芪参益气滴丸辅助治疗冠心病伴心力衰竭的疗效及对患者心功能指标、血液流变学和血清NT-proBNP、Hcy水平的影响

Efficacy of Qishen Yiqi Dripping Pills as adjuvant treatment for coronary heart disease with heart failure and the influence on cardiac function indicators,hemorheology,serum NT-proBNP,and Hcy levels

目的探究芪参益气滴丸辅助治疗冠心病(CHD)伴心力衰竭的疗效及对患者心功能指标、血液流变学和血清N-末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)水平的影响。方法选取2019年3月至2022年5月榆林市中医医院收治的84例CHD伴心力衰竭患者作为研究对象,采用随机数表法分为观察组和对照组各42例,对照组患者给予常规抗心衰治疗,观察组患者给予常规治疗联合芪参益气滴丸辅助治疗,两组均治疗2周,比较两组患者的治疗效果,以及治疗前后的心功能指标、血液流变学指标和血清NT-proBNP、Hcy水平。结果观察组患者的治疗总有效率为95.24%,明显高于对照组的80.95%,差异有统计学意义(P<0.05);治疗后,两组患者的心室射血分数(LVEF)、每分钟排血量(CO)均升高,且观察组患者的LVEF、CO分别为(47.60±5.50)%、(5.30±0.30)L/min,明显高于对照组的(43.50±4.40)%、(4.90±0.40)L/min,差异均有统计学意义(P<0.05);治疗后,两组患者的左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)均降低,且观察组患者的LVEDD、LVESD分别为(53.20±2.50)mm、(39.10±3.7)mm,明显低于对照组的(57.10±3.40)mm、(42.60±4.10)mm,差异均有统计学意义(P<0.05);治疗后,两组患者的血液流变学指标均降低,且观察组患者的血浆黏度、红细胞压积、全血黏度高切、全血黏度低切水平明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者的血清NT-proBNP、Hcy水平均降低,且观察组患者的NT-proBNP、Hcy分别为(1367.24±91.55)pg/mL、(14.31±4.55)μmol/L,明显低于对照组的(1864.51±96.37)pg/mL、(17.37±4.82)μmol/L,差异均有统计学意义(P<0.05)。结论芪参益气滴丸辅助常规治疗CHD伴心力衰竭可改善患者的心功能及血液流变学指标,降低血清NT-proBNP、Hcy水平,从而提高治疗效果,具有临床应用价值。

Objective To investigate the efficacy of Qishen Yiqi Dripping Pills as adjuvant treatment for coronary heart disease(CHD)with heart failure,and its influence on cardiac function indicators,hemorheology,serum N-terminal pro-brain natriuretic peptide(NT-proBNP),and homocysteine(Hcy)levels.Methods A total of 84 patients with CHD and heart failure who were admitted to Yulin Traditional Chinese Medicine Hospital from March 2019 to May 2022 were selected as the study subjects.They were divided into the control group(treated with conventional anti-heart failure therapy)and the observation group(treated with anti-heart failure therapy combined with Qishen Yiqi Dripping Pills)by random number table method,with 42 cases in each group.All patients underwent 2 weeks of treatment.The two groups were compared in terms of therapeutic effect,cardiac function indicators,hemorheological indicators,serum NT-proBNP,and Hcy levels before and after treatment.Results The total treatment response rate in the observation group was significantly higher than that in the control group(95.24%vs 80.95%,P<0.05).After treatment,left ventricular ejection fraction(LVEF)and cardiac output(CO)in the two groups increased;LVEF and CO in the observation group were(47.60±5.50)%and(5.30±0.30)L/min,significantly higher than(43.50±4.40)%and(4.90±0.40)L/min in the control group;the differences were statistically significant(P<0.05).After treatment,left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)in the two groups decreased;LVEDD and LVESD in the observation group were(53.20±2.50)mm and(39.10±3.70)mm,significantly smaller than(57.10±3.40)mm and(42.60±4.10)mm in the control group;the differences were statistically significant(P<0.05).After treatment,hemorheological indicators in the two groups decreased;plasma viscosity,hematocrit,whole blood high-shear viscosity,and low-shear viscosity in the observation group were significantly lower than those in the control group;the differences were statistically significant(P<0.05).After treatment,serum NT-proBNP and Hcy levels in the two groups decreased;the levels of NT-proBNP and Hcy in the observation group were(1367.24±91.55)pg/mL and(14.31±4.55)μmol/L,significantly lower than(1864.51±96.37)pg/mL and(17.37±4.82)μmol/L in the control group;the differences were statistically significant(P<0.05).Conclusion Qishen Yiqi Dripping Pills as adjuvant treatment for conventional treatment can improve cardiac function and hemorheological indicators,and lower serum NT-proBNP and Hcy levels in patients with CHD and heart failure,thereby improving the therapeutic effect.