破格救心汤联合重组人脑利钠肽对急性心力衰竭患者心功能及血清BNP、CK-MB和cTnI水平的影响  

Effect of Poge Jiuxin Decoction Combined with Recombinant Human Brain Natriuretic Peptide on Heart Function,Serum BNP,CK-MB and cTnI Levels in Acute Heart Failure

作　　者：及孟[1] 李光智[1] 余洪 王转转[1] 迟娇 Ji Meng;Li Guangzhi;Yu Hong(Hainan Provincial Hospital of Traditional Chinese Medicine,Hainan,Haikou 570203,China)

机构地区：[1]海南省中医院

出　　处：《中国中医急症》2019年第9期1524-1527,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：海南省卫生厅科研基金资助项目(琼卫2015-103)

摘　　要：目的探讨破格救心汤联合重组人脑利钠肽对急性心力衰竭(AHF)患者临床疗效。方法选取116例AHF患者作为研究对象,随机分为两组各58例,对照组采用重组人脑利钠肽治疗,研究组采用破格救心汤联合重组人脑利钠肽治疗。比较两组临床疗效、中医证候积分、心肾功能和血清脑钠肽(BNP)、磷酸肌酸激酶同工酶(CK-MB)及肌钙蛋白I(cTnI)水平的影响以及不良反应情况。结果1)研究组治疗后总有效率显著高于对照组(P<0.05)。2)两组治疗3d后LVEF水平较治疗前升高,LVEDD、LVESD水平较治疗前均降低,两组治疗7d后LVEF水平较治疗前及治疗3d后升高,LVEDD、LVESD水平较治疗前及治疗3d后均降低,且研究组改变幅度大于对照组(P<0.05)。3)两组治疗3d后中医证候积分较治疗前均降低,两组治疗7d后中医证候积分较治疗前及治疗3d后均降低,且研究组降低幅度明显大于对照组(P<0.05)。4)两组治疗3d后血清BNP、CK-MB及cTnI水平较治疗前均降低,两组治疗7d后血清BNP、CK-MB及cTnI水平较治疗前及治疗3d后均降低,且研究组降低幅度明显大于对照组(P<0.05)。5)研究组不良反应总发生率低于对照组,但差异无统计学意义(P>0.05)。结论破格救心汤联合重组人脑利钠肽治疗AHF患者可显著提高临床疗效,改善心肾功能,降低血清BNP、CK-MB及cTnI水平,安全性好。Objective:To investigate the effect of Poge Jiuxin Decoction combined with rhbnp on acute heart failure.Methods:116 patients were randomly divided into two groups,58 in each.The control group received rhbnp,while the study group received rhbnp combined with Poge Jiuxin Decoction.The clinical efficacy,TCM syndrome score,heart and kidney function,BNP,CK-MB and cTnI levels were compared between the two groups.Results:After treatment,the total effective rate of the study group was significantly higher than that of the control group(P < 0.05).On the 3rd day after treatment,the levels of LVEF increased and the levels of LVEDD and LVESD decreased in both groups.After 7 days of treatment,the levels of LVEF increased,and the levels of LVEDD and LVESD decreased compared with those before treatment and after 3 days of treatment,and the changes in the study group were greater than those in the control group(P < 0.05).The scores of TCM syndromes in the two groups decreased after 3 days of treatment compared with those before treatment.Those in the two groups decreased after 7 days of treatment compared with those before treatment and after 3 days of treatment,and the decrease in the study group was significantly greater than that in the control group(P < 0.05).The levels of serum BNP,CK-MB and cTnI in the two groups decreased after 3 days of treatment compared with before treatment. Those in the two groups decreased after 7 days of treatment compared with before treatment and after 3 days of treatment,and the decrease in the study group was significantly greater than that in the control group(P < 0.05). The total incidence of adverse reactions in the study group was lower than that in the control group,but there was no significant difference(P > 0.05).Conclusion:Poge Jiuxin Decoction combined with rhbnp can significantly improve the clinical efficacy,improve heart and kidney function,reduce serum BNP,CK-MB and cTnI levels,and has good safety,which can be further studied.

关 键 词：急性心力衰竭 破格救心汤 重组人脑利钠肽 临床疗效 

分 类 号：R541.61[医药卫生—心血管疾病]