扶正益气法联合低剂量沙库巴曲缬沙坦钠片治疗低血压性心力衰竭的疗效

The therapeutic effect of Fuzheng Yiqi method combined with low-dose Shakubaqu Valsartan sodium tablets on patients with hypotensive heart failure

目的:探讨运用扶正益气法联合低剂量沙库巴曲缬沙坦钠片治疗低血压性心力衰竭(HF)患者的疗效。方法:选取2021年6月~2022年12月肇庆市第二人民医院收治的53例低血压性心力衰竭患者为研究对象,随机分为观察组(n=27)与对照组(n=26)。两组均给予含利尿、β受体阻滞剂、控制危险因素等心力衰竭规范治疗,观察组给予沙库巴曲缬沙坦钠片(小剂量25~50 mg,1~2次/d开始)联合扶正益气的中药制剂,对照组给予低剂量血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂(ACEI/ARB)1/2粒,1次/d开始。两组均根据患者血压耐受情况逐渐把ACEI/ARB或沙库巴曲缬沙坦钠片加至最大耐受剂量。治疗6个月后,比较两组再住院率、左心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVDD)、左室收缩末期内径(LVDS)、N末端-B型钠尿肽前体(NT-proBNP)]等方面的差异。结果:治疗6个月后,两组LVEF较治疗前均升高,LVDS、NT-proBNP较治疗前均有降低,差异有统计学意义(P<0.05);两组治疗后LVEF、LVDS组间比较,差异有统计学意义(P<0.05),LVDD比较差异无统计学意义(P>0.05);观察组收缩压(SBP)较治疗前无明显下降,差异无统计学意义(P>0.05),对照组SBP较治疗前下降,差异有统计学意义(P<0.05),观察组舒张压(DBP)较治疗前升高,对照组DBP较治疗前下降,差异有统计学意义(P<0.05);两组再住院率比较,差异无统计学意义(P>0.05)。结论:扶正益气法联合沙库巴曲缬沙坦钠片治疗低血压性HF患者,可以维持其血压稳定,有助于改善低血压性HF患者的生活质量。

Objective To explore the effect of Fuzheng Yiqi method combined with low-dose Shakubaqu Valsartan sodium tablets on the treatment of patients with hypotensive heart failure(HF).Method 53 patients with hypotensive heart failure were selected as the study subjects from June 2021 to December 2022 and randomly divided into an observation group(n=27)and a control group(n=26).Both groups were given diureticsβStandard treatment for heart failure such as receptor blockers and control of risk factors.The observation group was given a small dose of 25-50mg of sacubatavalsartan sodium tablets 1-2 times a day,combined with traditional Chinese medicine preparations for nourishing qi.The control group was given a low dose of ACEI/ARB(1/2 capsule)once a day.Both groups gradually increased the ACEI/ARB or Sacubatrovalsartan sodium tablets to the maximum tolerable dose based on the patient's blood pressure tolerance.After 6 months of treatment,compare the differences in readmission rates,left ventricular function indicators such as LVEF,LVDD,LVDS,and NT proBNP between the two groups.Results After 6 months of treatment,LVEF of both groups of patients increased compared to before treatment,while LVDS and NT-proBNP decreased compared to before treatment,with statistically significant differences(P<0.05);There was a statistically significant difference in LVEF and LVDS between the two groups of patients after treatment(P<0.05),while there was no statistically significant difference in LVDD(P>0.05).The observation group showed no significant decrease in SBP compared to before treatment,with no statistically significant difference(P>0.05).The control group showed a statistically significant decrease in SBP compared to before treatment(P<0.05).The observation group showed an increase in DBP compared to before treatment,while the control group showed a decrease in DBP compared to before treatment(P<0.05);There was no significant difference in readmission rates between the two groups(P>0.05).Conclusion The combination of Fuzheng Yiqi method and Shakubaqu Valsartan sodium tablets can maintain blood pressure stability and help improve the quality of life of patients with hypotensive HF.