燧心胶囊治疗慢性心力衰竭临床疗效及对患者心肌能量代谢、心脏功能的影响

Clinical Efficacy of SuixinCapsule in the Treatment of Chronic Heart Failure and its Effect on Myocardial Energy Metabolism and Cardiac Function

目的探究燧心胶囊在慢性心力衰竭(Chronic heart failure,CHF)治疗中的临床价值。方法选取2019年3月—2020年9月期间黑龙江中医药大学附属第二医院收治的80例CHF患者作为研究对象,采用随机数字表法分为治疗组和对照组,每组各40例。对照组给予标准抗心衰治疗方案,治疗组在常规抗心衰基础上联合燧心胶囊治疗。治疗4周后,观察比较两组患者临床疗效、利尿剂与地高辛减停率、治疗安全性,以及治疗前后心脏功能[左室射血分数(Left Ventricular Ejection Fraction,LVEF)、左室收缩末内径(Left ventricular internal dimension systole,LVIDs)、左室舒张末内径(Left ventricular end diastolic diameter,LVIDd)]、心肌能量代谢[游离脂肪酸(Free fatty acids,FFA)、收缩末圆周室壁应力(circumferential end-systolic stress,cESS)、心肌能量消耗(Myocardial energy expenditure,MEE)]改善情况。结果治疗后治疗组治疗总有效率为92.50%(37/40)明显优于对照组77.50%(31/40),差异有统计学意义(P<0.05)。两组患者治疗后LVEF、LVIDs、LVIDd指标均较治疗前改善,差异有统计学意义(P<0.05);且治疗组LVEF较对照组明显升高,LVIDs、LVIDd较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗后血清FFA、cESS、MEE指标均较治疗前降低,差异有统计学意义(P<0.05)且治疗组血清FFA、cESS、MEE指标均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后治疗组利尿剂减停率为52.50%、地高辛减停率为62.50%较对照组利尿剂减停率32.50%、地高辛减停率35.0%明显升高,差异有统计学意义(P<0.05)。两组治疗安全性均评定为1级,未对治疗产生影响。结论燧心胶囊治疗CHF安全有效,有利于改善患者心功能,提高利尿剂、地高辛减停率,且可能与本品心肌能量代谢调节作用有关。

Objective To explore the clinical value of SuixinCapsule in the treatment of chronic heart failure(CHF).Methods Eighty CHF patients treated in The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from March 2019 to September 2020 were randomly divided into treatment group and control group by random number table,40 cases in each group.The control group was given standard heart failure treatment,while the treatment group received Suixin Capsule on the basis of conventional heart failure treatment.After treatment of 4 weeks,the clinical efficacy,discontinuation rate of diuretics and digoxin and the safety of treatment in the two groups were compared.Additionally,the improvement of cardiac function[left ventricular ejection fraction(LVEF),left ventricular internal dimension systole(LVIDs),left ventricular end diastolic diameter(LVIDd)],and myocardial energy metabolism[free fatty acids(FFA),circumferential end-systolic stress(cESS),myocardial energy expenditure(MEE)]were observed before and after treatment.Results The total effective rate of the treatment group was 92.50%(37/40),which was higher than 77.50%(31/40)of the control group(P<0.05).After treatment,LVEF,LVIDs and LVIDd of the two groups were improved(P<0.05),and LVEF of the treatment group was higher than that of the control group,while the situation of LVIDs and LVIDdwas opposite(P<0.05).After treatment,the serum FFA,cESS and MEE of the two groups were decreased compared withthe conditions before treatment,and the decrease in the treatment group was more significant than that in the control group(P<0.05).The discontinuation rates of diuretics(52.50%)and digoxin(62.50%)in the treatment group were higher than those(32.50%and 35.0%,respectively)in the control group(P<0.05).The safety of treatmentin both groups was rated as grade 1,with no impact on the treatment.Conclusion SuixinCapsule is safe and effective in the treatment of CHF.It is beneficial for improving the cardiac function of patients and increasing the discontinuation rate of diuretics and digoxin,which may be related to the effect of regulating myocardial energy metabolism in this article.