复方丹参滴丸联合曲美他嗪治疗老年慢性心力衰竭的临床研究

Clinical study on Compound Danshen Dropping Pills combined with trimetazidine in treatment of elderly patients with chronic heart failure

目的探讨复方丹参滴丸联合盐酸曲美他嗪片治疗老年慢性心力衰竭的临床疗效。方法选取2016年3月—2017年3月在解放军第三〇九医院治疗的106例老年慢性心力衰竭患者作为研究对象,将患者随机分为对照组(53例)和治疗组(53例)。对照组患者口服盐酸曲美他嗪片,20mg/次,3次/d;治疗组在对照组治疗的基础上口服复方丹参滴丸,10丸/次,3次/d。两组患者的疗程均为4周。观察两组患者的临床疗效,同时比较治疗前后两组患者的心功能、细胞因子的改善情况。结果治疗后,治疗组的总有效率为90.6%,显著高于对照组的73.6%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组心功能指标左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)明显降低,左室射血分数(LVEF)明显升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组上述指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)及血浆脑利钠肽(BNP)水平均明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组上述指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论复方丹参滴丸联合盐酸曲美他嗪片治疗老年心衰患者的临床疗效显著,能有效改善患者的心功能、细胞因子水平,安全可靠,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Compound Danshen Dropping Pills combined with Trimetazidine Hydrochloride Tablets in treatment of elderly patients with chronic heart failure. Methods Patients（106 cases） with elderly patients with chronic heart failure in the 309 th Hospital of PLA from March 2016 to March 2017 were randomly divided into control（53 cases） and treatment（53 cases） groups. Patients in the control group were po administered with Trimetazidine Hydrochloride Tablets, 20 mg/time, three times daily. Patients in the treatment group were po administered with Compound Danshen Dropping Pills on the basis of the control group, 10 pills/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the improvement of cardiac function and cytokine in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the treatment group was 90.6%, which was significantly higher than 73.6% in the control group, and there were differences between two groups（P〈0.05）. After treatment, LVEDD and LVESD in two groups were significantly decreased, but LVEF in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And cardiac function indexes in the treatment group after treatment were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the CRP, IL-6, MMP-9, and BNP levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And cytokines in the treatment group after treatment were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Compound Danshen Dropping Pills combined with Trimetazidine Hydrochloride Tablets has clinical curative effect in treatment of elderly patients with chronic heart failure, can effectively improve the cardiac function and cytokine levels of patients, and is safe and reliable, which has a certain clinical application value.