黄芪联合多巴酚丁胺及酚妥拉明治疗慢性肺源性心脏病顽固性心力衰竭疗效观察

Effect of astragalus membranaceus combined with dobutamine and phentolamine in the treatment of chronic pulmonary heart disease with refractory heart failure

目的探讨黄芪联合多巴酚丁胺及酚妥拉明治疗慢性肺源性心脏病顽固性心力衰竭的临床疗效。方法选择2016年7月至2017年8月驻马店市中心医院收治的68例慢性肺源性心脏病顽固性心力衰竭患者为研究对象,将患者随机分为对照组和观察组,每组34例。对照组患者给予抗感染、氧气治疗、改变通气、纠正心力衰竭等常规治疗,观察组患者在对照组治疗的基础上加用黄芪、多巴酚丁胺及酚妥拉明,2组患者均治疗7 d。观察2组患者的治疗效果、不良反应发生情况、住院时间、呼吸困难与发绀症状改善情况及治疗前后肺动脉收缩压(SPAP)、动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、第1秒用力呼气容积(FEV_(1))、心脏射血分数(EF)。结果观察组患者住院时间显著短于对照组,呼吸困难、发绀的发生率低于对照组(P<0.01)。治疗前2组患者SPAP、PaO_(2)、SaO_(2)、FEV_(1)、EF比较差异均无统计学意义(P>0.05);治疗后,2组患者SPAP较治疗前显著降低,PaO_(2)、SaO_(2)、FEV_(1)、EF较治疗前显著升高(P<0.05)。治疗后观察组患者SPAP显著低于对照组,PaO_(2)、SaO_(2)、FEV_(1)、EF显著高于对照组(P<0.05)。对照组和观察组患者总有效率分别为64.70%(22/34)和91.78%(31/34);观察组患者总有效率显著高于对照组(χ^(2)=6.928,P<0.05)。对照组和观察组患者不良反应发生率分别为38.24%(13/34)和14.71%(5/34);观察组患者不良反应发生率显著低于对照组(χ^(2)=4.837,P<0.05)。结论黄芪联合多巴酚丁胺及酚妥拉明治疗慢性肺源性心脏病顽固性心力衰竭具有显著效果。

Objective To investigate the clinical efficacy of astragalus membranaceus combined with dobutamine and phentolamine in the treatment of chronic pulmonary heart disease and refractory heart failure.Methods A total of 68 patients with chronic pulmonary heart disease with refractory heart failure admitted to the Central Hospital of Zhumadian from July 2016 to August 2017 were selected as the study objects,and all the patients were randomly divided into control group and observation group,with 34 patients in each group.Patients in the control group were given routine treatments such as anti-infection,oxygen therapy,change of ventilation,correction of heart failure,and so on.Based on the treatment of the control group,patients in the observation group were given astragalus,dobutamine and phentolamine.The patients in both groups were treated for seven days.The therapeutic effect,adverse events,hospital stay,improvement of dyspnea and cyanosis,and pulmonary arterial systolic pressure(SPAP),arterial oxygen partial pressure(PaO_(2)),blood oxygen saturation(SaO_(2)),forced expiratory volume in one second(FEV_(1)),and cardiac ejection fraction(EF)in the two groups before and after treatment were observed.Results The hospital stays in the observation group was significantly shorter than that in the control group,and the incidence of dyspnea and cyanosis was lower than that in the control group(P<0.01).There was no significant difference in the SPAP,PaO_(2),SaO_(2),FEV_(1) and EF between the two groups before treatment(P>0.05).After treatment,the SPAP of patients in the two groups was significantly lower than that before treatment,the PaO_(2),SaO_(2),FEV_(1) and EF were significantly higher than that before treatment(P<0.05).After treatment,the SPAP of patients in the observation group was significantly lower than that in the control group,the PaO_(2),SaO_(2),FEV_(1) and EF were significantly higher than those in the control group(P<0.05).The total effective rate in the control group and the observation group was 64.70%(22/34)and 91.78%(31/34).The total effective rate in the observation group was significantly higher than that in the control group(χ^(2)=6.928,P<0.05).The incidence of adverse reactions in the control group and the observation group was 38.24%(13/34)and 14.71%(5/34),respectively.The incidence of adverse reactions in the observation group was lower than that in the control group(χ^(2)=4.837,P<0.05).Conclusion Astragalus membranaceus combined with dobutamine and phentolamine has a significant effect in the treatment of chronic pulmonary heart disease with refractory heart failure.