results Comparing the observation group with the control group after the treatment, SBP of the former was higher than that of the latter, DBP lower, HR less, LVEF higher, LVESD and LVEDD lower, 6 min walking distance longer, and the difference was statistically significant （1~〈0.05）; the effective rate and total effective rate of the observa- tion group after the treatment were higher than those of the con- trol group and the difference was statistically significant （P〈0.05）; before the clinical treatment, there was no significant difference on the values of life quality evaluation between the two groups （P〉0.05）, so they were comparable; after 1 course of treatment, the scores of the two groups in various dimensions both signifi- cantly increased, and the difference was statistically significant （P〈0.05）; after 1 course of treatment, the treatment scores of the observation group for physical function, pain, vitality and social function in the scoring rules of life quality were all significandy higher than those of the control group, and the difference was sta- tistically significant （P〈0.05）. Conclusion： The application of tra- ditional Chinese medicine combined with trimetazidine in the clinical treatment of heart failure caused by coronary heart dis- ease is significantly superior to the application of single trimetazidine on the clinical curative effect, the technical indexes and the quality of life, so the former if worth a wide clinical ap- plication and further studying.