心宝丸联合美托洛尔缓释片治疗慢性心力衰竭患者效果及对左心室重塑的影响  

Effect of Xinbao Pills combined with metoprolol sustained release tablets in the treatment of patients with chronic heart failure and its effect on left ventricular remodeling

作　　者：汪俊秋 陈茜[2] 祁兴平 WANG Jun-qiu;CHEN Qian;QI Xing-ping(Department of Cardiovascular Medicine,,Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine,Chuzhou Anhui 239000,China;Department of Traditional Chinese Medicine,Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine,Chuzhou Anhui 239000,China.)

机构地区：[1]滁州市中西医结合医院心血管内科,安徽滁州239000 [2]滁州市中西医结合医院中医科,安徽滁州239000

出　　处：《临床和实验医学杂志》2024年第5期457-461,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省中医药传承创新科研项目(编号:2020ccyb27)。

摘　　要：目的分析心宝丸联合美托洛尔缓释片治疗慢性心力衰竭(CHF)患者效果及对左心室重塑的影响。方法回顾性选取2019年4月至2023年4月滁州市中西医结合医院收治的70例CHF患者进行研究,依据治疗方法不同将其分为3组,美托洛尔缓释片组(n=20)、心宝丸组(n=20)和联合组(n=30)。美托洛尔缓释片组给予单纯美托洛尔缓释片治疗,心宝丸组给予单纯心宝丸治疗,联合组给予心宝丸+美托洛尔缓释片治疗。记录3组患者的临床疗效,分别在治疗前和治疗4周后检测与比较3组患者的左心室重塑[左室内舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左室射血分数(LVEF)]、心脏相关指标[血清心型脂肪酸结合蛋白(H-FABP)、脑钠肽]、血清学指标[血清内皮细胞生长因子(VEGF)、细胞间黏附分子-1(ICAM-1)、胰岛素样生长因子-1(IGF-1)],并比较3组的不良反应。结果联合组总有效率为93.33%,高于美托洛尔缓释片组(65.00%)、心宝丸组(70.00%),差异均有统计学意义(P<0.05)。治疗4周后,联合组LVEDd、LVESd水平分别为(44.63±4.12)、(33.26±4.25)mm,均低于美托洛尔缓释片组[(449.52±4.58)、(39.15±4.25)mm]、心宝丸组[(48.12±4.25)、(37.89±4.12)mm],LVEF水平为(56.84±5.15)%,高于美托洛尔缓释片组[(50.68±5.58)%]、心宝丸组[(52.68±5.45)%],差异均有统计学意义(P<0.05)。治疗4周后,联合组脑钠肽、H-FABP水平分别为(362.54±30.58)ng/L、(25.46±3.65)pg/mL,均低于美托洛尔缓释片组[(489.68±30.58)ng/L、(38.69±4.58)pg/mL]、心宝丸组[(478.59±30.58)ng/L、(36.84±4.25)pg/mL],差异均有统计学意义(P<0.05)。治疗4周后,联合组ICAM-1水平为(33.16±4.58)ng/L,低于美托洛尔缓释片组[(42.69±5.12)ng/L]、心宝丸组[(41.12±5.18)ng/L],VEGF、IGF-1水平分别为(564.26±40.84)ng/L、(150.69±15.47)ng/mL,均高于美托洛尔缓释片组[(468.59±40.84)ng/L、(130.69±15.25)ng/mL]、心宝丸组[(478.65±40.58)ng/L、(133.69±15.88)ng/mL],差异�Objective To analyze the effect of Xinbao Pills combined with metoprolol sustained release tablets in the treatment of patients with chronic heart failure(CHF)and its effect on left ventricular remodeling.Methods This study was a retrospective analysis,70 cases of CHF patients admitted to Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2019 to April 2023 were selected for the study,and they were divided into 3 groups based on the treatment method,metoprolol sustained release tablets group(n=20),Xinbao Pills group(n=20),and the combined group(n=30).The metoprolol sustained release tablets group was given simple metoprolol sustained release tablets treatment,the Xinbao Pills group was given simple Xinbao Pills treatment,and the combination group was given Xinbao Pills+metoprolol sustained release tablets treatment.The clinical efficacy in the three groups were recorded,and left ventricular remodeling[left ventricular end-diastolic internal diameter(LVEDd),left ventricular end-systolic internal diameter(LVESd),and left ventricular ejection fraction(LVEF)],cardiac-related indexes[serum heart-type fatty acid-binding protein(H-FABP),and brain natriuretic peptide],and serological indexes[serum endothelial growth factor(VEGF),intercellular adhesion molecule-1(ICAM-1),insulin-like growth factor-1(IGF-1)]were detected and compared among three groups of patients before treatment and after 4 weeks of treatment,respectively.The adverse reactions of the three groups were compared.Results The total effective rate of the combined group was 93.33%,which was higher than that of the metoprolol sustained release tablets group(65.00%)and the Xinbao Pills group(70.00%),and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the levels of LVEDd,LVESd in the combined group were(44.63±4.12),(33.26±4.25)mm,respectively,which were lower than those in the metoprolol sustained release tablets group[(449.52±4.58),(39.15±4.25)mm]and the Xinbao Pills group[(48.12±4.25),(37.89±

关 键 词：慢性心力衰竭 心宝丸 美托洛尔缓释片 左心室重塑 

分 类 号：R541.6[医药卫生—心血管疾病]