芪苈强心胶囊对扩张型心肌病失代偿心力衰竭治疗好转出院患者易损期心功能的影响

Effects of Qiliqiangxin capsule on cardiac function in vulnerable stage patients with dilated cardiomyopathy and decompensated heart failure

目的观察芪苈强心胶囊对扩张型心肌病(DCM)失代偿心力衰竭治疗好转出院患者易损期心功能的影响。方法选取2016年10月—2020年7月广安门医院心血管科治疗好转出院的DCM伴心力衰竭患者80例,按照密封信封法随机分为对照组与观察组,每组40例。对照组按照优化的出院治疗方案继续服用药物,观察组在优化的出院治疗方案基础上加用芪苈强心胶囊,疗程均为12周。观察2组治疗总有效率,出院前和出院12周时的心脏超声、NT-proBNP水平、6 min步行距离试验(6MWD)、明尼苏达心力衰竭生活质量问卷调查(MLHFQ)评分,以及复合心脏事件发生情况。结果出院12周时,观察组总有效率高于对照组(87.2%vs.69.2%,χ^(2)/P=6.770/0.034);2组左心室射血分数(LVEF)和6 MWD升高,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、MLHFQ评分、NT-proBNP水平降低(P<0.01),且观察组LVEF、6 MWD高于对照组,NT-proBNP水平低于对照组(t/P=2.000/0.025,2.318/0.012,6.386/<0.001)。2组复合心脏事件发生率比较差异无统计学意义(P>0.05)。结论对于DCM失代偿心力衰竭治疗好转出院患者在优化西药治疗基础上联合使用芪苈强心胶囊,可以在心力衰竭易损期进一步改善患者的心功能、降低NT-proBNP水平,提高生活质量。

Objective To observe the effect of Qiliqiangxin capsule on the cardiac function of patients with dilated cardiomyopathy(DCM)decompensated heart failure in the vulnerable period.Method A total of 80 patients with DCM and heart failure who were cured and discharged from the Department of Cardiology of Guang'anmen Hospital from October 2016 to July 2020 were selected and randomly divided into the control group and the observation group according to the sealed envelope method,with 40 cases in each group.The control group continued to take drugs according to the optimized discharge treatment plan,and the observation group was additionally treated with Qiliqiangxin capsule on the basis of the optimized discharge treatment plan,and the course of treatment was 12 weeks.The total effective rate of treatment in the two groups was observed,echocardiography,NT proBNP level,6-minute walking distance test(6MWD),Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ)score before discharge and at 12 weeks after discharge,and the occurrence of composite cardiac events.Results At 12 weeks after discharge,the total effective rate in the observation group was higher than that in the control group(87.2%vs.69.2%,χ^(2)/P=6.770/0.034).Left ventricular ejection fraction(LVEF)and 6 MWD increased,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),MLHFQ score,and NT proBNP level decreased in the two groups(P<0.01),and the observation group LVEF and 6 MWD were higher than those in the control group,and the level of NT proBNP was lower than that in the control group(t/P=2.000/0.025,2.318/0.012,6.386/<0.001).There was no significant difference in the incidence of composite cardiac events between the two groups(P>0.05).Conclusion For patients with decompensated heart failure in DCM who have improved after treatment and discharged,the combined use of Qiliqiangxin capsule on the basis of optimized western medicine treatment can further improve the cardiac function,reduce the level of NT proBNP,and improve the quality of life of patients in the vulnerable period of heart failure.