参附注射液联合糖皮质激素治疗急性左心衰竭合并支气管痉挛患者的临床疗效  

Clinical effect of Shenfu injection combined with glucocorticoid on patients with acute left heart failure complicated with bronchospasm

作　　者：张能锋[1] 马志芳 杨乃全[1] 王旭[3] Zhang Nengfeng;Ma Zhifang;Yang Naiquan;Wang Xu(Department of Cardiology,Huai'an Second People's Hospital,Huai'an 223002,Jiangsu,China;Department of Pharmacy,Huai'an Second People's Hospital,Huai'an 223002,Jiangsu,China;Department of Endocrinology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]淮安市第二人民医院心内科,江苏淮安223002 [2]淮安市第二人民医院药剂科,江苏淮安223002 [3]南京中医药大学附属江苏省中医院内分泌科,南京210029

出　　处：《中华危重病急救医学》2023年第12期1298-1303,共6页Chinese Critical Care Medicine

基　　金：江苏省卫生厅干部保健科研项目(BJ21012)。

摘　　要：目的探讨参附注射液联合糖皮质激素治疗急性左心衰竭合并支气管痉挛患者的临床效果。方法采用前瞻性研究,选择2021年1月至2022年7月淮安市第二人民医院收治的90例急性左心衰竭合并支气管痉挛患者,并按随机数字表法分为常规治疗组、激素治疗组、联合治疗组,每组30例。3组患者均接受西医基础治疗,在此基础上,常规治疗组给予氨茶碱注射液0.25~0.50 g加入5%葡萄糖注射液或0.9%氯化钠注射液(糖尿病患者)100 mL中缓慢静脉滴注,每日1~2次;激素治疗组给予吸入用布地奈德混悬液1 mg加入0.9%氯化钠注射液稀释至2 mL雾化吸入,每日2次,应用至肺部哮鸣音消失后48 h;联合治疗组给予糖皮质激素联合参附注射液80 mL加入5%葡萄糖注射液或0.9%氯化钠注射液(糖尿病患者)250 mL中静脉滴注,每日1次,均治疗1周。对比3组患者一般资料、中医证候积分、中医证候疗效指数、急性左心衰竭疗效、支气管痉挛疗效、收缩压(SBP)、平均动脉压(MAP)、血清N末端脑钠肽前体(NT-proBNP)水平及安全性;随访6个月,记录3组患者病死率和再住院率。结果90例患者中,除去因死亡等原因脱落的病例,共有83例患者完成本研究。其中联合治疗组29例,激素治疗组25例,常规治疗组29例。3组患者年龄、性别、病程、既往史(糖尿病史、高血压史、高脂血症史)比较差异均无统计学意义,具有可比性。联合治疗组、激素治疗组治疗前后中医证候积分差值、中医证候疗效指数均高于常规治疗组〔中医证候积分差值(分):15.14±5.74、13.24±5.75比10.62±5.87,中医证候疗效指数:(67.84±14.31)%、(59.94±14.26)%比(48.92±16.74)%,均P<0.05〕,且联合治疗组治疗前后中医证候积分差值、中医证候疗效指数高于激素治疗组(均P<0.05)。联合治疗组急性左心衰竭疗效总有效率、支气管痉挛疗效总有效率明显高于常规治疗组(急性左心衰竭疗效总�Objective To investigate the clinical effect of Shenfu injection combined with glucocorticoid in the treatment of acute left heart failure complicated with bronchospasm.Methods A prospective study was conducted.Ninety patients with acute left heart failure complicated with bronchospasm admitted to Huai'an Second People's Hospital from January 2021 to July 2022 were selected and divided into conventional treatment group,hormone therapy group and combined treatment group according to random number table method,with 30 cases in each group.All patients in the 3 groups received basic Western medicine treatment.On this basis,the conventional treatment group was given 0.25-0.50 g aminophylline injection plus 5%glucose injection or 0.9%sodium chloride injection(diabetes patients)100 mL slow intravenous infusion,1-2 times a day.In the hormone treatment group,1 mg of budesonide suspension for inhalation was diluted to 2 mL by 0.9%sodium chloride injection,twice a day,and applied until 48 hours after the pulmonary wheezing disappeared.The combined treatment group was given glucocorticoid combined with Shenfu injection 80 mL plus 5%glucose injection or 0.9%sodium chloride injection(diabetes patients)250 mL intravenously,once a day.All treated for 1 week.The general data,traditional Chinese medicine(TCM)syndrome score,TCM syndrone efficacy index,acute left heart failure efficacy,bronchospasm efficacy,systolic blood pressure(SBP),mean arterial pressure(MAP),serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level and safety of the 3 groups were compared.The patients were followed up for 6 months,and the mortality and re-hospitalization rate of the 3 groups were recorded.Results Among the 90 patients,a total of 83 patients completed the study,excluding the cases dropped due to death and other reasons.There were 29 cases in the combined treatment group,25 cases in the hormone therapy group and 29 cases in the conventional treatment group.There were no significant differences in age,gender,course of disease,and previous his

关 键 词：参附注射液 糖皮质激素 急性左心衰竭 支气管痉挛 临床疗效 

分 类 号：R541.6[医药卫生—心血管疾病] R562.23[医药卫生—内科学]