芪苈强心胶囊联合曲美他嗪治疗慢性心力衰竭临床研究  

Clinical study on combination of Qiliqiangxin capsule with trimetazidine in patients with chronic heart failure

作　　者：陈万强[1] 于军[1] 白玲强[1] 杨瑞金[1] 王芳[1] 马涛[1] 姜敏华[1] 

机构地区：[1]陕西宝鸡解放军第三医院心内科,721004

出　　处：《疑难病杂志》2012年第11期830-832,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨芪苈强心胶囊联合曲美他嗪对慢性心力衰竭(CHF)患者的临床疗效。方法选择CHF患者180例,随机分为3组:对照组60例,给予常规抗心力衰竭治疗;曲美他嗪组60例,在常规治疗的基础上加用曲美他嗪;联合治疗组60例,在常规治疗基础上加用芪苈强心胶囊和曲美他嗪。治疗前后观察心力衰竭症状和体征,记录NYHA分级和心功能等指标的变化及6 min步行试验(6 min WT),超声心动图测定左心室舒张末内径(LVEDD)、LVEF、左心室短轴缩短率(FS)、二尖瓣舒张早期血流峰值速度(E)/二尖瓣舒张晚期血流峰值速度(A)之比(E/A)。结果曲美他嗪组、联合治疗组显效率及总有效率均高于对照组,而联合治疗组优于曲美他嗪组,差异均有统计学意义(P<0.05)。曲美他嗪组和联合治疗组治疗后LVEDD、LVEF、FS、E/A较对照组明显改善,6 min WT距离明显延长(P<0.05,P<0.01);与曲美他嗪组比较,联合治疗组治疗后上述指标改善更为显著,差异有统计学意义(P<0.05)。结论在常规治疗基础上联合应用曲美他嗪和芪苈强心胶囊能进一步改善心功能、提高患者运动耐量及改善心室重构。Objective To evaluate clinical efficacy of combination of Qiliqiangxin capsule with trimetazidine on chro- nic heart failure （CHF）. Methods One hundred and eighty patients with CHF were randomly divided into 3 groups ： control group （ n = 60）, received routine treatment of heart failure only; the trimetazidine group （ n = 60）, received routine treat- ment plus trimetazidine ; the combined group （ n = 60）, received routine treatment plus Qiliqiangxin capsule and trimetazi- dine. left ventricular end-diastolic diameter （ LVEDD）, LVEF, 1 eft ventricle shortening fraction （ FS）, and the ratio of maxi- mal velocity of bicuspid blood flow in the early （E） and advanced （A） stages of left ventricle diastole （E/A） were detected by echocardiogram, and NYHA functional class and six-minute walking test （6 min WT） were recorded before and after treat- ment. Results The effective rate and total effective rate in trimetazidine group, combined group were higher than those in the control group, while the combined treatment group better than trimetazidine group, the differences were statistically significant （ P 〈 0.05 ）. LVEDD, LVEF, FS, E/A in trimetazidine group and combined treatment group after treatment improved signifi- cantly than the control group, 6 min WT distance was extended （ P 〈 0.05, P 〈 0.01 ） ; and compared with trimetazidine group, after the treatment indicator of combined treatment group improved more significantly, the difference was statistically significant（ P 〈 0. 05 ）. Conclusion On the basis of routine treatment of combined application of trimetazidine and Qiliqiangxin capsule can further improve cardiac function, improves exercise tolerance and myocardial remodeling.

关 键 词：芪苈强心胶囊 曲美他嗪 心力衰竭 慢性 心室重构 超声心动图 

分 类 号：R541.6[医药卫生—心血管疾病]