生脉养心颗粒对老年人心功能干预的临床观察

Clinical observation on intervening heart function in the elderly with the Shengmai Yangxin granule

目的:通过对生脉养心颗粒的临床观察,探讨生脉养心颗粒治疗老年慢性心力衰竭(Chronic Heart Failure,CHF)患者的治疗效果,并预测其远期临床获益。方法:将120例中医辨证分型为气阴两虚型的老年慢性心力衰竭患者随机分为两组,治疗组60例,对照组60例。对照组给予单纯的常规西药治疗,治疗组在常规西药治疗的基础上加用生脉养心颗粒治疗,两组治疗时间均为24个月。观察两组患者临床疗效,检测用药不同时间(分别于第3、12、24个月末)治疗前后B型脑钠肽(BNP)、左室射血分数(Left Ventricular Ejection Fracfion,LVEF)、6分钟步行试验(6-minute walk Test,6MWT)等疗效指标的变化,并且随访两组患者再入院率与病死率。结果:24个月后治疗组总有效率为86.7%(52/60),优于对照组的68.3%(41/60),两组差异比较有统计学意义(P<0.05)。治疗后两组BNP、LVEF、6MWT较治疗前均有明显改善(P<0.01)。组间比较:治疗3、12、24个月后BNP比较,治疗组优于对照组,差异有统计学意义(P<0.01)或(P<0.05)。治疗3个月后LVEF比较,两组间差异无统计学意义(P>0.05);治疗12、24个月后,治疗组LVEF优于对照组,两组差异有统计学意义(P<0.05)。治疗3、12、24个月后,治疗组6MWT优于对照组,比较差异有统计学意义(P<0.01)。随访2年,治疗组的再入院率和病死率显著低于对照组,组间差异有统计学意义(P<0.05)。结论:生脉养心颗粒能够改善老年慢性心力衰竭患者心功能及预后,提高其临床疗效,值得在临床推广应用。

Objective:To discuss the long-term efficacy of the Shengmai Yangxin(生脉养心)granules on elderly patients with CHF.Methods:120 patients were randomly assigned to the treatment group(60 cases)and control group(60 cases).The control group was given routine western medicine,the treatment group was treated with the Shengmai Yangxin granules more.The efficacy in groups were observed,BNP,LVEF and 6MWT were measured at different times,the readmission rate and mortality in groups were recorded.Results:The efficiency in the treatment group was 86.7%,significantly higher than 68.3%in the control group(P<0.05).LVEF,BNP and 6MWT were markedly improved after treatment in groups(P<0.01).In 3-month,12-month and 24-month post-treatment,BNP level in the treatment group was better than the control group,with significant differences(P<0.01,P<0.05).There was no significant difference of LVEF in 3-month post-treatment between groups.In 12-month and 24-month post-treatment,LVEF in the treatment group was better than the control group(P<0.05).There were significant differences of 6MWT in 3-month,12-month and 24-month post-treatment between groups.The readmission rate and mortality in the treatment group were significantly lower than the control group(P<0.05).Conclusion:The Shengmai Yangxin granules can improve heart function and prognosis of elderly CHF patients and clinical efficacy,is worthy of clinical application.