芪苈强心胶囊辅治老年慢性心力衰竭疗效观察

目的观察芪苈强心胶囊辅治老年慢性心力衰竭(CHF)对心功能、血浆NT-proBNP水平的影响及临床安全性。方法采用随机方法将64例老年CHF患者分为2组:对照组(32例)和治疗组(32例)。2组均给予常规西药治疗,治疗组在常规西药治疗的基础上加用芪苈强心胶囊,疗程均为4周。观察治疗前后患者体质量变化、Lee氏心力衰竭积分、6 min步行试验、血浆NT-proBNP水平,超声心动图检查左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)、心输出量(CO)等疗效指标,并检测肝肾功能、电解质等安全性指标。结果 (1)治疗组与对照组体质量较治疗前均有减轻,但组间比较差异无统计学意义(P>0.05);(2)Lee氏心力衰竭积分:治疗组总有效率90.6%,对照组总有效率78.2%,差异有统计学意义(P<0.05);(3)6 min步行试验:治疗组总有效率87.5%,对照组总有效率75.0%,差异有统计学意义(P<0.05);(4)血浆NT-proBNP水平比较:治疗4周后2组NT-proBNP水平均有所下降,且治疗组较对照组下降更为明显,差异有统计学意义(P<0.05);(5)心功能超声变化:治疗4周后2组IVEDD较治疗前均有所缩小,LVEF、CO均有提高,且治疗组优于对照组,差异有统计学意义(P<0.05)。2组治疗过程中均未发现明显不良反应,治疗后复查肝肾功能、电解质、血常规未见异常。结论芪苈强心胶囊联合西药治疗中重度老年CHF,可以更有效地改善患者心功能,缓解临床症状,且药物安全性好。

Clinical observation of Qiliqiangxin capsule for treatment of elderly patients with chronic heart failure

Objective To observe the safety and the effect on cardiac function indexes,NT-proBNP in plasma and heart ultrasonic testing of elderly patients with chronic heart failure（CHF） by Qiliqiangxin capsule.Methods A total of 64 CHF patients were randomly divided into two groups;control group（n = 32） and treatment group（n =32）.Both groups were treated with routine western medicine treatment for four weeks,besides this,the treatment group also received Qiliqiangxin capsule.The following curative norm and safety indicators were recorded before and after treatment：weight change,Lees heart failure score,6 min walking distance,NT-proBNP level in plasma,echocardiography,left ventricular end diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF）,cardiac output（CO）,liver and kidney function, electrolyte and so on.Results（1） The body weight of the treatment group and the control group also reduced after the treatment, but there had no statistical differences between the two groups（P0.05）;（2） Lees heart failure score showed more statistical significance between the treatment group and the control group（90.6%vs 78.2%,P0.05）;（3） 6 min walk test also showed statistical differences between the two groups（87.5%vs 75.0%,P0.05）;（4） Plasma NT-proBNP levels in both groups decreased significantly after treatment than that before treatment,it is more obvious in treatment group than control group,there were significant differences（P0.05）;（5） Echocardiography changes of cardiac function were obvious in both groups after treatment than those before treatment,the LVEDD decreased and LVEF,CO increased,the improvement in treatment group were superior than control group（P0.05）.Having finished the treatment,there had no obvious adverse reaction,and liver or kidney function,electrolyte and blood routine was normal.Conclusion For the moderate to severe elderly chronic heart failure,Qiliqiangxin capsule with routine western medicine could be more effective to improve cardiac function,relieve the clinical symptoms and enhance sports endurance,narrow LVEDD,improve LVEF and CO,and effectively reduce the NT-proBNP level.The combined treatment also was very safe,and it had no adverse effects on the liver and kidney function,electrolyte and routine blood.