补益强心片联合左卡尼汀治疗慢性心力衰竭的临床研究

Clinical study on Buyi Qiangxin Tablets combined with levocarnitine in treatment of chronic heart failure

目的探讨补益强心片联合左卡尼汀治疗慢性心力衰竭的临床疗效。方法选取2012年5月—2015年5月在延安大学咸阳医院接受治疗的慢性心力衰竭患者150例,按照治疗方法的差别分成对照组和治疗组,每组各75例。对照组静脉滴注左卡尼汀注射液,3 g加入生理盐水250 m L,1次/d。治疗组在对照组的基础上口服补益强心片,4片/次,3次/d。两组患者均连续治疗4周。观察两组的临床疗效,同时比较治疗前后两组Lee氏积分、6 min步行试验(6MWT)、左心室射血分数(LVEF)、CO、生活质量评分、N末端脑钠肽原(NT-pro BNP)、心钠素(ANP)、血浆醛固酮(ALD)及血管紧张素Ⅱ(AngⅡ)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为88.00%、97.33%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,两组患者Lee氏心衰积分、生活质量评分、以及血浆NT-pro BNP、ANP、ALD和AngⅡ水平均显著降低,6MWT、LVEF和CO则升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些指标改善的程度更明显,两组比较差异有统计学意义(P<0.05)。结论补益强心片联合左卡尼汀治疗慢性心力衰竭效果显著,可明显改善患者心功能,提高其生活质量,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacies of Buyi Qiangxin Tablets combined with levocarnitine in treatment of chronic heart failure. Methods Patients（150 cases） with chronic heart failure in Xianyang Hospital of Yan＇an University from May 2012 to May 2015 were divided into control and treatment groups based on different treatments, and each had 75 cases. The patients in the control group were iv administered with Levocarnitine Injection, 3 g added into normal saline 250 m L, once daily. The patients in the treatment group were po administered with Buyi Qiangxin Tablets on the basis of the control group, 4 tablets/time, three times daily. The patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the changes of Lee＇s integral, 6MWT, LVEF, CO, quality of life scores, NT-pro BNP, ANP, ALD, AngⅡ in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 88.00% and 97.33%, respectively, and there were differences between two groups（P〈0.05）. After treatment, Lee＇s integral, quality of life scores, NT-pro BNP, ANP, ALD, and AngⅡ in two groups were significantly decreased, but 6MWT, LVEF, and CO were increased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, these 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 Buyi Qiangxin Tablets combined with Levocarnitine Injection has a significant clinical effect in treatment of chronic heart failure, can significantly improve cardiac function and the quality of life, which has a certain clinical application value.