養心複脈飲治療冠心病心力衰竭的療效觀察
中醫中藥
作者：李巧等
[摘要] 目的 探討養心複脈飲對冠心病心力衰竭患者的療效與安全性。 方法 156例臨床症狀穩定的冠心病心力衰竭患者，隨機分為研究組（n=78）及對照組（n=78），對照組采用常規西藥治療，研究組在此基礎上加用養心複脈飲（20mL/口服/每日2次）。觀察24周，比較兩組治療前後左室射血分數（LVEF）、血漿氨基末端腦鈉肽（NT-pro BNP）水平，同時觀察肝腎功能。 結果 研究組治療前後丙氨酸氨基轉移酶（ALT）、天門冬氨酸氨基轉移酶（AST）、尿素氮（BUN）明顯降低，血清肌酐（SCR）無顯著變化，對照組四項指標治療前後無顯著變化。治療24周後，兩組患者LVEF水平明顯升高，NT-pro BNP水平明顯降低，且研究組升高或降低水平較對照組更明顯。 結論 在西藥治療的基礎上加用養心複脈飲能有效改善心力衰竭患者的心功能。
[關鍵詞] 養心複脈飲；心力衰竭； 冠心病；心功能
[中圖分類號] R541.4 [文獻標識碼] B [文章編號] 1673-9701（2015）08-0115-03
[Abstract] Objective To investigate the efficacy and safety of Yangxin Fumai drink in the treatment of patients with coronary heart disease heart failure. Methods All 156 patients with coronary heart disease heart failure who had stable clinical symptoms were randomly divided into the study group（n=78） and the control group （n=78）. The control group was given conventional western medicine treatment and the study group was given additional Yangxin Fumai drink （20 mL/orally/b.i.d） on the basis of the control group. Both groups were observed for 24 weeks. The left ventricular ejection fraction（LVEF） and N-terminal pro-brain natriuretic peptide（NT-pro BNP） levels of the two groups were compared and the liver and kidney function was observed. Results ALT， AST and BUN of study group reduced significantly before and after the treatment，there was no significant change for Scr；there was no significant change for these four indicators before and after treatment in the control group.24 weeks after treatment， LVEF level increased significantly of two groups，the NT-pro BNP levels significantly decreased， and the raise or lower level of study group were more clearly than that of the control group. Conclusion The additional application of Yangxin Fumai drink on the basis of western medicine treatment can effectively improve the heart function of patients with heart failure.
[Key words] Yangxin Fumai drink； Heart failure； Coronary heart disease； Heart function
心力衰竭（heart failure， HF）是各種原因引起的心肌損傷，導致心肌結構和功能的變化，引起心肌泵血和充盈功能低下。冠狀動脈粥樣硬化性心髒病（冠心病）是引起心力衰竭的主要原因，常規的利尿、擴冠、強心治療通常有效，但不令人滿意，中醫藥在治療慢性心力衰竭方麵越來越受重視[1]，本研究探討在常規抗心力衰竭藥物治療基礎上用養心複脈飲對冠心病心力衰竭者心功能的影響，以評價養心複脈飲治療冠心病心力衰竭的臨床療效與安全性，為中醫治療心力衰竭提供循證依據。
1 對象與方法
1.1研究對象
選擇2013年1～12月心內科住院患者156例，入選條件：紐約心功能協會心功能分級NYHA心功能評分Ⅱ～Ⅳ級；心髒彩超顯示左室射血分數（LVEF）≤40%；確診冠心病心力衰竭穩定2周以上患者；確定患者依從性良好。入選病例年齡47～86歲，平均（62.2±6.8）歲，男89例，女67例，入選患者有陳舊性心肌梗死63例，冠脈中重度狹窄93例。