生脉胶囊联合米力农注射液治疗缺血性心肌病的临床研究

Clinical study on Shengmai Capsules combined with Milrinone Injection in treatment of ischemic cardiomyopathy

目的探讨生脉胶囊联合米力农注射液治疗缺血性心肌病的临床效果。方法选取2015年7月—2017年7月南阳市中心医院收治的缺血性心肌病患者106例,随机分为对照组(53例)和治疗组(53例)。对照组在1~7 d静脉注射米力农注射液,首次负荷剂量为50μg/kg,5~10 min缓静注完,再以0.5μg/(kg·min)进行维持治疗,最大剂量≤1.13 mg/(kg·d)。治疗组在对照组基础上口服生脉胶囊,0.9 g/次,3次/d。两组患者均连续治疗2周。评价两组患者临床疗效,同时比较治疗前后两组患者临床症状积分、血清炎性因子和血浆脑钠肽(BNP)水平及心功能指标。结果治疗后,对照组和治疗组临床有效率分别为73.58%和92.45%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者各项症状积分均显著减少(P<0.05),且治疗组临床症状积分明显低于对照组(P<0.05)。治疗后,两组血清C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α和血浆BNP水平较治疗前均显著降低P<0.05),且治疗后治疗组明显低于对照组(P<0.05)。治疗后,两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)值均显著降低(P<0.05),左室射血分数(LVEF)值显著增加(P<0.05),同时,治疗组治疗后心功能指标明显优于对照组(P<0.05)。结论生脉胶囊联合米力农注射液治疗缺血性心肌病更能迅速缓解患者症状体征,减轻机体炎性损伤,提高心功能。

Objective To investigate the clinical effect of Shengmai Capsules combined with Milrinone Injection in treatment of ischemic cardiomyopathy. Methods Patients（106 cases） with ischemic cardiomyopathy in Nanyang City Central Hospital from July 2015 to July 2017 were randomly divided into control（53 cases） and treatment（53 cases） groups. Patients in the control group were iv administered with Milrinone Injection, the first loading dose was 50 μg/kg for 5 — 10 min, then maintained with 0.5 μg/（kg·min）, and the maximum dose was less than 1.13 mg/（kg·d）. Patients in the treatment group were po administered with Shengmai Capsules on the basis of the control group, 0.9 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the clinical symptom scores, the serum inflammatory factors and plasma BNP levels, and the cardiac function in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 73.58% and 92.45% respectively, and there were differences between two groups（P〈0.05）. After treatment, the clinical symptom scores in two groups were significantly decreased（P〈0.05）, and the scores in the treatment group after treatment were significantly lower than those in the control group（P〈0.05）. After treatment, the CRP, TNF-α and BNP levels in two groups were significantly decreased（P〈0.05）, at the same time, the serum inflammatory factors and plasma BNP levels in the treatment group after treatment were significantly lower than those in the control group（P〈0.05）. After treatment, the LVEDD and LVESD in two groups were significantly decreased（P〈0.05）, LVEF was significantly increased（P〈0.05）, and the cardiac function indexes in the treatment group after treatment were significantly better than those in the control group（P〈0.05）. Conclusion Shengmai Capsules combined with Milrinone Injection in treatment of ischemic cardiomyopathy can quickly alleviate the disease symptoms and signs, reduce the inflammatory injury, which has a certain clinical application value.