注射用益气复脉(冻干)治疗老年冠心病合并慢性心力衰竭伴低血压的临床观察

Clinical observation of Yiqi Fumai Lyophilized Injection in treatment of elderly patients with coronary heart disease,chronic heart failure and hypotension

目的观察注射用益气复脉(冻干)治疗老年冠心病合并慢性心力衰竭(CHF)伴低血压患者的临床疗效及安全性。方法回顾性收集2018年2月-2022年2月在贵州医科大学附属医院中医科住院的老年冠心病合并CHF伴低血压患者90例为研究对象,根据治疗方案不同分为对照组和试验组,每组各45例。对照组患者仅行抗心衰治疗,试验组在对照组基础上给予注射用益气复脉(冻干)5.2 g用5%葡萄糖注射液或0.9%氯化钠注射液250 mL溶解,静脉滴注,每天1次,连续使用14 d。治疗后观察两组的临床疗效,比较两组患者治疗前后心功能指标[左室射血分数(LVEF)、氨基端前心钠肽(NT-proBNP)、6 min步行试验距离(6MWD)]和血压水平。观察治疗期间两组不良反应发生情况。结果治疗后,试验组总有效率为95.56%,显著高于对照组的84.44%(P<0.05)。治疗前两组患者LVEF、NT-proBNP、6MWD比较,差异无统计学意义(P>0.05);治疗后两组患者LVEF和6MWD均较本组治疗前显著增加(P<0.05),NT-proBNP均较本组治疗前显著降低(P<0.05),且试验组LVEF和6MWD显著高于对照组(P<0.05),NT-proBNP显著低于对照组(P<0.05)。治疗前两组患者平均收缩压和舒张压比较,差异均无统计学意义(P>0.05);治疗后,两组患者平均收缩压和舒张压均较本组治疗前显著升高(P<0.05),且试验组治疗后平均收缩压和舒张压均显著高于对照组(P<0.05)。治疗期间对照组不良反应发生率为11.11%,试验组不良反应发生率为6.67%,两组比较,差异有统计学意义(P<0.05)。结论注射用益气复脉(冻干)治疗老年冠心病合并CHF伴低血压患者临床疗效肯定,改善患者心功能,并升压平稳,具有较高安全性。

Objective To observe the clinical efficacy and safety of Yiqi Fumai Lyophilized Injection in the treatment of coronary heart disease with chronic heart failure(CHF)and hypotension.Methods A total of 90 elderly patients with coronary heart disease with chronic heart failure(CHF)and hypotension hospitalized in the Department of Traditional Chinese Medicine of the Affiliated Hospital of Guizhou Medical University from February 2018 to February 2022 were retrospectively collected as the research objects.According to different treatment schemes,they were divided into the control group and the experimental group,with 45 cases in each group.Patients in the control group only received anti heart failure treatment(including sufficient rest,oxygen inhalation,correction of arrhythmia,control of blood pressure,and maintenance of electrolytes,applicationβ-receptor blockers,angiotensin II receptor antagonists,angiotensin converting enzyme inhibitors,etc).On the basis of the control group,the patients in experimental group were given 5.2 g of Yiqi Fumai Lyophilized Injection,dissolved in 250 mL of 5%Glucose Injection or 0.9%Sodium Chloride Injection,intravenous drip once a day,for 14 consecutive days.After 14 days of treatment the clinical efficacy of the two groups was observed,and the heart function indexes[left ventricular ejection fraction(LVEF),N-terminal fragment of brain natriuretic peptide(NT-proBNP),and 6-minute walk test distance(6MWD)]and blood pressure were compared between the two groups before and after treatment.The occurrence of adverse reactions in both groups during the treatment period were observed.Results After 14 days of treatment,the total effective rate of the experimental group was 95.56%,significantly higher than 84.44%in the control group(P<0.05).There was no statistically significant difference in LVEF,NT-proBNP,and 6MWD between the two groups of patients before treatment(P>0.05).After treatment,LVEF and 6MWD in both groups of patients significantly increased compared to before treatment in same group(P<0.05),while NT-proBNP significantly decreased compared to before treatment in same group(P<0.05).LVEF and 6MWD in the experimental group were significantly higher than those in the control group(P<0.05),while NT-proBNP was significantly lower than those in the control group(P<0.05).There was no statistically significant difference in average systolic and diastolic blood pressure between the two groups of patients before treatment(P>0.05).After After 14 days of treatment,the average systolic and diastolic blood pressure of both groups of patients significantly increased compared to before treatment in same group(P<0.05),and the average systolic and diastolic blood pressure of the experimental group after treatment was significantly higher than that of the control group(P<0.05).During the treatment period,the incidence of adverse reactions in the control group was 11.11%,while the incidence of adverse reactions in the experimental group was 6.67%.The difference between the two groups was statistically significant(P<0.05).Conclusion The clinical efficacy of Yiqi Fumai Lyophilized Injection in the treatment of elderly patients with coronary heart disease complicated with CHF and hypotension is positive,and it can improve the patients'cardiac function,stabilize the pressure rise,and has high safety.