伊伐布雷定联合炙甘草汤治疗慢性心力衰竭的疗效观察

Clinical efficacy of Ivabradine combined with Zhigancao Decoction in the treatment of chronic heart failure

目的:探讨伊伐布雷定联合炙甘草汤对于慢性心力衰竭的临床疗效。方法:选取于我院医治的90例慢性心力衰竭病例随机分成对照组(30例)、治疗组1(30例)、治疗组2(30例)。给予对照组常规治疗;治疗组1在对照组治疗基础上加伊伐布雷定片治疗;治疗组2在治疗组1治疗基础上加炙甘草汤进行治疗。1个月后记录6 min步行试验、心率变化、N末端B型脑钠肽前体(NT-proBNP)、左心室射血分数、左心室舒张末期内径、左心室收缩末期内径,并评价临床疗效及药物的不良反应。结果:治疗组2的6 min步行距离、左心室射血分数>治疗组1>对照组(P均<0.05);治疗组2的NT-proBNP、左心室舒张末期内径、左心室收缩末期内径<治疗组1<对照组(P均<0.05);治疗组2的临床总有效率>治疗组1>对照组(P均<0.05)。三组均未发生严重不良反应。结论:对于慢性心力衰竭,应用伊伐布雷定联合炙甘草汤临床疗效确切,可以显著改善心功能,安全性较好。

Objective:To explore the clinical effect of ivabradine combined with Zhigancao decoction on patients with chronic heart failure. Methods:90 cases of chronic heart failure were randomly divided into control group(30 cases), treatment group 1(30 cases), treatment group 2(30 cases). Routine treatment was given to the control group;treatment group 1 was treated on the basis of the control group + Ivabradine tablets;treatment group 2 was treated on the basis of treatment group 1 + Zhigancao decoction. One month later, car-diac function indexes such as 6-minute walking test, heart rate change, N-terminal B-type Pro BNP, left ventricular ejection fraction, left ventricular end diastolic diameter, left ventricular end systolic diameter were recorded, and clinical efficacy and adverse drug reactions were evaluated. Results:In the treatment group 2, the 6-minute walking distance and left ventricular ejection fraction were higher than those in the treatment group 1 and the control group(P<0.05);in the treatment group 2, NT proBNP, left ventricular end diastolic diameter and left ventricular end systolic diameter were lower than those in the treatment group 1 and the control group(P<0.05);in the treatment group 2, the total clinical effective rate was higher than those in the treatment group 1 and the control group(P<0.05). No serious adverse reactions occurred in the three groups.Conclusion:For patients with chronic heart failure, the combination of ivabradine and Zhigancao decoction has a definite clinical effect, can significantly improve the cardiac function of patients, and has a good safety.