血府逐瘀胶囊联合沙库巴曲缬沙坦对扩张型心肌病的治疗效果研究

Study on the therapeutic effect of Xuefu Zhuyu Capsule combined with sacubitril valsartan on patients with dilated cardiomyopathy

目的研究血府逐瘀胶囊联合沙库巴曲缬沙坦对扩张型心肌病的治疗效果。方法选取2020年1-12月在该院住院的70例扩张型心肌病患者作为研究对象,分为对照组和试验组,各35例。对照组仅采用沙库巴曲缬沙坦治疗,试验组采用血府逐瘀胶囊联合沙库巴曲缬沙坦治疗。根据患者血压及肾功能情况,将沙库巴曲缬沙坦从小剂量开始逐步增加至最大剂量,血府逐瘀胶囊用法为2.4 g/次,2次/d,治疗时间为3个月。观察治疗后两组患者心力衰竭症状、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL)、总胆固醇(TC)、甘油三酯(TG)、ALT、AST、氨基末端脑钠肽前体(NT-proBNP)、左室收缩末内径(LVEDd)、左室舒张末内径(LVEDs)、射血分数(EF)及心律失常发生率情况。结果治疗后,与对照组比较,试验组患者NT-proBNP水平明显下降(P<0.05);两组LDL、TC、TG、LVEDd、LVEDs、EF比较差异无统计学意义(P>0.05);试验组房性心动过速及室性早搏发生率高于对照组(P<0.05)。结论血府逐瘀胶囊联合沙库巴曲缬沙坦能明显改善心力衰竭患者症状,降低NT-proBNP水平,但可能会增加患者发生房性心动过速及室性早搏发生率。

Objective To study the therapeutic effect of Xuefu Zhuyu Capsule combined with sacubitril valsartan on dilated cardiomyopathy.Methods A total of 70 patients with dilated cardiomyopathy who were hospitalized in the Hospital from January to December 2020 were selected as the research objects and randomly divided into control group and experimental group,with 35 cases in each group.The control group was only treated with sacubitril valsartan,and the experimental group was treated with Xuefu Zhuyu Capsule combined with sacubitril valsartan.According to the patient’s blood pressure and renal function,sacubitril valsartan was titrated from a small dose to the maximum dose.Xuefu Zhuyu Capsule was uesd 2.4 g each time,twice a day,and the treatment time was three months.The symptoms of heart failure,glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL),total cholesterol(TC),triglyceride(TG),ALT,AST,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-systolic diameter(LVEDd),left ventricular end-diastolic diameter(LVEDs),ejection fraction(EF)and the incidence of arrhythmia were observed in the two groups after treatment.Results After treatment,the level of NT-proBNP in the experimental group was significantly lower than that in the control group(P<0.05).There was no significant difference in LDL,TC,TG,LVEDd,LVEDs and EF between the two groups(P>0.05).The incidence of atrial tachycardia and ventricular premature beat in the experimental group was higher than that in the control group(P<0.05).Conclusion Xuefu Zhuyu Capsule combined with sacubitril valsartan can significantly improve the symptoms of patients with heart failure and reduce the level of NT-proBNP,but it may increase the proportion of patients with atrial tachycardia and ventricular premature beats.