芪参益气滴丸联合米力农治疗扩张性心肌病心力衰竭的临床研究

Clinical study on Qishen Yiqi Dripping Pills combined with milrinone in treatment of dilated cardiomyopathy with heart failure

目的探讨芪参益气滴丸联合米力农注射液治疗扩张性心肌病心力衰竭的临床疗效。方法选取2014年5月—2017年5月天津市第三中心医院分院心内科收治的扩张性心肌病心力衰竭患者64例为研究对象,将所有患者随机分为对照组和治疗组,每组各32例。对照组静脉泵注米力农注射液,0.3μg/(kg·min),10 mg/d;治疗组在对照组的基础上口服芪参益气滴丸,1袋/次,3次/d。两组均连续治疗10 d。观察两组的临床疗效,比较两组的心功能指标和生化指标。结果治疗后,对照组和治疗组的总有效率分别为75.0%、93.8%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组心排出量(CO)、每搏输出量(SV)、左室射血分数(LVEF)均显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些心功能指标明显高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组肌钙蛋白I(cTnI)和脑利钠肽(BNP)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些生化指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论芪参益气滴丸联合米力农注射液治疗扩张性心肌病心力衰竭具有较好的临床疗效,能改善心功能,降低cTnI、BNP水平,安全性较好,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Qishen Yiqi Dripping Pills combined with Milrinone Injection in treatment of dilated cardiomyopathy with heart failure. Methods Patients（64 cases） with dilated cardiomyopathy with heart failure in Branch of Tianjin Third Hospital from May 2014 to May 2017 were randomly divided into control and treatment groups, and each group had 32 cases. Patients in the control group were intravenous pump injection administered with Milrinone Injection, 0.3 μg/（kg·min）, 10 mg/d. Patients in the treatment group were po administered with Qishen Yiqi Dripping Pills on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and cardiac function indexes and biochemical indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.0% and 93.8%, respectively, and there was difference between two groups（P＜0.05）. After treatment, CO, LVEF, and SV in two groups were significantly increased, and the difference was statistically significant in the same group（P＜0.05）. And the cardiac function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P＜0.05）. After treatment, the levels of cTnI and BNP in two groups were significantly decreased, and the difference was statistically significant in the same group（P＜0.05）. And the biochemical indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P＜0.05）. Conclusion Qishen Yiqi Dripping Pills combined with Milrinone Injection has clinical curative effect in treatment of dilated cardiomyopathy with heart failure, can improve cardiac function, and decrease the levels of cTnI and BNP, with good safety, which has a certain clinical application value.