芪冬颐心口服液辅助治疗小儿重症肺炎合并心力衰竭疗效观察

Clinical effects of Qidong Yixin Oral Solution for the auxiliary treatment of severe pneumonia complicated heart failure in children

目的了解芪冬颐心口服液辅助治疗小儿重症肺炎合并心力衰竭的疗效。方法选取2013~2015年收治的重症肺炎合并心力衰竭患儿76例,随机选取数字分为观察组、对照组各38例,对照组给予西药常规强心、利尿、抗感染、止咳祛痰等综合治疗,观察组在上述基础上加用中药芪冬颐心口服液辅助治疗。治疗前后采用彩色多普勒血流仪测定两组患儿左心室射血分数（LVEF）、左心室缩短分数（LVSF）、心脏舒张早期心室充盈速度/舒张晚期心室充盈速度（E/A）。测血清氨基N末端B型利钠肽前体（NT-pro BNP）、心肌酶谱（CK、CK-MB、LDH）变化。结果观察组患儿肺啰音消失时间、心衰纠正时间、憋喘消失时间、平均住院时间均优于对照组,差异有统计学意义（P〈0.05）。观察组治疗后左心室射血分数、左心室缩短分数、心脏舒张早期心室充盈速度/舒张晚期心室充盈速度改善效果优于对照组,差异有统计学意义（P〈0.05）。观察组治疗后,血清氨基N末端B型利钠肽前体、心肌酶谱显著低于对照组,差异有统计学意义（P〈0.05）。结论芪冬颐心口服液辅助治疗肺炎合并心力衰竭患儿,能够提高心肌收缩力、保护心肌细胞,有效改善心功能,有利于患儿预后,临床疗效较好。

Objective To observe the clinical effects of Qidong Yixin Oral Solution for the auxiliary treatment of severe pneumonia complicated heart failure in children. Methods 76 cases of children with severe pneumonia complicated heart failure from 2013 to 2015 were selected,and randomly divided them into the observation group and the control group on average.The control group was treated with strong heart,diuresis,anti-infection,relieving cough and phlegm and other comprehensive treatment by western medicine.On the basis of the above treatment,the oral adjuvant therapy Qidong Yixin Oral Solution was carried out in the observation group. LVEF,LVSF,E / A of two groups of children were determined by color Doppler flow imaging before and after treatment.The changes of NT-pro BNP and myocardial enzymes（ CK,CK-MB,LDH）were detected.Results In the aspects of pulmonary rales,correction time of heart failure,breath holding time and average length of stay of children,the observation group was better than the control group,and the differences were statistically significant（ P〈0.05）.The observation group were better than the control group in the improvement effect of LVEF,LVDD,E / A after treatment,and the differences were statistically significant（ P〈 0.05）. Each index of the observation group after treatment was significantly lower than the control group,such as NT-pro BNP,myocardial enzyme spectrum,and the difference was statistically significant（ P〈0.05）.Conclusion The method of Qidong Yixin Oral Solution for the auxiliary treatment of severe pneumonia complicated heart failure in children can improve the myocardial contractile force,protect the cardiac muscle cells and improve the cardiac function,which was beneficial to the prognosis of the patients with good clinical effect.