参附注射液在扩张性心肌病合并Ⅱ型心肾综合征治疗中的应用效果  

Efficacy of Shenfu Injection in Dilated Cardiomyopathy with Type Ⅱ Cardiorenal Syndrome

作　　者：梅芳[1] 吴志勇[2] 邹来勇[1] 

机构地区：[1]江西中医药高等专科学校附属医院,抚州市第一中医医院药剂科,江西抚州344000 [2]江西省人民医院心内科,南昌330006

出　　处：《实用临床医学（江西）》2017年第4期10-13,共4页Practical Clinical Medicine

摘　　要：目的观察参附注射液在扩张性心肌病合并Ⅱ型心肾综合征患者治疗中的应用效果。方法将110例扩张性心肌病合并Ⅱ型心肾综合征患者按随机数字表法分为观察组(55例)和对照组(55例),对照组根据慢性心力衰竭治疗指南使用利尿剂、血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体抑制剂、β-受体阻滞剂以及多巴胺、多巴酚丁胺等药物行常规治疗,观察组在常规治疗基础上静脉注射参附注射液80 mL(1次·d-1),2组均治疗1周。比较2组治疗前后心功能、肾功能、肾内动脉血流动力学相关指标的变化情况及治疗期间非洋地黄类正性肌力药物、利尿剂、神经激素拮抗剂的用药剂量。结果 2组治疗后心功能、肾功能、肾内动脉血流动力学相关指标均较治疗前明显改善(P<0.05),且观察组改善程度较对照组更为显著(P<0.05);观察组治疗期间非洋地黄类正性肌力药物、利尿剂的日均剂量较对照组明显减少(P<0.05),而神经激素拮抗剂的日均剂量显著增加(P<0.05)。结论对于扩张性心肌病合并Ⅱ型心肾综合征患者,在常规治疗的基础上参附注射液可进一步改善心、肾功能,同时可减少非洋地黄类正性肌力药物的使用,增加神经激素拮抗剂的耐受程度,从而进一步改善心肾功能及预后。Objective To observe the therapeutic efficacy of Shenfu injection in the treatment of dilated cardiomyopathy（DCM） with type Ⅱ cardiorenal syndrome（CRS）. Methods A total of 110 patients with DCM and type Ⅱ CRS were randomly divided into two groups, with 55 patients in each group. Patients in control group were treated with diuretics, angiotensin converting en-zyme inhibitors or angiotensin H receptor inhibitor, β -receptor blockers, dopamine, dobutamine and other conventional drugs for 1 week. On the basis of conventional treatment, patients in ob-servation group were given intravenous administration of Shenfu injection（80 mL） once per day for 1 week. The parameters reflecting cardiac function, renal function and renal arterial hemody-namics were measured before and after treatment. In addition,the dosages of non-digitalis positive inotropic drugs, diuretics and neurohormonal antagonists were compared between the two groups.Results After treatment , the indexes of cardiac function, renal function and renal arterial hemo-dynamics were significantly improved in both groups, and the improvement in observation group was more obvious than that in control group（P〈0. 05）. Furthermore, compared with control group,the dosages of non-digitalis positive inotropic drugs and diuretics were decreased but the dosages of neurohormonal antagonists were increased in observation group（P〈0. 05）. Conclusion Shenfu injection can improve cardiac and renal function,reduce the use of non-digitalis positive in-otropic drugs, increase the tolerance to neurohormonal antagonists, and ameliorate the prognosis in DCM patients with type Ⅱ CRS.

关 键 词：扩张性心肌病 Ⅱ型心肾综合征 参附注射液 疗效 

分 类 号：R542.2[医药卫生—心血管疾病]