托拉塞米联合参脉注射液治疗老年慢性心力衰竭的疗效及对RAAS的影响  

Curative Effect of Torasemide Combined with Shenmai Injection in the Treatment of Elderly Chronic Heart Failure and Its Effect on RAAS

作　　者：卢磊 刘晓丹 樊丽 李尚洪 刘敏 张庆 LU Lei;LIU Xiaodan;FAN Li;LI Shanghong;LIU Min;ZHANG Qing(Department of Cardiology,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州市中医院心血管科,江苏徐州221000

出　　处：《系统医学》2022年第6期29-32,45,共5页Systems Medicine

基　　金：江苏省中医药科技发展计划项目(YB2020047)。

摘　　要：目的探究托拉塞米联合参麦注射液治疗老年慢性心力衰竭的疗效及对RAAS的影响。方法选择徐州市中医院心血管科2019年1月—2020年12月收治的128例老年慢性心力衰竭患者为研究对象,按照计算机流水分组法,分为对照组(常规治疗)和观察组(常规治疗+托拉塞米联合参麦注射液治疗),各64例。对比分析两组疗效、中医临床症状积分、肾素-血管紧张素-醛固酮系统(RAAS)指标、心功能指标、血液流变学指标。结果观察组治疗总有效率为96.88%,高于对照组的87.50%,差异有统计学意义(χ^(2)=3.905,P=0.048)。治疗后,观察组患者中医证候积分及症状总积分低于对照组,差异有统计学意义(P<0.05)。观察组患者AngⅡ、ALD、PRA水平低于对照组,差异有统计学意义(P<0.05)。观察组LVEDV低于对照组,LVEF、SV、6MWD均高于对照组,差异有统计学意义(P<0.05)。观察组患者全血高切黏度、全血低切黏度、血小板1 min聚集率及纤维蛋白原低于对照组,差异有统计学意义(P<0.05)。结论老年慢性心力衰竭患者予以托拉塞米联合参麦注射液治疗,疗效确切,治疗总有效率高,而且患者症状改善确切,心功能得到明显提升,有助于患者康复,推荐临床应用和使用。Objective To explore the curative effect of torasemide combined with Shenmai injection in the treatment of senile chronic heart failure and its effect on RAAS.Methods 128 elderly patients with chronic heart failure admitted to the Cardiology Department of Xuzhou Hospital of Traditional Chinese Medicine from January 2019 to December 2020 were selected as the study objects.They were divided into control group(conventional treatment)and observation group(conventional treatment+torasemide combined with Shenmai injection treatment)according to the computer flow grouping method,64 cases in each group.The curative effect,TCM clinical symptom score,renin-angiotensin-aldosterone system(RAAS)index,cardiac function index and hemorheology index were compared and analyzed between the two groups.Results The total effective rate of treatment in the observation group was 96.88%,which was higher than that in the control group 87.50%,and the difference was statistically significant(χ^(2)=3.905,P=0.048).After treatment,the TCM syndrome scores and total symptom scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The levels of AngⅡ,ALD and PRA in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The LVEDV of the observation group was lower than that of the control group,and the LVEF,SV,and 6MWD of the observation group were higher than those of the control group,the difference was statistically significant(P<0.05).The whole blood high shear viscosity,whole blood low shear viscosity,platelet aggregation rate at 1 min and fibrinogen in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion For elderly patients with chronic heart failure,torasemide combined with Shenmai injection has a definite curative effect,with a high total effective rate of treatment,definite improvement of symptoms,and significant improvement

关 键 词：老年慢性心力衰竭 托拉塞米 参麦注射液 肾素-血管紧张素-醛固酮系统 

分 类 号：R4[医药卫生—临床医学]