丹红注射液联合卡维地洛治疗心力衰竭的临床研究  

Clinical study on Danhong Injection combined with carvedilol in treatment of heart failure

作　　者：王艳 张丽 刘玉 张治祥 

机构地区：[1]陕西中医药大学附属医院药剂科,陕西咸阳712000 [2]宁夏灵武市宁东镇宁东医院药政科,宁夏银川750411 [3]陕西中医药大学附属医院心内科,陕西咸阳712000

出　　处：《现代药物与临床》2017年第12期2328-2332,共5页Drugs & Clinic

摘　　要：目的探讨丹红注射液联合卡维地洛片治疗心力衰竭的临床疗效。方法选取2014年7月—2016年8月在陕西中医药大学附属医院进行治疗的心力衰竭患者150例,随机分为对照组(75例)和治疗组(75例)。对照组患者口服卡维地洛片,初始剂量5 mg/次,2次/d,服用5 d后以5 mg/d递增,总量不超过50 mg/d。治疗组在对照组的基础上静脉滴注丹红注射液,20 m L加入5%葡萄糖溶液250 m L,1次/d。两组患者均连续治疗4周。观察两组的临床疗效,比较治疗前后两组患者心功能指标、血清细胞因子水平和血清氧化应激指标。结果治疗后,对照组临床总有效率为82.67%,显著低于治疗组的97.33%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期容积(LVESV)和左心室收缩末期内径(LVESD)显著降低,左室射血分数(LVEF)明显升高,同组比较差异具有统计学意义(P<0.05);且治疗组患者心功能指标比对照组改善更显著(P<0.05)。治疗后,两组患者血清N末端前脑利钠肽(NT-pro BNP)、生长分化因子-15(GDF-15)、β内啡肽(β-EP)、细胞黏附分子-1(ICAM-1)水平均显著降低,血管内皮生长因子(VEGF)和心肌营养素1(CT-1)水平均升高,同组比较差异具有统计学意义(P<0.05);且治疗组上述指标改善后水平明显优于对照组(P<0.05)。治疗后,两组患者血清超氧化物歧化酶(SOD)和总抗氧化能力(TAC)水平均明显升高,丙二醛(MDA)和脂质过氧化物(LPO)水平明显降低,同组比较差异具有统计学意义(P<0.05);且治疗组患者血清氧化应激指标显著优于对照组(P<0.05)。结论丹红注射液联合卡维地洛片治疗心力衰竭可有效改善心功能,具有一定的临床推广应用价值。Objective To investigate the clinical efficacy of Danhong Injection combined with carvedilol in treatment of heart failure. Methods Patients（150 cases） with heart failure in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from July 2014 to August 2016 were randomly divided into control（75 cases） and treatment（75 cases） groups. Patients in the control group were po administered with Carvedilol Tablets, the initial dose was 5 mg/time, twice daily, then increased by 5 mg/d after 5 d, and the maximum dose was not more than 50 mg/d. Patients in the treatment group were iv administered with Danhong Injection on the basis of the control group, 20 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, cardiac function indexes, serum cytokines levels and serum oxidative stress indexes in two groups before and after treatment were compared. Results After treatment, clinical efficacy in the control group was 82.67%, which were significantly lower than 97.33% in the treatment group, and there were differences between two groups（P〈0.05）. After treatment, the LVEDD, LVESV and LVESD in two groups was significantly decreased, but the LVEF was significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the improvement of cardiac function indexes in the treatment group was more significant than that in the control group（P〈0.05）. After treatment, the NT-pro BNP, GDF-15, β-EP, and ICAM-1 levels in two groups were significantly decreased, but VEGF and CT-1 levels were significantly increased, and there were differences in the same group（P〈0.05）. And these indicators levels in the treatment group were significantly better than those in the control group（P〈0.05）. After treatment, the SOD and TAC levels in two groups were significantly increased, but MDA and LPO levels were significantly decreased, and there were differe

关 键 词：丹红注射液 卡维地洛片 心力衰竭 左心室舒张末期内径 N末端前脑利钠肽 细胞黏附分子-1 丙二醛 

分 类 号：R972[医药卫生—药品]