曲美他嗪联合中药方剂对老年心力衰竭合并肺部感染的疗效观察

Effect of trimetazidine combined with traditional Chinese medicine on treatment of elderly heart failure patients complicated with pulmonary infection

目的观察和分析曲美他嗪联合中药对老年心力衰竭合并肺部感染的疗效,为制定合理的治疗方案提供研究依据。方法选取2015年7月-2017年7月120例老年心力衰竭合并肺部感染患者作为研究对象,按是否应用中药辅助治疗分为研究组和对照组,每组60例。对照组患者给予常规对症疗法联合口服盐酸曲美他嗪治疗,研究组患者在对照组疗法基础上给予口服自拟中药汤剂治疗,观察并记录两组患者治疗后心衰和肺部感染改善情况,比较两组患者治疗前后血清脑钠肽(BNP)和左室射血分数(LVEF)水平的差异。结果治疗后研究组患者心衰临床有效率和肺炎有效率分别为88.33%和96.67%,高于对照组的65.00%和71.67%,差异均有统计学意义(χ~2=9.130,14.070;均P<0.05);研究组患者治疗后血清BNP水平为(126.35±22.19)ng/L,LVEF水平为(56.56±11.14)%,分别优于对照组的(253.64±27.31)ng/L和(45.06±9.87)%,两组比较差异均有统计学意义(P<0.05);研究组患者体温恢复正常时间、咳嗽消失时间和住院时间相比对照组均缩短(P<0.05)。结论应用曲美他嗪联合中药治疗老年心力衰竭合并肺部感染,能够提高针对心衰和肺炎的治疗效果,减轻心肌损害,促进心室射血功能的恢复,有利于改善患者的预后。

OBJECTIVE To observe the effect of trimetazidine combined with traditional Chinese medicine on treatment of elderly heart failure patients complicated with pulmonary infection so as to formulate appropriate treatment schemes.METHODS A total of 120 elderly heart failure patients complicated with pulmonary infection who were treated in the hospital from Jul 2015 to Jul 2017 were recruited as the study objects and divided into the study group and the control group according to the adjuvant therapy of traditional Chinese medicine,with 60 cases in each group.The control group was given conventional heteropathy combined with oral administration of trimetazidine hydrochloride,while the study group was treated with additional oral administration of traditional Chinese medicine decoction on basis of the treatment of the control group.The status of improvement of heart failure and pulmonary infection in the two groups of patients were observed and recorded,and the levels of serum brain natriuretic peptide(BNP)and left ventricular ejection fraction(LVEF)were compared between the two groups of patients before and after the treatment.RESULTS The effective rates of clinical treatment of heart failure and pneumonia of the study group were respectively 88.33%and 96.67%,significantly higher than 65.00%and 71.67%of the control group(χ~2=9.130,14.070;all P<0.05).After the treatment,the serum BNP level of the study group was(126.35±22.19)ng/L,significantly lower than(253.64±27.31)ng/L of the control group;the LVEF level of the study group was(45.06±9.87)%,significantly better than(56.56±11.14)%of the control group(P<0.05).The time of body temperature returning to normal,time of disappearance of cough and length of hospital stay were shorter in the study group than in the control group(P<0.05).CONCLUSIONTrimetazidine combined with traditional Chinese medicine can achieve remarkable effect on treatment of heart failure and pneumonia in the elderly heart failure patients complicated with pulmonary infection,alleviate myocardial damage,promote the recovery of ventricular ejection function and improve the prognosis of the patients.