生脉注射液联合靶剂量比索洛尔对高血压伴心力衰竭患者血管内皮功能和心功能的影响

Effects of Shengmai injection combined with target dose bisoprolol on vascular endothelial function and cardiac function in patients with hypertension and heart failure

目的:研究生脉注射液与靶剂量比索洛尔联合治疗对高血压伴心力衰竭(气阴两虚证)患者血管内皮功能和心功能的影响。方法:随机数字表法将92例原发性高血压伴心力衰竭患者均分为两组。对照组接受常规西医治疗,研究组在常规治疗基础上联合使用生脉注射液与靶剂量的比索洛尔。对比两组治疗前后主要中医证候(心悸、气短、乏力、头晕目眩、失眠、盗汗)、血管内皮功能[肱动脉内径基础值、含服硝酸甘油后肱动脉内径及反应性充血舒张百分比、血清血管内皮生长因子(VEGF)、一氧化氮(NO)、内皮素(ET)]、心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]和NYHA功能分级变化情况。结果:与对照组比,研究组治疗后主要中医证候心悸、气短、乏力、头晕目眩、失眠、盗汗积分明显下降(P<0.05),肱动脉内径基础值和反应性充血舒张百分比明显增大(P<0.05),血清VEGF和ET水平明显降低,NO水平明显升高(P<0.05),心功能指标LVESD、LVEDD和NYHA功能分级减小,LVEF明显增大(P<0.05)。结论:生脉注射液与靶剂量比索洛尔联合治疗利于高血压伴心力衰竭(气阴两虚证)患者临床指征改善,减轻血管内皮损伤,促进血管内皮功能和心功能恢复。

Objective:To investigate the effect of Shengmai injection combined with target dose bisoprolol on vascular endothelial function and cardiac function in patients with hypertension and heart failure(qi and yin deficiency).Methods:92 patients with essential hypertension with heart failure were divide into two groups the random number table method.The control group was treated by conventional western medicine,and the research group was treated by Shengmai injection combined with the target dose of bisoprolol on the basis of conventional method.The change of main TCM syndromes(palpitations,shortness of breath,fatigue,dizziness,insomnia,night sweats),vascular endothelial function basal diameter of brachial artery diameter,brachial artery diameter after taking nitroglycerin and reactive hyperemic diastolic percentage,serum before and after treatment between two groups (VEGF,NO,ET,LVESD,LVEDD,LVEF)and NYHA functional classification was compared between two groups.Results:Compared with the control group,the main TCM symptom scores of palpitations,shortness of breath,fatigue,dizziness,insomnia,and night sweats in the study group after treatment were significantly decreased(P<0.05),the basal diameter of the brachial artery and the percentage of reactive hyperemia diastole significantly increased(P<0.05),serum VEGF and ET levels were significantly reduced,NO levels were significantly increased(P<0.05),LVESD,LVEDD,and NYHA functional grades were reduced,and LVEF was significantly increased(P<0.05).Conclusion:The combination of Shengmai injection and target dose of bisoprolol is beneficial to the improvement of clinical indications in patients with hypertension and heart failure,reduce vascular endothelial damage,and promote their vascular endothelial function and cardiac function recovery.