芪参益气滴丸联合曲美他嗪治疗左室射血分数降低心力衰竭的临床研究

Clinical study of Qishen Yiqi dropping pill combined with trimetazidine in treating heart failure and reduced left ventricular ejection fraction

目的评价芪参益气滴丸联合曲美他嗪治疗左室射血分数降低心力衰竭的临床疗效。方法 120例左室射血分数降低心力衰竭患者,随机分为治疗组、对照1组、对照2组,每组40例。三组均予常规西医抗心力衰竭治疗,此外,治疗组加用芪参益气滴丸和曲美他嗪治疗,对照1组加用芪参益气滴丸治疗,对照2组加用曲美他嗪治疗。比较三组治疗后心功能疗效以及治疗前后6 min步行试验(6-MWT)、左心室射血分数(LVEF)、脑钠肽(BNP)水平。结果治疗3个月后,治疗组患者心功能治疗总有效率95.0%明显高于对照1组的80.0%及对照2组的47.5%,且对照1组患者心功能治疗总有效率明显高于对照2组,差异具有统计学意义(P<0.05)。治疗前,三组患者LVEF、6-MWT和BNP水平比较差异无统计学意义(P>0.05)。治疗后,三组患者的LVEF和6-MWT较治疗前明显升高, BNP水平较治疗前明显降低,差异具有统计学意义(P<0.05);治疗后,治疗组的LVEF、6-MWT及BNP水平改善情况均优于对照1组和对照2组,差异具有统计学意义(P<0.05)。结论在常规抗心力衰竭治疗基础上应用芪参益气滴丸和曲美他嗪,对治疗左室射血分数降低心力衰竭具有显著的疗效,在临床中值得推广。

Objective To evaluate the clinical efficacy of Qishen Yiqi dropping pill combined with trimetazidine in treating heart failure and reduced left ventricular ejection fraction. Methods A total of 120 patients with heart failure and reduced left ventricular ejection fraction were randomly divided into treatment group, control group 1 and control group 2, with 40 cases in each group. All the three groups were treated with conventional Western medicine for anti-heart failure. In addition, the treatment group was treated with Qishen Yiqi dropping pills and trimetazidine. The control group 1 was treated with Qishen Yiqi dropping pills, and the control group 2 was supplemented with trimetazidine. Comparison were made on cardiac function after treatment, 6 min walking distance time(6-MWT), left ventricular ejection fraction(LVEF) and brain natriuretic peptide(BNP) level in three groups. Results After 3 months of treatment, the treatment group had obviously higher total effective rate of cardiac function as 95.0% than 80.0% in control group 1 and 47.5% in control group 2. Control group 1 had obviously higher total effective rate of cardiac function than control group 2. Their difference was statistically significant(P<0.05). Before treatment, three groups had no statistically significant difference in LVEF, 6-MWT and BNP level(P>0.05). After treatment, three groups had obviously higher LVEF and 6-MWT than those before treatment, and obviously lower BNP level than those before treatment. Their difference was statistically significant(P<0.05). After treatment, the treatment group had obviously better LVEF, 6-MWT and BNP improvement than control group 1 and control group 2, their difference was statistically significant(P<0.05). Conclusion On the basis of conventional anti-heart failure treatment, the application of Qishen Yiqi dropping pill and trimetazidine has significant efficacy on the treatment of left ventricular ejection fraction and heart failure, and it is worthy of promotion in clinical practice.