参附注射液联合沙库巴曲缬沙坦钠治疗顽固性心力衰竭的效果

The Effect of Shenfu Injection Combined with Sacubitril Valsartan Sodium in the Treatment of Intractable Heart Failure

目的:分析在顽固性心力衰竭的临床治疗中,参附注射液联合沙库巴曲缬沙坦钠的应用效果。方法:选择淄博市中医医院心血管病科2020年2月—2023年2月收治的80例顽固性心力衰竭患者,按随机数字表法分为两组,各40例。对照组采用沙库巴曲缬沙坦钠治疗,观察组联用参附注射液,比较两组的临床疗效、治疗前后的心功能和心肌损伤标志物。结果:观察组治疗总有效率为92.50%,高于对照组的75.00%,组间差异有统计学意义(P<0.05)。治疗开始前3 d,两组左室射血分数(LVEF)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)、左室收缩末期内径(LVESD)与左室舒张末期内径(LVEDD)比较,差异均无统计学意义(P>0.05),治疗结束后3 d,观察组LVEF为(74.91±4.26)%,高于对照组的(65.57±2.74)%,LVPWT、IVST、LVESD、LVEDD分别为(8.19±0.21)、(9.03±0.38)、(31.32±1.77)、(49.33±1.71)mm,低于对照组的(9.28±0.47)、(10.60±0.60)、(36.27±2.16)、(55.20±2.14)mm,组间差异均有统计学意义(P<0.05)。治疗开始前3 d,两组肌酸激酶同工酶(CK-MB)、生长分化因子-15(GDF-15)、和肽素(CPP)和脑自然肽氨基端前体蛋白(NT-proBNP)水平比较,差异均无统计学意义(P>0.05),治疗结束后3 d,观察组CPP、CK-MB与NT-proBNP、GDF-15水平分别为(14.11±0.54)pmol/L、(15.31±1.26)μg/L、(490.62±15.55)ng/mL、(0.89±0.08)ng/mL,低于对照组的(19.32±0.89)pmol/L、(19.09±1.34)μg/L、(544.42±17.25)ng/mL、(1.03±0.10)ng/mL,组间差异均有统计学意义(P<0.05)。结论:在顽固性心力衰竭的临床治疗中,参附注射液联合沙库巴曲缬沙坦钠应用能够减轻患者心肌损伤,抑制心肌纤维化,降低心肌酶谱水平,改善其心功能和预后表现,治疗实用性较高。

Objective:To analyze the application effect of Shenfu Injection combined with Sacubitril Valsartan Sodium in the clinical treatment of intractable heart failure.Method:A total of 80 patients with intractable heart failure admitted to the Cardiovascular Department of Zibo Traditional Chinese Medicine Hospital from February 2020 to February 2023 were selected and randomly divided into two groups,with 40 cases in each group.The control group was treated with Sacubitril Valsartan Sodium,while the observation group was treated with Shenfu Injection in combination.The clinical efficacy,cardiac function and myocardial injury markers before and after treatment were compared between the two groups.Result:The total effective rate of the observation group was 92.50%,which was higher than 75.00% of the control group,the difference between groups was statistically significant(P<0.05).Three days before the start of treatment,there were no statistically significant differences in left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)between the two groups(P>0.05),three days after treatment,the LVEF of the observation group was(74.91±4.26)%,which was higher than(65.57±2.74)% of the control group,LVPWT,IVST,LVESD and LVEDD were(8.19±0.21),(9.03±0.38),(31.32±1.77)and(49.33±1.71)mm,respectively,which were lower than(9.28±0.47),(10.60±0.60),(36.27±2.16)and(55.20±2.14)mm in the control group,with statistical significance(P<0.05).Three days before the start of treatment,there were no statistically significant differences in the levels of creatine kinase isoenzyme(CK-MB),growth and differentiation factor-15(GDF-15),copeptin(CPP)and brain natural peptide amino terminal precursor protein(NT-proBNP)between the two groups(P>0.05).Three days after treatment,the levels of CPP,CK-MB,NT-proBNP and GDF-15 in the observation group were(14.11±0.54)pmol/L,(15.31±1.26)μg/L,(490.62±15.55)ng/mL,(0.89±0.08)ng/mL,which were lower than(19.32±0.89)pmol/L,(19.09±1.34)μg/L,(544.42±17.25)ng/mL,(1.03±0.10)ng/mL in the control group,the differences between groups were statistically significant(P<0.05).Conclusion:In the clinical treatment of intractable heart failure,the combination of Shenfu Injection and Sacubitril Valsartan Sodium can alleviate myocardial injury,inhibit myocardial fibrosis,lower myocardial enzyme levels,improve cardiac function and prognosis,and has high therapeutic practicality.