葛根素注射液联合左西孟旦治疗慢性充血性心力衰竭的疗效观察

Clinical observation of Puerarin Injection combined with levosimendan in treatment of chronic congestive heart failure

目的探讨葛根素注射液联合左西孟旦治疗慢性充血性心力衰竭临床疗效。方法选取2013年2月—2014年8月井陉县医院收治的充血性心力衰竭患者98例,随机分成对照组和治疗组,每组各49例。对照组iv左西孟旦注射液,首次剂量12μg/kg,5～10 min完成,之后调整为0.5μg/（kg·min）进行维持治疗,1次/d。治疗组在对照组基础上静脉滴注葛根素注射液,500 mg加入5%葡萄糖溶液250 m L中,1次/d。两组患者均治疗20 d。观察两组的临床疗效,比较两组的临床症状和心脏功能。结果治疗后,对照组和治疗组的总有效率分别为77.55%、83.67%,两组比较差异具有统计学意义（P〈0.05）。治疗后,治疗组患者中心率（HR）减缓、呼吸困难好转和啰音消失的比例明显高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组患者心排血量（CO）和左心室射血分数（LVEF）均升高,而左心室舒张末期的压力（LVEDP）下降,同组治疗前后差异有统计学意义（P〈0.05）;且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义（P〈0.05）。结论葛根素注射液联合左西孟旦治疗慢性充血性心力衰竭具有较好的临床疗效,能缓解临床症状,改善心脏功能,安全性较好,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Puerarin Injection combined with levosimendan in treatment of chronic congestive heart failure. Methods Patients（98 cases） with chronic congestive heart failure in Jingxing County Hospital from Februay 2013 to August 2015 were randomly divided into the control and treatment groups, and each group had 49 cases. Patients in the control group were iv administered with Levosimendan Injection, the first dosage was 12 μg/kg, 5 — 10 min to finish, and the dosage was 0.5μg/（kg·min）, once daily. Patients in the treatment group were iv administered with Puerarin Injection on the basis of the control group, 500 mg added to 5% glucose solution 250 m L, once daily. After treatment, the clinical efficacies were evaluated, and clinical symptom, and heart function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.55% and 83.6%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the proportion of HR slow, dyspnea improved, and rales disappeared in the treatment group were significantly higher than those in the control group, and there was difference between two groups（P〈0.05）. After treatment, CO, LVEF, and LVEDP in two groups were decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Puerarin Injection combined with levosimendan has the curative effect in treatment of chronic congestive heart failure, and can relieve clinical symptom, improve heart function, with good safety, which has a certain clinical application value.