脉血康胶囊加用曲美他嗪治疗心力衰竭的临床疗效观察

Observation on effects of Mai Xuekang capsule combined with Trimetazidine on chronic heart failure

目的:观察脉血康胶囊加用盐酸曲美他嗪治疗心力衰竭(慢性收缩性)的临床疗效。方法:60例心功能Ⅲ级以上的慢性收缩性心力衰竭患者,随机分成对照组30例、治疗组30例,根据收缩压情况,如果收缩压高于100mm Hg,两组均常规给予B受体阻滞剂、ACEI类(或ARB类)、螺内酯等利尿剂,部分患者加用地高辛以及针对原发病的治疗药物;除常规应用上述药物外,治疗组加用脉血康胶囊2粒/次,3次/d;合并应用曲美他嗪20mg/次,3次/d,治疗共持续8周。治疗后根据临床症状改善的情况以及观察超声心动图的指标如左室收缩末直径、射血分数评价心功能。结果:心功能的改善分为三类,即显效、有效及无效。治疗组显效25例(83.3%),有效3例(10.0%),无效2例(6.7%),总有效率为93.3%;对照组显效10例(33.3%),有效12例(40.0%),无效8例(26.7%),有效率达73.3%,统计学分析,对照组与治疗组间有显著差异(P<0.01)。用药前后治疗组左室舒张末内径(LVEDV)显著减小(P<0.05),左室射血分数(LVEF)显著上升(P<0.05)。治疗期间用药安全,无不良反应。结论:脉血康胶囊加用曲美他嗪能够改善心功能,可中西医结合试用于治疗慢性心力衰竭。

Objective：To observe therapeutic efficacy of Mai Xuekang capsule combined with trimetazidine on chronic heart failure. Methods： 60 patients whose cardiac function classification was over three grade were randomly divided into two groups.Patients were treated withβ-blockers , Angiotensin Converting Enzyme Inhibitor/Angiotensin Receptor Blocker and Spironolactone or other conventional thiazide diuretic therapy in control group if systolic blood pressure were over （100mmHg,n=30）.Patients in treatment group were treated with trimetazidine （20mg one each and three times a day）and Mai Xuekang capsule （2 capsules one each and three times a day） except conventional therapy （n=31 ） .After 8 weeks, Clinical efficacy were investigated based on improvement of cardiac function classification. Meanwhile, EF and LVEDV of UCG were.measured. For treatment group,the total effective rate 93.3%, notable effective rate ,effective rate and ineffective rate was 83.3% （n=25）, 10% （n=3） and 6.6% （n=2） respectively; For matched group,the total effective rate 73.3%, notable effective rate ,effective rate and ineffective rate was 33.3%（n=10） , 40%（n=12） and 26.7% （n=8） respectively. There was significantly different on the two groups about effective rate between （P〈0.01）.In treatment group,there are obviously increased on EF （E^ection fraction of Left ventricular ）and decreased on LVED （left ventricular end diastolic diameter ）between before and after treatment （P〈0.01）. No suspected adverse drug reactions were found in the two groups. Conclusion： Mai xuekang capsule combined with Trimetazidine on the basis of conventional therapy on heart failure can improve cardiac function classification in a way.