逸心汤联合曲美他嗪治疗慢性心力衰竭患者疗效观察

Application of Yixin Decoction Combined with Trimetazidine in Patients with Chronic Heart Failure

目的通过观察逸心汤与曲美他嗪联合治疗慢性心力衰竭患者时,患者整体受益情况,旨在指导临床相关疾病患者治疗方案的制定。方法选取2019年6月—2020年12月期间惠州市第六人民医院收治的120例慢性心力衰竭患者,单纯西医治疗的60例患者纳入西医组(常规治疗+曲美他嗪),中西医结合治疗的60例患者纳入中西医组(常规治疗+曲美他嗪+逸心汤)。两组患者均接受为期3个月的治疗。分别于不同时间段观察比较两组患者中医证候积分(治疗前、治疗2周、治疗结束时)、血清学指标[治疗前、治疗结束时血清B型脑利钠肽(Brain natriuretic peptide type B,BNP)、超敏C反应蛋白(High-sensitivity c-reactive protein,hs-CRP)]、心肌重塑情况[治疗前、治疗结束时左心室舒张末径(End diastolic diameter of left ventricle,LVEDD)、左室收缩末期内径(Left ventricular end systolic diameter,LVESD)、左室射血分数(Left ventricular ejection fraction,LVEF)]。结果两组治疗2周、治疗后的中医证候积分与治疗前比较,差异均有统计学意义(P<0.05);治疗后两组中医证候积分均呈下降趋势,且中西医组低于西医组,差异有统计学意义(P<0.05);治疗结束后,两组患者BNP、hs-CRP、LVEDd、LVESD水平较治疗前均下降,LVEF水平较治疗前升高,差异均有统计学意义(P<0.05);且中西医组BNP、hs-CRP、LVEDd、LVESD水平低于西医组,LVEF水平高于西医组,差异有统计学意义(P<0.05)。结论逸心汤联合曲美他嗪治疗慢性心力衰竭患者时,可显著缓解患者临床症状,纠正血清学指标,抑制心肌重构。

Objective To observe the clinical efficacy of Yixin Decoction combined with trimetazidine in patients with chronic heart failure and provide references for the development of therapeutic protocols for patients with clinical diseases.Methods A total of 120 patients with chronic heart failure admitted to Huizhou Sixth People's Hospital from June 2019 to December 2020 were enrolled and divided into a western medicine group(n=60,conventional treatment+trimetazidine)and a traditional Chinese medicine(TCM)+western medicine group(n=60,conventional treatment+trimetazidine+Yixin Decoction).All patients received treatment for 3 months.TCM syndrome scores(before treatment,2 weeks after treatment,and after treatment),serum indexes[B-type natriuretic peptide(BNP)and high-sensitivity C-reactive protein(hs-CRP)before and after treatment],and myocardial remodeling[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular ejection fraction(LVEF)before and after treatment]of the two groups were compared.Results TCM syndrome scores in the two groups 2 weeks after treatment and at the end of the treatment were significantly different from those before treatment(P<0.05).After treatment,the TCM syndrome scores in both groups showed a downward trend,and the TCM+western medicine group was lower than the western medicine group(P<0.05).After treatment,the levels of BNP,hs-CRP,LVEDD,and LVESD in the two groups were decreased and the level of LVEF was increased as compared with those before treatment(P<0.05).The levels of BNP,hs-CRP,LVEDD,and LVESD in the TCM+western medicine group were lower and the level of LVEF was higher than those in the western medicine group(P<0.05).Conclusion Yixin Decoction combined with trimetazidine in the treatment of patients with chronic heart failure can significantly relieve the clinical symptoms,restore serum indexes,and inhibit myocardial remodeling.