血府逐瘀胶囊联合对症治疗射血分数保留心衰合并冠心病患者的临床研究

Clinical Study of Xuefu Zhuyu Capsule Combined with Symptomatic Treatment of Patients with Heart Failure and Coronary Heart Disease with Preservation of Ejection Fraction

目的观察血府逐瘀胶囊联合对症治疗对射血分数保留心力衰竭合并冠心病患者的疗效。方法选择2019年6—12月在该院心血管内科就诊及住院治疗的73例射血分数保留心力衰竭合并冠心病患者,根据病情、性别、年龄随机分为治疗组(37例)和对照组(36例)。两组均给予口服阿托伐他汀钙片降脂、缬沙坦胶囊、单硝酸异山梨酯片、阿司匹林肠溶片等药物对症治疗3个月。治疗组同时给予血府逐瘀胶囊6片,2次/d,治疗3个月。治疗前常规检查心电图、超声心动图,B型利钠肽(B-type natriuretic peptide,BNP)、生物标志物;治疗后分别对比两组患者临床症状、超声心动图、B型利钠肽等结果,6 min步行试验。结果治疗组临床症状有效率为97.30%,显著高于对照组的77.78%,差异有统计学意义(χ^(2)=4.753,P=0.029);治疗组治疗后LVEF为(62.54±2.27)%,显著高于对照组的(53.31±2.24)%,差异有统计学意义(t=17.482,P<0.001);治疗组治疗后BNP为(152.01±6.24)pg/mL,显著低于对照组的(257.27±4.34)pg/mL,差异有统计学意义(t=83.453,P<0.001);治疗组治疗后6 min步行实验结果为(552.26±7.18)m,显著高于对照组的(451.35±6.59)m,差异有统计学意义(t=62.512,P<0.001)。结论血府逐瘀胶囊联合对症治疗对射血分数保留心力衰竭合并冠心病患者的机制,可能与其激活肾素-血管紧张素-醛固酮系统、增加NO合成,提高机体抗缺氧能力等作用有关。

Objective To observe the effect of Xuefu Zhuyu Capsule combined with symptomatic treatment on patients with heart failure and coronary heart disease with preserved ejection fraction.Methods Seventy-three patients with heart failure and coronary heart disease who were treated and hospitalized in the Department of Cardiovascular Medicine of our hospital from June to December 2019 were selected and randomly divided into treatment groups(37 cases)and the control group(36 cases)according to their condition,gender and age.Both groups were given oral atorvastatin calcium tablets,valsartan capsules,isosorbide mononitrate tablets,aspirin enteric-coated tablets and other drugs for symptomatic treatment for 3 months.The treatment group was given 6 pieces of Xuefu Zhuyu Capsules twice a day for 3 months.Routine examination of electrocardiogram,echocardiography,B-type natriuretic peptide(B-type natriuretic peptide,BNP),biomarkers,before treatment;after treatment,compare the clinical symptoms,echocardiogram,B-type natriuretic peptide and other results of the two groups of patients,6-minute walk test.Results The effective rate of clinical symptoms in the treatment group was 97.30%,which was significantly higher than 77.78%in the control group,the difference was statistically significant(χ^(2)=4.753,P=0.029);the LVEF after treatment in the treatment group was(62.54±2.27)%,which was significantly higher than the(53.31±2.24)%,the difference was statistically significant(t=17.482,P<0.001);the BNP of the treatment group after treatment was(152.01±6.24)pg/mL,which was significantly lower than the(257.27±4.34)pg/mL of the control group,the difference was statistically significant(t=83.453,P<0.001);the result of the 6 min walking experiment in the treatment group was(552.26±7.18)m,which was significant higher than the control group's(451.35±6.59)m,the difference was statistically significant(t=62.512,P<0.001).Conclusion The mechanism of Xuefu Zhuyu Capsule combined with symptomatic treatment in patients with heart failure and coronary heart disease with preservation of ejection fraction may be related to the activation of the renin-angiotensin-aldosterone system,the increase of NO synthesis,and the improvement of the body's anti-hypoxia ability.