中西医结合治疗老年性退行性心瓣膜病心力衰竭的临床疗效和安全性观察

Clinical Efficacy and Safety of Intergrated Traditional Chinese and Western Medicine Treatment of Senile Degenerative Valvular Heart Disease with Heart Failure

目的:研究坎地沙坦酯联合氢氯噻嗪和祛瘀活血汤治疗老年性退行性心瓣膜病心力衰竭的临床疗效和安全性。方法:选取2013年6月—2014年6月医院收治的老年性退行性心瓣膜病心力衰竭患者138例,按照随机数字表法将患者分为研究组和对照组,每组69例,所有患者均给予常规治疗,对照组在常规治疗基础上给予坎地沙坦酯治疗,研究组在对照组的基础上给予氢氯噻嗪和祛瘀活血汤治疗,比较两组临床疗效,治疗前、后脑钠肽(BNP)、每博输出量(SV)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)水平,并比较两组治疗依从性和不良反应。结果:研究组总有效率94.2%(65/69)显著高于对照组的81.2%(56/69),比较差异具有统计学意义(P<0.05);治疗前两组LVEDD、SV、LVEF和BNP比较差异无统计学意义(P>0.05),治疗后两组LVEDD和BNP均显著降低,SV和LVEF均显著升高,且研究组显著优于对照组,比较差异具有统计学意义(P<0.05);研究组治疗依从性为95.7%(66/69),对照组治疗依从性91.3%(63/69),两组比较差异无统计学意义(P>0.05);两组不良反应比较无统计学意义(P>0.05)。结论:坎地沙坦酯联合氢氯噻嗪和祛瘀活血汤治疗老年性退行性心瓣膜病心力衰竭疗效显著,能明显改善患者心功能,具有一定安全性。

Objective： To study the clinical efficacy and safety of candesartan combined with hydrochlorothiazide and Quyu Decoction in treatment of senile degenerative valvular heart disease with heart failure.Methods： 138 cases of senile degenerative valvular heart disease with heart failure were selected from our hospital from June 2013 to June 2014 and were divided into study group and control group according to the random number table method,69 cases in each group.All patients were given conventional treatment and the control group were treated with candesartan treatment on the basis of conventional treatment.The study group was given hydrochlorothiazide and Quyu Huoxue Decoction on the basis of the control group.We compared the clinical effect,brain natriuretic peptide（ BNP）,left ventricular ejection fraction（ SV）,left ventricular ejection fraction（ LVEF）,left ventricular end diastolic diameter（ LVEDD） levels before and after treatment of the two groupsand the treatment compliance and adverse reactions of the two groups were compared.Results： Total efficiency of the study group was 94.2%（ 65 /69）,significantly higher than 81.2%（ 56 /69） in the control group and the difference was statistically significant（ P〈0.05）.LVEDD,SV,LVEF and BNP before treatment of the two groups were statistically significant（ P〈0.05）.LVEDD and BNP after treatment of the two groups were significantly reduced and SV and LVEF were significantly higherand the study group was significantly better than the control group and the difference was statistically significant（ P〈0.05）.The treatment compliance of the study group was 95.7%（ 66 /69） and that of the control group was 91.3%（ 63 /69）.There was no significant difference between the two groups（ P〈0.05）.The adverse reactions of the two groups were not statistically significant（ P〈0.05）.Conclusions： Candesartan combined with hydrochlorothiazide and Quyu Decoction in treatment of senile degenerative valvular heart disease with heart failurehad significant effect and can significantly improve the patients＇ heart function,with a certain safety.