参附注射液联合地尔硫[艹卓]治疗慢性肺源性心脏病合并心力衰竭的临床效果及安全性分析

Clinical efficacy and safety of Shenfu injection combined with diltiazem in treatment of chronic pulmonary heart disease complicated with heart failure

目的探究参附注射液联合地尔硫[艹卓]治疗慢性肺源性心脏病(肺心病)合并心力衰竭的临床效果及安全性。方法选取2017年3月至2019年3月郑州颐和医院收治的慢性肺心病合并心力衰竭患者72例,完全随机分为对照组和观察组,各36例。对照组给予常规基础治疗,观察组在此基础上给予参附注射液联合地尔硫[艹卓]治疗,2组均连续治疗2周。观察临床疗效,测定治疗前后C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、左心室射血分数(LVEF)、N末端B型脑钠肽前体(NT-proBNP)、6min步行距离(6MWD)、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2),比较不良反应发生情况。结果观察组总有效率明显高于对照组[94.4%(34/36)比77.8%(28/36)],差异有统计学意义(P=0.041)。治疗2周后,2组患者CRP、IL-6、TNF-α、NT-proBNP、PaCO2均明显降低,且观察组明显低于对照组[(2.8±0.6)mg/L比(4.3±0.7)mg/L、(68±7)ng/L比(83±8)ng/L、(2.2±0.6)ng/L比(4.1±1.0)ng/L、(0.81±0.08)μg/L比(2.03±0.19)μg/L、(6.0±1.0)kPa比(7.6±1.0)kPa];2组患者LVEF、6MWD、PaO2均增高,且观察组明显高于对照组[(54±5)%比(44±4)%、(373±37)m比(290±30)m、(8.4±1.6)kPa比(7.3±1.3)kPa],差异均有统计学意义(均P<0.05)。2组不良反应发生率比较,差异无统计学意义(P=0.496)。结论参附注射液联合地尔硫[艹卓]治疗慢性肺心病合并心力衰竭效果明显,能够有效缓解患者临床症状,改善患者心功能,安全性高.

Objective To explore the clinical efficacy and safety of Shenfu injection combined with diltiazem in treatment of chronic pulmonary heart disease complicated with heart failure.Methods Seventy-two patients with chronic pulmonary heart disease and heart failure admitted to Zhengzhou Yihe Hospital from March 2017 to March 2019 were randomly divided into control group and observation group,with 36 cases in each group.The control group was treated with routine basic treatment.The observation group was treated with Shenfu injection and diltiazem tablets on the basis of routine treatment.Both groups were treated for 2 weeks.Clinical efficacy,changes of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),left ventricular ejection fraction(LVEF),N-terminal pro-B-type brain natriuretic peptide(NT-proBNP),6 min walking distance(6 MWD),arterial partial pressure of oxygen(PaO2)and arterial partial pressure of carbon dioxide(PaCO2)were analyzed before and after treatment,including adverse reactions.Results Total clinical effective rate in the observation group was significantly higher than that in the control group[94.4%(34/36)vs 77.8%(28/36)](P=0.041).After 2 weeks of treatment,CRP,IL-6,TNF-α,NT-proBNP and PaCO2 significantly decreased and the indexes in the observation group were lower than those in the control group[(2.8±0.6)mg/L vs(4.3±0.7)mg/L,(68±7)ng/L vs(83±8)ng/L,(2.2±0.6)ng/L vs(4.1±1.0)ng/L,(0.81±0.08)μg/L vs(2.03±0.19)μg/L,(6.0±1.0)kPa vs(7.6±1.0)kPa];LVEF,6 MWD and PaO2 significantly increased and they were higher in the observation group than those in the control group[(54±5)%vs(44±4)%,(373±37)m vs(290±30)m,(8.4±1.6)kPa vs(7.3±1.3)kPa](all P<0.05).There was no significant difference in the incidence of adverse reactions between groups(P=0.496).Conclusion Shenfu injection combined with diltiazem treating chronic pulmonary heart disease with heart failure can effectively alleviate clinical symptoms and improve cardiac function;the side effects are tolerable.