心宝丸联合卡维地洛治疗慢性心力衰竭的临床研究

Clinical study on Xinbao Pills combined with carvedilol in treatment of chronic heart failure

目的研究心宝丸联合卡维地洛片治疗慢性心力衰竭的临床疗效。方法选取2017年4月-2019年4月天津市第三中心医院分院收治的120例慢性心力衰竭患者为研究对象,将所有患者随机分为对照组和治疗组,每组各60例。对照组患者口服卡维地洛片,初始剂量为5mg/次,两天后增加至10mg/次,2次/d;治疗组患者在对照组治疗的基础上口服心宝丸,按美国纽约心脏病协会(NYHA)分级Ⅱ级4丸/次,Ⅲ级6丸/次,3次/d。两组患者持续治疗2个月。观察两组的临床疗效,比较两组的心功能指标、6分钟步行距离(6 MWD)、血清因子水平。结果治疗后,对照组和治疗组的总有效率分别为85.00%、93.33%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者左心室射血分数(LVEF)、心指数(CI)、6 MWD均明显升高,左室舒张末期内径(LVEDD)和左室收缩末容积(LVESV)均明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组心功能指标和6 MWD明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者N末端脑钠肽元(NT-pro BNP)和血管紧张素Ⅱ(AngⅡ)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);并且治疗组患者NT-pro BNP和AngⅡ水平均明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论心宝丸联合卡维地洛片治疗慢性心力衰竭具有较好的治疗效果,可改善临床症状和心功能指标,降低血清因子水平,具有一定的临床推广应用价值。

Objective To study the clinical efficacy of Xinbao Pills combined with Carvedilol Tablets in treatment of chronic heart failure. Methods Patients(120 cases) with chronic heart failure in the Branch of Tianjin Third Central Hospital from April 2017 to April 2019 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were po administered with Carvedilol Tablets, starting dosage 5 mg/time, increased to 10 mg/time after two days, twice daily. Patients in the treatment group were po administered with Xinbao Pills on the basis of the control group, grade Ⅱ(NYHA): 4 pills/time, grade Ⅲ(NYHA): 6 pills/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, 6 MWD, and serum factor level in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 85.00% and 93.33%, respectively, and there was difference between two groups(P < 0.05). After treatment, LVEE, CI, and 6 MWD in two groups were significantly increased, but LVEDD and LVESV in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of NT-pro BNP and AngⅡ in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the serum factor levels in the treatment group were significantly higher than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Xinbao Pills combined with Carvedilol Tablets has clinical curative effect in treatment of chronic heart failure, can improve clinical symptoms and heart function indexes, and reduce serum factor level, which has a certain clinical application value.