麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的效果观察

The effect of Shexiang Baoxin Pills combined with recombinant human brain natriuretic peptide in the treatment of ischemic heart failure

目的探讨麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的临床疗效,以期为缺血性心力衰竭患者的治疗提供参考。方法选取2022年1月-2023年1月杭州市富阳区中医院收治的100例缺血性心力衰竭患者,采用随机数字表法随机分为2组,对照组患者(50例)在常规治疗基础上给予重组人脑利钠肽治疗,观察组患者(50例)在对照组的基础上联合麝香保心丸治疗,均连续用药3个月,比较2组治疗总有效率、治疗前后心功能、中医证候积分和不良反应。结果与对照组比较,观察组患者左室射血分数显著提高[(50.25±5.64)%vs.(45.58±5.47)%,t=4.203,P<0.001],左室舒张末期内径[(52.64±4.44)mm vs.(55.38±4.07)mm,t=3.217,P=0.002]、左室收缩末期内径[(38.21±4.16)mm vs.(42.38±4.58)mm,t=4.766,P<0.001]、中医证候积分[(8.39±2.66)分vs.(11.67±2.95)分,t=5.839,P<0.001]显著降低;观察组中医证候整体疗效优于对照组(Z=-2.289,P=0.022);2组临床总有效率和不良反应发生率比较,差异均无统计学意义(均P>0.05)。结论麝香保心丸联合重组人脑利钠肽可显著提高缺血性心力衰竭患者的临床疗效,改善心功能,优于单独应用重组人脑利钠肽。

Objective To explore the clinical efficacy of Shexiang Baoxin pills combined with recombinant human brain natriuretic peptide in the treatment of ischemic heart failure,in order to provide reference for the treatment of ischemic heart failure patients.Methods A total of 100 patients with ischemic heart failure admitted to Fuyang District Hospital of Traditional Chinese Medicine in Hangzhou from January 2022 to January 2023 were selected as study subjects and randomly divided into two groups by random number table method.Patients in control group(n=50)received recombinant human brain natriuretic peptide therapy on the basis of conventional treatment,and patients in observation group(n=50)received combined therapy with Shexiang Baoxin Pills on the basis of control group.The overall response rate,pre-and post-treatment cardiac function(left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter),traditional Chinese medicine(TCM)syndrome score and adverse drug reactions were compared in both groups.Results Compared with the control group,left ventricular Ejection fraction was significantly increased in the observation group[(50.25±5.64)%vs.(45.58±5.47)%,t=4.203,P<0.001],the left ventricular end diastolic diameter[(52.64±4.44)mm vs.(55.38±4.07)mm,t=3.217,P=0.002],left ventricular end systolic diameter[(38.21±4.16)mm vs.(42.38±4.58)mm,t=4.766,P<0.001],and the TCM syndrome score was significantly reduced[(8.39±2.66)points vs.(11.67±2.95)points,t=5.839,P<0.001];The overall effect of TCM syndrome in the observation group was better than that in the control group(Z=-2.289,P=0.022).There were no significant differences in the overall efficacy rate and the incidence of adverse reactions between the two groups(all P>0.05).Conclusion The combined use of Shexiang Baoxin Pills and recombinant human brain natriuretic peptide on the basis of conventional heart failure treatment can significantly improve the clinical efficacy and cardiac function of patients with ischemic heart failure,which is superior to the use of recombinant human brain natriuretic peptide alone.