麝香保心丸联合曲美他嗪治疗冠心病PCI术后并发心力衰竭临床观察

Clinical Observation on Shexiang Baoxin Pills Combined with Trimetazidine in Treating Heart Failure After Percutaneous Coronary Intervention for Coronary Disease

目的:观察麝香保心丸联合曲美他嗪治疗冠心病PCI术后并发心力衰竭的临床疗效及安全性。方法:将80例PCI术后合并心力衰竭患者随机分为观察组和对照组各40例,对照组常规给予硝酸酯类、阿托伐他汀钙片、阿司匹林、氯吡格雷、血管紧张素转换酶抑制剂、β-受体阻滞剂、利尿剂及进行规范化抗凝等治疗,并给予盐酸曲美他嗪口服;观察组在对照组基础上加用麝香保心丸治疗;2组疗程均为3月,观察比较2组临床疗效,治疗前后脑钠肽(BNP)水平、左室射血分数(LVEF)变化及不良事件发生情况。结果:总有效率观察组为97.5%,对照组为82.5%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者BNP水平较治疗前明显降低(P <0.05),LVEF值明显升高(P <0.05);且观察组上述指标改善优于对照组(P <0.05)。不良事件发生率观察组为12.5%,对照组为27.5%,2组比较,差异有统计学意义(P <0.05)。结论:麝香保心丸联合曲美他嗪治疗冠心病PCI术后合并心力衰竭患者疗效显著,可以显著降低患者BNP含量,提高EF值,且安全性高。

Objective.. To observe the clinical effect and safety of Shexiang Baoxin pills combined with trimetazidine for heart failure after percutaneous coronary intervention（PCI）. Methods. Divided 80 cases of patients with heart failure after PCI into the observation group and the control group randomly, 40 cases in each group. The control group received routine medicine treatment of nitrate esters, diuretic and atorvastatin calcium tablets, aspirin, clopidogrel, angiotensin converting enzyme inhibitor, β-receptor blocker and standardized anticoagulation as well as oral administration of trimetazidine hydrochioride. The observation group additionally received Shexiang Baoxin pills based on the treatment of the control group. The treatment lasted for three months in the two groups. Observed and compared the clinical effect, levels of brain natriuretic peptide （BNP） before and after treatment, changes of left ventricular ejection fraction （LVEF） and the adverse reactions. Results. The total effective rate was 97.5% in the observation group and was 82.5% in the control group, the difference being significant（P 〈 0.05）. After treatment, levels of BNP in the two groups were significantly decreased when compared with those before treatment （P 〈 0.05）, while the values of LVEF in the two groups were significantly increased when compared with those before treatment （P 〈 0.05）. The improvement of the above indexes in the observation group was obviously better than that in the control group（P 〈 0.05）. The incidence of adverse reactions was ;2.5% in the observation group and 27.5% in the control group, the difference being significant（P 〈 0.05）. Conclusion. The therapy of Shexiang Baoxin pills combined with trimetazidine has significant effect in treating heart failure after PCI for coronary disease, which can effectively decrease the content of BNP and increase the value of EF of patients with high safety.