益气复脉汤联合左西孟旦治疗老年心力衰竭的临床研究  

Clinical Efficacy of Yiqi fumai Decoction Combined with Levosimendan in Treatment of Chronic Heart Failure in Elderly Patients

作　　者：王祚克 曾庆宁 周晓露 严思 WANG Zuoke;ZENG Qingning;ZHOU Xiaolu;YAN Si(Department of Traditional Chinese Medicine,Qionghai People's Hospital,Qionghai 571400,Hainan,China;Department of Critical Medicine,Qionghai People's Hospital,Qionghai 571400,Hainan,China)

机构地区：[1]琼海市人民医院中医科,海南琼海571400 [2]琼海市人民医院重症医学科,海南琼海571400

出　　处：《中华中医药学刊》2019年第2期442-445,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：海南省医药卫生科研项目(1404000320A2004)

摘　　要：目的:探讨益气复脉汤联合左西孟旦治疗老年心力衰竭的临床疗效。方法:采用随机数字表法将2016年1月—2017年12月收治的168例老年心力衰竭患者分为观察组及对照组,两组均给予常规治疗,包括控制感染及控制血压等,对照组另给予左西孟旦,观察组在对照组的基础上同时给予益气复脉汤。治疗1个月后,对两组患者进行疗效评价。治疗前后,分别检测两组患者超声心动图相关参数[左心射血分数(LVEF)、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左室舒张早期与晚期充盈速度比值(E/A)及左房内径(LADD)];检测两组患者心脏功能指标[脑钠肽前体(NT-proBNP)、心胸比、心率、6min步行试验长度(6WMT)]。治疗前后,检测两组患者血清炎性因子[肿瘤抑制因子-α(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6)及超敏C反应蛋白(hs-CRP)]含量,检测氧化应激指标[谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、丙二醛(MDA)和总抗氧化能力(T-Aoc)]含量。结果:治疗后,观察组总有效率明显高于对照组(P<0.05)。治疗后,观察组各项超声心动图相关参数、心脏功能指标及炎性因子改善程度均明显优于对照组(P<0.05),且GSH-PX、SOD、MDA及T-Aoc的改善程度亦均明显优于对照组(P<0.05)。结论:益气复脉汤联合左西孟旦治疗老年心力衰竭疗效较好,值得进行深入研究。Objective:To study the clinical efficacy of Yiqi fumai Decoction combined with levosimendan in the treatment of chronic heart failure in elderly patients.Methods:Totally 168 elderly patients with chronic heart failure from Jan.2016 to Dec.2017 were randomly divided into observation group(84 cases)and control group(84 cases).The two groups were treated by regular methods including control blood pressure and infection.The control group was given levosimendan while the observation group was treated with Yiqi fumai Decoction.The effects were observed one month after treatment.Before and after treatment,the levels of cardiac function indexes[left ventricular end-diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left anterior descending diagonal(LADD)and left ventricular early and late diastolic filling velocity ratio(E/A)],general cardiovascular indexes[cardiothoracic ratio,6 WMT,pro-brain natriuretic peptide(NT-proBNP)content and heart rate]were detected in the two groups.Before and after treatment,the inflammatory factors(TNF-α,IL-1,IL-6 and hs-CRP),oxidative stress index(GSH-PX,SOD,MDA and T-Aoc)were observed in the two groups.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group(P<0.05).After treatment,the levels of cardiac function indexes and general cardiovascular indexes were significantly promoted in observation group than those of the control group(P<0.05).After treatment,TNF-α,IL-1,IL-6 and hs-CRP levels were significantly lower,while the levels of GSH-PX,SOD,MDA and T-Aoc were significantly higher in the observation group than those of the control group(P<0.05).Conclusions:Yiqi fumai Decoction combined with levosimendan in the treatment of chronic heart failure in elderly patients has a good clinical efficacy and worth to the next study.

关 键 词：益气复脉汤 左西孟旦 老年 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]