心衰合剂联合西药治疗扩张型心肌病伴心力衰竭患者43例临床观察  

Clinical Observation on Xinshuai Heji(心衰合剂) Combined with Western Medicine for 43 Dilated Cardiomyopathy Patients with Heart Failure

作　　者：卢磊[1,2] 夏伟[3] 徐重白[3] 平凡[1] 朱尧[1] 刘敏 张培影[4] 

机构地区：[1]南京中医药大学第一临床医学院 [2]南京中医药大学附属徐州市中医院 [3]江苏省中西医结合医院 [4]徐州市中心医院

出　　处：《中医杂志》2015年第13期1124-1127,共4页Journal of Traditional Chinese Medicine

摘　　要：目的观察心衰合剂联合西药治疗扩张型心肌病伴心力衰竭的临床疗效。方法将85例扩张型心肌病伴心力衰竭患者随机分为治疗组43例和对照组42例。两组均给予常规抗心力衰竭治疗,治疗组同时给予心衰合剂,每天2次,每次25 ml。两组均连续治疗3个月。观察治疗前后两组患者临床症状、体征、心功能分级并判定临床疗效;治疗前、治疗2周后检测两组患者血浆转化生长因子β1(TGF-β1)、脑钠肽(BNP)水平;治疗前、治疗2周及3个月测量左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左心室射血分数(LVEF)及左心室短轴缩短率(FS)。结果治疗2周、3个月时治疗组临床疗效总有效率分别为90.7%、97.7%,对照组分别为80.9%、88.1%,治疗组均明显优于对照组(P<0.05)。治疗2周、3个月时治疗组LVEDD、LVESD均明显降低,LVEF、FS均明显升高,对照组LVEF明显升高(P<0.05或P<0.01)。治疗2周时治疗组LVESD明显低于对照组(P<0.05);治疗3个月时治疗组LVESD明显低于对照组,FS明显高于对照组(P<0.05)。治疗2周时两组患者BNP、TGF-β1水平均明显下降(P<0.05或P<0.01);治疗组BNP、TGF-β1水平明显低于对照组(P<0.05)。结论心衰合剂联合西药可以改善扩张型心肌病伴心力衰竭患者的心功能,可能对改善患者左室重构有一定作用。Objective To observe the clinical efficacy of Xinshuai Heji（ XH） combined with western medicine in treating dilated cardiomyopathy with heart failure. Methods Totally 85 dilated cardiomyopathy patients with heart failure were randomly divided into a treatment group with 43 cases and a control group with 42 cases. Both groups were given conventional treatments for heart failure. Meanwhile,the treatment group was also given XH,twice per day,25 ml each time. After continual treatments for 3months,the clinical symptoms,signs and heart functional classification before and after treatments in the two groups were observed and the clinical efficacies were evaluated.The plasma transforming growth factor β1（ TGF-β1） and brain natriuretic peptide（ BNP） contents were tested before treatment and treating for 2 weeks. The left ventricular end diastolic diameter（ LVEDD）,left ventricular end systolic diameter（ LVESD）,left ventricular ejection fraction（ LVEF） and fraction shortening（ FS） were examined before treatment and treating for 2 weeks,3 months. Results The total effective rates at the 2-week and 3-month treatment in the treatment group were 90. 7% and 97. 7% respectively,while 80. 9% and 88. 1% in the control group.The treatment group was significantly better than the control group（ P〈0. 05）. At the treatment for 2 weeks and 3months,the LVEDD and LVESD were significantly diminished and the LVEF and FS were markedly improved in the treatment group（ P〈0. 05 or P〈0. 01）,and LVEF was significantly increased in the control group（ P〈0. 05）.Compared with the control group,LVESD in the treatment group was obviously diminished after treating for 2 weeks and 3 months（ P〈0. 05）,FS in the treatment group was markedly higher after treating for 3 months（ P〈0. 05）.The BNP and TGF-β1 contents were significantly reduced in the two groups after treating for 2 weeks than before（ P〈0. 05 or P〈0. 01）,and the treatment group was much lower than the control group（ P〈0. 0

关 键 词：扩张型心肌病 心力衰竭 心衰合剂 心室重构 心功能 

分 类 号：R542.2[医药卫生—心血管疾病]