黄芪保心汤联合比索洛尔治疗射血分数保留型心力衰竭疗效及对患者心功能的影响

Clinical efficacy of Huangqi Baoxin decoction combined with bisoprolol in the treatment of heart failure with preserved ejection fraction and its effects on cardiac function and 6MWT

目的:探究黄芪保心汤联合比索洛尔治疗射血分数保留型心衰(HFPEF)临床疗效及对心功能、6 min步行试验(6MWT)的影响。方法:采用随机数字表法将80例HFPEF患者随机分为观察组、对照组各40例,两组均予以血管紧张素转化酶抑制剂、利尿剂等基础治疗,对照组患者予以比索洛尔片口服,观察组患者在此基础上加服黄芪保心汤。比较两组患者治疗3个月后临床疗效,以及治疗前、治疗3个月后运动耐力(6MWT)、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)、舒张晚期血流峰速率(A)、舒张早期血流峰速率(E)]、血清生化指标[B型尿钠肽(BNP)、C反应蛋白(CRP)、半乳糖凝集素-3(Gal-3)、可溶性ST 2(aST 2)]水平变化。结果:治疗3个月后,观察组患者治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);两组患者6MWT均较治疗前增加,且观察组高于对照组,差异有统计学意义(P<0.05);两组患者LVEF、LVEDV、E均较治疗前升高,且观察组高于对照组,LVEDD、LVESD、A均较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05);两组患者血清BNP、CRP、Gal-3、aST 2水平均较治疗前明显降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:黄芪保心汤联合比索洛尔治疗HFPEF可增强疗效,改善心功能,于患者预后有利。

Objective:To investigate the clinical efficacy of Huangqi Baoxin decoction combined with bisoprolol in the treatment of heart failure with preserved ejection fraction(HFPEF)and its effects on cardiac function and 6min walking test(6MWT).Methods:According to the random number table method,80 patients with heart failure with preserved ejection fraction were randomly divided into observation group and control group,with 40 cases in each group.The two groups were given basic treatments of angiotensin converting anzyme inhibitiors and diuretics,and patients in control group were given bisoprolol tablets orally while the patients in observation group were given Huangqi Baoxin decoction on this basis.The clinical efficacy after 3 months of treatment,as well as exercise tolerance(6MWT),cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV),late diastolic blood flow peak rate(A),early diastolic blood flow peak rate(E)]and serum biochemical indexes[brain natriuretic peptide(BNP),C-reactive protein(CRP),Galectin-3(Gal-3),soluble ST 2(aST 2)]before treatment and after 3 months of treatment.Results:After 3 months of treatment,the total effective rate of treatment in observation group was significantly higher than those in control group(P<0.05).The 6MWT in the two groups was increased compared with that before treatment,and the index in observation group was higher than that in control group(all P<0.05).The LVEF,LVEDV and E in the two groups were increased compared with those before treatment,and the indexes in observation group were higher than those in control group,and the LVEDD,LVESD and A were decreased compared with those before treatment,and the indexes in observation group were lower than those in control group(all P<0.05).The serum levels of BNP,CRP,Gal-3 and aST 2 in the two groups were significantly decreased compared with those before treatment,and the levels in observation group were lower than those in control group(all P<0.05).Conclusion:Huangqi Baoxin decoction combined with bisoprolol for HFPEF can enhance the efficacy and improve cardiac function,and it is also helpful for prognosis.