参附注射液并无创通气治疗心肾阳虚型心衰的临床疗效观察

Clinical therapeutic effects of the combined treatment with shenfu injection and noninvasive ventilation on heart failure of heart and kidney yang deficiency

目的观察参附注射液并无创呼吸机辅助呼吸治疗心肾阳虚型心衰的临床疗效。方法将60例心衰患者按随机数字表法随机分为对照组30例,采用西医常规综合治疗(给予鼻导管吸氧,口服地高辛、呋塞米、螺内酯及硝酸甘油加入生理盐水静脉泵入),治疗组30例在对照组的基础上给予参附注射液联合无创呼吸机辅助通气,观察生命体征、BNP、CVP、LVEF及中医症候疗效的变化。结果经过1周治疗,对照组和治疗组生命体征均趋于平稳,心率和中心静脉压(CVP)较治疗前下降,治疗组较对照组更为明显,差异有统计学意义(P<0.05,P<0.01);经过治疗两组患者BNP水平均较治疗前明显降低,差异有统计学意义(P<0.05,P<0.01),且治疗组明显低于对照组,组间比较差异有统计学意义(P<0.01);两组患者治疗后LVEF值均升高,治疗组升高更明显,两组治疗前后差异有统计学意义(P<0.05,P<0.01),且两组间比较,差异有统计学意义(P<0.05);两组患者临床疗效比较,治疗组总有效率为96.6%,高于对照组的76.6%,差异有统计学意义(P<0.05)。结论参附注射液并无创呼吸机辅助通气治疗心衰有较好疗效,有效改善中医症状。

Objective To observe the clinical effects of shenfu injection and the assisted respiratory therapy with noninvasive respirator on heart failure of heart and kidney yang deficiency. Methods A total of60 patients of heart failure were divided into a control group（ 30 cases） and a treatment group（ 30 cases） according to the random number table. In the control group,the conventional comprehensive treatment with western medicine was adopted（ the oxygen uptake with nasal catheter,oral administration of digoxin,furosemide and spirolactone and the venous pumping of nitroglycerin with physical saline）. In the treatment group,on the base of the treatment as the control group,shenfu injection and the assisted ventilation with noninvasive respirator were given. The vital signs,BNP,CVP,LVEF and the therapeutic effects on TCM symptoms were observed. Results After one week treatment,the vital signs were all getting stable in the control group and the treatment group,the heart rate and CVP were reduced as compared with those before treatment. The results in the treatment group were more remarkable than the control group,indicating the significant differences（ P〈0. 05,P〈0. 01）. After treatment,BNP was reduced remarkably as compared with that before treatment in the two groups,indicating the significant differences（ P〈0. 05,P〈0. 01）. The result in the treatment group was lower remarkably than the control group,indicating the significant difference（ P〈0. 01）.After treatment,LVEF value was all increased in the two groups. The increase in the treatment group was more obvious,indicating the significant difference（ P〈0. 05,P〈0. 01）,and the comparison between the two groups,the difference was statistically significant（ P〈0. 05）. Regarding the clinical therapeutic effects,the total effective rate（ 96. 6%） in the treatment group was higher than the control group（ 76. 6%）,indicating the significant difference（ P〈0. 05）. Conclusion The shenfu injection and the assisted ventilation with noninvasive respirator achieve the better effects on heart failure and effectively relieve TCM symptoms.