参附益气强心汤联合米力农治疗心力衰竭的临床疗效  

Clinical effect of Shenfuyiqiqiangxin decoction combined with milrinone on treating heart failure

作　　者：尧文钟 王金凤 赖晓兰 YAO Wenzhong;WANG Jinfeng;LAI Xiaolan(ICU,Anyuan County People's Hospital,Ganzhou 342100,China)

机构地区：[1]江西省赣州市安远县人民医院ICU,342100

出　　处：《临床合理用药杂志》2021年第36期18-20,24,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨参附益气强心汤联合米力农治疗心力衰竭的临床疗效。方法选取安远县人民医院2019年3月—2021年3月收治的心力衰竭患者84例,按照就诊顺序不同分为对照组与试验组,各42例。对照组给予米力农注射液治疗,试验组在对照组基础上加用鼻饲参附益气强心汤治疗。2组疗程均为4周。比较2组治疗前后超声心动图参数〔左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)和左心室收缩末期容积(LVESV)〕、6 min步行距离(6MWD)、Lee氏心衰积分、血清心肌型-脂肪酸结合蛋白(H-FABP)水平、心室重构机制指标〔血清转化生长因子β1(TGF-β1)、基质金属蛋白酶抑制因子1(TIMP-1)、基质金属蛋白酶9(MMP-9)〕,并观察2组不良反应发生情况。结果治疗后,试验组LVEDD、LVESV小于对照组,LVEF高于对照组,试验组Lee氏心衰积分、血清H-FABP水平低于对照组,6MWD长于对照组(P<0.05)。治疗后,试验组血清TGF-β1、MMP-9水平低于对照组,血清TIMP-1水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在米力农的基础上应用参附益气强心汤能有效改善心力衰竭患者的心功能,降低H-FABP水平,有利于心室重构,且安全性较高。Objective To discuss the clinical effect of Shenfuyiqiqiangxin decoction combined with milrinone on treating heart failure.Methods A total of 84 cases of patients with heart failure were selected from March 2019 to March 2021 in Anyuan County People's Hospital,which were divided into control group and experimental group,with 42 cases in each group.The control group was treated with milrinone injection,while the experimental group was treated with Shenfuyiqiqiangxin decoction by nasal feeding on the basis of the control group.The course of treatment of both groups were 4 weeks.Echocardiographic parameters〔left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and left ventricular end systolic volume(LVESV)〕,six-minute walking distance(6MWD),Lee's heart failure score,serum myocardial type-fatty acid binding protein(H-FABP)level,ventricular remodeling mechanism indicators〔transforming growth factor β1(TGF-β1),matrix metalloproteinase inhibitor 1(TIMP-1),matrix metalloproteinase 9(MMP-9)〕before and after treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results After treatment,LVEDD and LVESV in the experimental group were less than those in the control group,LVEF was higher than that in the control group,Lee's heart failure score and serum H-FABP level in the experimental group were lower than those in the control group,and 6MWD was longer than that in the control group(P<0.05).After treatment,serum TGF-β1 and MMP-9 levels in the experimental group were lower than those in the control group,while serum TIMP-1 level was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion On the basis of milrinone,Shenfuyiqiqiangxin decoction can effectively improve the cardiac function of patients with heart failure,it can reduce the level of H-FABP,which is beneficial to ventricular remodeling and has high safety.

关 键 词：心力衰竭 参附益气强心汤 心功能 超声心动图参数 心室重构 治疗结果 

分 类 号：R541.6[医药卫生—心血管疾病]