参附注射液对急性心衰患者炎性指标、心功能及临床疗效的影响

Effect of Shenfu Injection on Inflammatory Index,Cardiac Function and Clinical Efficacy in Patients with Acute Heart Failure

目的观察参附注射液对急性心力衰竭(心肾阳虚型)患者的疗效,并探讨其作用机制。方法89例患者按随机数字表法分为观察组45例与对照组44例,两组均给予常规西药治疗,观察组在对照组基础上加用参附注射液。比较两组血清炎性指标、血流动力学指标、心功能及临床疗效。结果两组治疗前白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、左心室射血分数(LVEF)、脑利钠肽(BNP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)水平和血流动力学指标心排血量(CO)、平均动脉压(MAP)、肺动脉压(PAP)水平比较,差异无统计学意义(均P>0.05)。两组治疗后5、10 d,IL-6、hs-CRP、LVEF、BNP、CK-MB、cTnT水平和血流动力学指标CO、MAP、PAP水平均较治疗前改善(均P<0.05),且观察组的各项指标改善均优于对照组(P<0.05)。治疗后观察组的总有效率为86.67%,高于对照组的72.73%。两组治疗期间及治疗后均未发现不良反应。结论参附注射液治疗急性心力衰竭可有效降低患者的血清炎性指标,改善血流动力学,提高心功能,改善生活质量,疗效良好。

Objective:To observe the efficacy of Shenfu Injection in patients with acute heart failure(syndrome of yang deficiency of heart and kidney)and to explore its mechanism of action.Methods:A total of 89 patients were randomly divided into the observation group(45 cases)and the control group(44 cases)according to random number table method,and both groups were treated with conventional western medicine;the observation group was added with Shenfu Injection on the basis of the control group.Serum inflammatory indexes,hemodynamic indexes,cardiac function and clinical efficacy were compared between the two groups.Results:There was no significant difference in the levels of IL-6,hs-CRP,LVEF,BNP,CK-MB,cTnT and the levels of hemodynamic indexes CO,MAP and PAP between the two groups before treatment(all P>0.05).On the 5th and 10th days after treatment,the levels of IL-6,hs-CRP,LVEF,BNP,CK-MB,and cTnT and the levels of hemodynamic indexes CO,MAP and PAP in the two groups were improved compared with those before treatment(all P<0.05),and the improvement of all indicators in the observation group was better than that in the control group in the same period(all P<0.05).The total effective rate of treatment in the observation group was 86.67%,which was higher than 72.73%in the control group.No adverse reactions were found during or after treatment in both groups.Conclusion:Shenfu Injec⁃tion can effectively reduce the serum related inflammatory index,improve hemodynamics,improve cardiac function,improve the quality of life,and have a good effect.