芪苈强心胶囊联合通络膏方对慢性心力衰竭患者心功能及心室重构的影响

Effect of Qiliqiangxin capsule combined with tongluo paste on cardiac function and ventricular remodeling in patients with chronic heart failure

目的观察芪苈强心胶囊联合通络膏方对慢性心力衰竭（CHF）患者心功能及心室重构的影响。方法选取2011年3月—2015年3月鹤壁市人民医院及鹤壁市中医院收治CHF患者82例进行观察,按随机数字表法分为2组,每组41例。对照组给予基础治疗及西药抗心力衰竭治疗,观察组在对照组基础上加用芪苈强心胶囊联合通络膏方治疗,6个月后对比2组心功能疗效、主要症候评分、6 min步行距离（6MWT）、血清N末端脑钠肽前体（NTproBNP）水平及左室射血分数（LVEF）、左室舒张期末内径（LVEDd）、每搏输出量（SV）、心脏指数（CI）等心脏超声指标。结果观察组心功能疗效显效率为29.79%,优于对照组的17.02%（χ^2=6.68,P=0.01）,观察组心悸、气短、乏力、下肢水肿等主要症候评分均低于对照组,差异均有统计学意义（t=4.84、2.03、3.02、3.28,P〈0.05）,观察组6MWT、LVEF、SV、CI均高于对照组,NT-proBNP、LVEDd均低于对照组,差异均有统计学意义（t=5.13、5.67、2.36、5.03、8.75、4.02,P〈0.05）。2组不良反应均主要为男性乳腺增生、电解质紊乱,差异无统计学意义（χ^2=0.35、0.35,P〉0.05）。结论芪苈强心胶囊联合通络膏方可在规范化抗心力衰竭治疗基础上,进一步抑制或逆转心室重构,提高运动耐力,抑制心力衰竭进展,改善心功能,疗效确切,值得临床推广应用。

Objective To observe the effect of Qiliqiangxin capsule combined with Tongluo paste on heart function and ventricular remodeling in chronic heart failure（CHF） patients.Methods From March 2011 to March 2015,82 cases of CHF were observed in the Hebi Municipal People＇s Hospital and Hebi Hospital of Traditional Chinese Medicine,and they were divided into 2 groups according to the random number table method,41 cases in each group.The control group was given the basic treatment of Western medicine and anti heart failure treatment,the observation group in the control group plus Qiliqiangxin capsule combined with Tongluo paste after 6 months treatment,compared 2 groups of curative effect on cardiac function,main symptom score,6 min walking distance（6MWT）,serum NT-proBNP and left ventricular ejection fraction（LVEF）,left ventricular end diastolic diameter（LVEDD）,stroke volume（SV）,cardiac index（CI） and echocardiographic parameters.Results Observe groups curative effect of heart function was 29.79%,better than 17.02%in the control group（χ^2=6.68,P=0.01）,the observation group＇s heart palpitations,shortness of breath and fatigue,lower extremity edema syndrome score were lower than the control group,the differences were statistically significant（t=4.84,t= 2.03,t=3.02,t=3.28,P〈0.05）,the observation group＇s 6MWT,LVEF.SV and CI were higher than the control group,NT-proBNP,LVEDD were lower than the control group,the differences were statistically significant（t=5.13,5.67,t=2.36,t=5.03,t=8.75,t=4.02,P〈0.05）.The adverse reactions of 2 groups were mainly male breast hyperplasia,electrolyte disorder,the difference was not statistically significant（χ^2= 0.35,χ^2= 0.35,P〉0.05）.Conclusion Qiliqiangxin capsule combined with Tongluo paste in treatment of heart failure on the basis of standardization,further inhibiting or reversing ventricular remodeling,improve exercise tolerance and inhibit the progression of heart failure and improve heart function,definite curative effect,worthy of clinical application.