芪参益气汤治疗老年慢性心力衰竭临床观察

Clinical Observation on Qishen Yiqi Decoction in the Treatment of Senile Chronic Heart Failure

目的探讨自拟芪参益气汤治疗老年慢性心力衰竭的临床效果。方法选取2018年12月—2019年12月中国医科大学附属盛京医院心内科收治的66例老年慢性心力衰竭患者,随机分为对照组和试验组,各33例。对照组采取常规治疗方案,厄贝沙坦片每次75~150 mg口服,每日1~2次;盐酸曲美他嗪片每次20 mg口服,每日3次;富马酸比索洛尔片2.5 mg口服,每日1次。试验组在对照组的基础上联用自拟芪参益气汤治疗,2组均治疗2个月。比较2组患者的临床治疗效果、左心室舒张末期内径(Left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(Left ventricular end systolic diameter,LVESD)、左心室射血分数(Left ventricular ejection fraction,LVEF)、B型脑钠肽(B-type natriuretic peptide,BNP)、肌钙蛋白I(Troponin I,cTnI)及不良反应总发生率。结果试验组的治疗总有效率高于对照组,差异有统计学意义(P<0.05);试验组治疗后的LVEDD、LVESD低于对照组,LVEF高于对照组,差异均有统计学意义(P<0.05);试验组治疗后的BNP、cTnI水平低于对照组,差异有统计学意义(P<0.05)。结论芪参益气汤应用于老年慢性心力衰竭患者,能提高临床治疗效果,下调血清BNP、cTnI水平,对心功能具有保护作用,值得临床推广。

Objective To explore the clinical effect of Qishen Yiqi decoction in treating senile chronic heart failure.Methods A total of 66 elderly patients with chronic heart failure who were admitted to the Department of Cardiology,Shengjing Hospital affiliated to China Medical University from December 2018 to December 2019 were randomly divided into control group and experimental group,with 33 cases in each group.The control group received conventional treatment,irbesartan tablets 75~150 mg orally,1~2 times a day;Trimetazidine hydrochloride tablet 20 mg orally,3 times a day;Bisoprolol fumarate tablet 2.5 mg orally,qd.The experimental group was treated with self-made Qishen Yiqi decoction on the basis of the control group,and both groups were treated for 2 months.Clinical efficacy,left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVEDD),Diameter(LVESD),left ventricular ejection fraction(LVEF),B-type natriuretic peptide(BNP),Troponin I(Troponin I,cTnI)and the total incidence of adverse reactions were compared between 2 groups.Conclusion Qishen Yiqi decoction can significantly improve the clinical efficacy of elderly patients with chronic heart failure,reduce the level of serum BNP,cTnI,and have a protective effect on heart function.It is worthy of promotion.