葛酮通络胶囊联合缬沙坦沙库巴曲对扩张型心肌病心力衰竭患者心功能及血清sICAM-1、LPO水平的影响

Effect of Getong Tongluo capsule combined with sacubitril/valsartan on cardiac function and levels of serum sICAM-1 and LPO in patients with dilated cardiomyopathy and heart failure

目的探讨葛酮通络胶囊联合缬沙坦沙库巴曲治疗扩张型心肌病心力衰竭的临床疗效及对患者心功能与血清人可溶性细胞间黏附分子1(sICAM-1)、过氧化脂质(LPO)的影响。方法选取2016年9月—2018年8月海南省人民医院/海南医学院附属海南医院收治的扩张型心肌病心力衰竭患者90例,随机分为中西药结合组45例与单纯西药组45例。单纯西药组选择规范化治疗方案及缬沙坦沙库巴曲治疗,中西药结合组在单纯西药组治疗方案基础上予葛酮通络胶囊口服,2组均持续治疗8周。统计2组临床疗效,观察2组治疗前后左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左房内径(LAD)、心排血量(CO)、舒张早期充盈速度(E)、舒张晚期充盈速度(A)、左室舒张早期与晚期充盈速度比值(E/A)及血清sICAM-1、LPO水平的变化。结果中西药结合组患者的治疗总有效率为97.8%(44/45),相比单纯西药组的77.8%(35/45)明显提高(P<0.05)。治疗后2组患者的LVEF、CO、E、E/A均较治疗前明显增加(P均<0.05),LVEDD均较治疗前明显降低(P均<0.05),中西药结合组患者治疗后的A明显低于治疗前(P<0.05)。中西药结合组患者治疗后的LVEF、E/A明显高于单纯西药组(P均<0.05),LVEDD、A明显低于单纯西药组(P均<0.05)。治疗后2组患者血清sICAM-1、LPO水平均明显降低(P均<0.05),且中西药结合组患者治疗后的sICAM-1、LPO水平明显低于单纯西药组(P均<0.05)。结论葛酮通络胶囊联合缬沙坦沙库巴曲治疗扩张型心肌病心力衰竭效果更好,可以明显改善患者的临床症状,增强心功能,同时可以减轻心肌炎症损伤。

Objective It is to explore the clinical efficacy of Getong Tongluo capsule combined with sacubitril/valsartan on dilated cardiomyopathy and heart failure and its effect on cardiac function and levels of serum soluble intercellular adhesion molecule 1(sICAM-1)and lipid peroxide(LPO)in the patients.Methods A total of 90 patients with dilated cardiomyopathy and heart failure admitted from September 2016 to August 2018 in Hainan Provincial People’s Hospital were selected and randomly divided into combination of Chinese and western medicine group(combination group)and simple western medicine group,45 cases in each group.The simple western medicine group was given standardized therapy with sacubitril/valsartan,the combination group was given Getong Tongluo capsules orally based on the treatment in the control group.Both groups were continuously treated for 8 weeks.The clinical curative effects of the two groups were evaluated,and the changes of left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrium diameter(LAD),cardiac output(CO),early diastolic filling velocity(E),late diastolic filling velocity(A),E/A,and the levels of serum sICAM-1,LPO before and after treatment were observed.Results The total effective rate of patients in the combination group was 97.8%(44/45),which was significantly higher than that 77.8%(34/45)in the simple western medicine group(P<0.05).After treatment,the LVEF,CO,E and E/A of the patients in the combination group were significantly increased(P<0.05),while LVEDD was significantly decreased compared with those before treatment in the two groups(P<0.05),A after treatment was lower than that before treatment in the combination group(P<0.05).The LVEDD and E/A were significantly higher while LVEDD and A were significantly lower in the combination group than those in the simple western medicine group after treatment(P<0.05).The levels of serum sICAM-1 and LPO in the combination group and simple western medicine group were significantly lower than those before treatment(P<0.05),and the levels of these indexes in the combination group were lower than those in the simple western medicine group.Conclusion Geketong Tongluo capsules combined with sacubitril/valsartan have a good therapeutic effect on dilated cardiomyopathy with heart failure,it can significantly improve the patients’clinical symptoms,enhance cardiac function,and relieve inflammatory injury of myocardium.