摘要
目的观察芪苈强心胶囊治疗慢性心力衰竭患者的临床疗效。方法选择2021年10月—2022年10月在医院心血管内科住院治疗的120例慢性心力衰竭患者作为研究对象,按照不同治疗方法将患者平均分为常规治疗组和芪苈强心组,各组60例,常规治疗组患者予以西医常规治疗,芪苈强心组患者同时予以芪苈强心胶囊治疗。观察两组患者临床效果和不良反应,比较干预前后临床症状、心功能、血流动力学以及血管内皮功能变化。结果常规治疗组和芪苈强心组的总有效率分别为78.33%(47/60)、91.67%(55/60),芪苈强心组的总有效率相较于常规治疗组明显上升(P<0.05)。干预前,两组患者的中医证候积分水平无明显差异(P>0.05)。干预8周后,芪苈强心组患者的心悸、气短、乏力以及下肢水肿等证候积分水均明显下降(P<0.01)。干预8周后,芪苈强心组患者的左室射血分数(left ventricular e⁃jection fractions,LVEF)相较于常规治疗组明显升高,而左心室收缩末期内径(left ventricular end-systolic dimension,LVESD)和左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)水平则明显降低(P<0.01);与常规治疗组比较,芪苈强心组患者的血管内皮生长因子(vascular endothelial growth factor,VEGF)和一氧化氮(nitric oxide,NO)水平明显升高,而血浆内皮素-1(endothelin-1,ET-1)水平则明显下降(P<0.01)。干预8周后,与常规治疗组比较,芪苈强心组患者的CI、SV和CO水平均明显升高(P<0.01);与常规治疗组比较,芪苈强心组患者的6 min步行试验(6MWT)水平明显升高,而明尼苏达生活质量评分(MLHFQ)评分水平则明显下降(P<0.01)。两组患者干预过程中生命体征平稳,主要不良反应有恶心呕吐、消化不良、眩晕乏力等,两组总不良反应发生率分别为8.33%(5/60)和11.67%(7/60),差异不具有统计学意义(P>0.05)。结论芪苈强心胶囊联合西医常规治疗能够明显提高慢性心力衰竭患者的临床疗效,改善心功能和心力衰竭症状,调节血流动力学,保护血管内皮功能,且无不良反应增加,提高患者生活质量。
Objective To observe the clinical effect of Qili Qiangxin Capsule(芪苈强心胶囊)on chronic heart failure.Meth⁃od A total of 120 patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine of the hospital from October 2021 to October 2022 were selected as the study subjects.According to different treatment methods,all patients were divided into conventional treatment group and Qili Qiangxin Capsule group,with 60 cases in each.The conventional treat⁃ment was treated with conventional Western medicine,and Qili Qiangxin Capsule was also given to Qili Qiangxin Capsule group on the basis of the conventional Western medicine.The clinical effects and adverse reactions of the two groups were observed,and the changes of clinical symptoms,cardiac function,hemodynamics and vascular endothelial function before and after intervention were compared.Results The total effective rates of Qili Qiangxin Capsule group and conventional treatment group were 78.33%(47/60)and 91.67%(55/60),respectively,and the total effective rate of Qili Qiangxin Capsule group was significantly higher than that of the conventional treatment(P<0.05).Before intervention,there was no significant difference in TCM syndrome scores between the two groups(P>0.05).After 8 weeks of intervention,the scores of palpitation,shortness of breath,fatigue and lower limb edema were significantly reduced in Qili Qiangxin Capsule group(P<0.01).After 8 weeks of intervention,the value of left ventricular ejection fractions(LVEF)in Qili Qiangxin Capsule group was significantly higher than that of the conventional treatment group,while the values of left ventricular end-systolic dimension(LVESD)and left ventricular end-diastolic dimen⁃sion(LVEDD)were significantly lower(P<0.01).Compared with those of the conventional treatment group,the levels of vascu⁃lar endothelial growth factor(VEGF)and nitric oxide(NO)were significantly increased,while endothelin-1(ET-1)levels were significantly decreased in Qili Qiangxin Capsule group(P<0.01).After 8 weeks of intervention,the values of cardiac index(CI),stroke output(SV)and cardiac output(CO)in Qili Qiangxin Capsule group were significantly higher than those of the con⁃ventional treatment group(P<0.01).Compared with those of the conventional treatment group,6-minute walking test(6MWT)level was significantly increased,while Minnesota Living with Heart Failure Questionnaire(MLHFQ)score was significantly de⁃creased in the Qili Qiangxin Capsule group(P<0.01).The vital signs of the two groups were stable during the intervention,and the main adverse reactions included nausea and vomiting,dyspepsia,dizziness and fatigue,etc.The incidence of total adverse re⁃actions in the two groups was 8.33%(5/60)and 11.67%(7/60),respectively,and the difference was not statistically significant(P>0.05).Conclusion Qili Qiangxin Capsule combined with conventional Western medicine treatment can significantly improve the clinical efficacy and the cardiac function and symptoms of heart failure patients,regulate the hemodynamics,protect the vascu⁃lar endothelial function,has no increased adverse reactions and can improve the quality of life.
作者
胡耀东
杨一波
田敏
HU Yaodong;YANG Yibo;TIAN Min(Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi,China)
出处
《中华中医药学刊》
CAS
北大核心
2024年第5期36-40,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(81302518)
首都医科大学重点实验室开放研究项目(2021-04)。
关键词
慢性心力衰竭
芪苈强心胶囊
临床疗效
心功能
血管内皮功能
血流动力学
chronic heart failure
Qili Qiangxin Capsule(芪苈强心胶囊)
clinical effect
cardiac function
vascular endothe⁃lial function
hemodynamics
