苦碟子注射液联合磷酸肌酸钠治疗老年冠心病心力衰竭患者的临床随机对照研究
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摘要
目的:探究苦碟子注射液联合磷酸肌酸钠治疗老年冠心病心力衰竭及对心功能、预后的影响。方法:选取2014年8月至2016年12月承德医学院附属医院收治的老年冠心病心力衰竭患者96例,按照随机数字表法将其分为对照组和观察组,每组48例。对照组患者给予强心、扩血管及利尿等常规治疗,观察组在对照组的基础上给予苦碟子注射液联合磷酸肌酸钠治疗,2组均连续治疗2周。统计2组临床疗效及中医症候疗效;检测并比较治疗前后2组心功能指标及血清APN、NT-proBNP水平的变化。结果:与对照组比较,观察组临床疗效及中医证候疗效显效率均显著升高(P <0. 05),无效率显著降低(P <0. 01),且观察组临床疗效及中医证候疗效总有效率分为高达95. 83%及93. 75%,均显著高于对照组的66. 67%及68. 75%(P <0. 01);与治疗前比较,治疗后观察组LVEDd及LVEDs均显著降低,LVEF显著升高,且2组间差异有统计学意义(P <0. 01);与治疗前比较,治疗后观察组血清APN及NT-proBNP水平显著降低,且显著低于对照组(P<0. 01)。结论:在常规治疗的基础上以苦碟子注射液联合磷酸肌酸钠治疗老年冠心病心力衰竭可明显提高治疗效果,改善患者临床症状及心功能。
Objective: To explore the clinical efficacy of Kudiezi Injection combined with creatine phosphate sodium in the treatment of senile patients with coronary heart disease( CHD) and heart failure,and analyze the influence on the cardiac function and prognosis. Methods: A total of 96 senile patients with CHD and heart failure in Affiliated Hospital of Chengde Medical University from August 2014 to December 2016 were selected and divided into control group and treatment group,with 48 patients in each group. The control group was treated with the conventional therapy of cardiotonic,vascular dilation and diuresis,on the basis of which treatment group was treated with Kudiezi Injection combined with creatine phosphate sodium. The patients in the 2 groups were treated continuously for 2 weeks. The clinical efficacy and Traditioanl Chinese Medicine( TCM) syndrome efficacy of 2 groups were counted; the changes of cardiac function indexes and the levels of serum APN,NT-proBNP in 2 groups before and after treatment were detected and compared. Results: Compared with control group,the marked effective rate of clinical efficacy and TCM syndrome efficacy in treatment group increased significantly( P < 0. 05),and the inefficiency rate decreased significantly( P <0. 01),and the total effective rate of clinical efficacy and TCM syndrome efficacy in treatment group were 95. 83% and 93. 75%,which were higher than 66. 67% and 68. 75% in control group( P < 0. 01). Compared with before treatment,the LVEDd and LVEDs of treatment group decreased significantly,which were lower than that of control group after treatment( P < 0. 01); and the LVEF of treatment group increased significantly,which was higher than that of control group after treatment( P < 0. 01). Compared with before treatment,the levels of serum APN and NT-proBNP in treatment group decreased significantly,which were lower than that in control group after treatment( P < 0. 01). Conclusion: Kudiezi Injection combined with creatine phosphate sodium on the basis of conventional therapy can obviously increase the therapeutic effect in senile patients with CHD and heart failure,and improve the patients' clinical symptoms and cardiac function.
Objective: To explore the clinical efficacy of Kudiezi Injection combined with creatine phosphate sodium in the treatment of senile patients with coronary heart disease( CHD) and heart failure,and analyze the influence on the cardiac function and prognosis. Methods: A total of 96 senile patients with CHD and heart failure in Affiliated Hospital of Chengde Medical University from August 2014 to December 2016 were selected and divided into control group and treatment group,with 48 patients in each group. The control group was treated with the conventional therapy of cardiotonic,vascular dilation and diuresis,on the basis of which treatment group was treated with Kudiezi Injection combined with creatine phosphate sodium. The patients in the 2 groups were treated continuously for 2 weeks. The clinical efficacy and Traditioanl Chinese Medicine( TCM) syndrome efficacy of 2 groups were counted; the changes of cardiac function indexes and the levels of serum APN,NT-proBNP in 2 groups before and after treatment were detected and compared. Results: Compared with control group,the marked effective rate of clinical efficacy and TCM syndrome efficacy in treatment group increased significantly( P < 0. 05),and the inefficiency rate decreased significantly( P <0. 01),and the total effective rate of clinical efficacy and TCM syndrome efficacy in treatment group were 95. 83% and 93. 75%,which were higher than 66. 67% and 68. 75% in control group( P < 0. 01). Compared with before treatment,the LVEDd and LVEDs of treatment group decreased significantly,which were lower than that of control group after treatment( P < 0. 01); and the LVEF of treatment group increased significantly,which was higher than that of control group after treatment( P < 0. 01). Compared with before treatment,the levels of serum APN and NT-proBNP in treatment group decreased significantly,which were lower than that in control group after treatment( P < 0. 01). Conclusion: Kudiezi Injection combined with creatine phosphate sodium on the basis of conventional therapy can obviously increase the therapeutic effect in senile patients with CHD and heart failure,and improve the patients' clinical symptoms and cardiac function.
引文
[1]左征.美托洛尔联合曲美他嗪治疗冠心病心力衰竭效果探讨[J].世界中医药,2015,10(12):1584-1585.
[2]Nakamura Y,Turin T C,Rumana N,et al. Risk factors for heart failure and coronary heart disease mortality over 24-year follow-up period in Japan:NIPPON DATA80[J]. Cvd Prevention&Control,2010,5(3):97-103.
[3]王爱琴.磷酸肌酸钠治疗51例冠心病合并心力衰竭的疗效观察[J].中国医学创新,2013,10(3):130-131.
[4]邓恩平,黄汉光,李艳.磷酸肌酸钠治疗冠心病合并心力衰竭疗效观察[J].海南医学,2011,22(3):88-89.
[5]徐茂凤,李永杰,代生厚,等.苦碟子对老年冠心病心力衰竭患者心功能的改善作用[J].中国老年学杂志,2010,30(16):2362-2363.
[6]卢永昕.慢性心力衰竭的临床评估和治疗原则--2005 ACC/AHA慢性心力衰竭治疗指南简介[J].临床心血管病杂志,2005,21(11):691-695.
[7]夏铁崖.冠心病心力衰竭的诊断及治疗临床效果观察[J].中外医疗,2012,31(16):82-83.
[8]Muntner P,Whittle J,Lynch AI,et al. Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease,Stroke,Heart Failure,and Mortality:A Cohort Study[J]. Ann Intern Med,2015,163(5):329-338.
[9]高继梅,汤诺.冠心病慢性心衰的中医辨证治疗近况[J].环球中医药,2015,8(s2):272.
[10]王贤良,毛静远,赵志强,等.冠心病心力衰竭的中医药治疗研究概况[J].中西医结合心脑血管病杂志,2013,11(2):202-203.
[11]梁涛.加味椒目瓜蒌汤治疗冠心病心力衰竭气虚痰瘀、水饮内停证的临床观察[D].长沙:湖南中医药大学,2015.
[12]李湘玉,喻正科,蔡光先.冠心病舒张性心力衰竭的中医药研究进展[J].湖南中医杂志,2010,26(3):123-124.
[13]张锦茹,阎红梅,马宝情.苦碟子注射液联合美托洛尔治疗慢性心力衰竭的疗效观察[J].临床医学,2010,30(9):116-117.
[14]Liao X,Zeng X B,Xie Y M,et al. Use propensity score method to analyze data about effectiveness of coronary heart disease treated by kudiezi injection[J]. China Journal of Chinese Materia Medica,2013,38(18):3172-3179.
[15]刁克,逯艺,郭德刚.磷酸肌酸钠联合丹参多酚酸盐治疗冠心病心绞痛的疗效观察[J].现代药物与临床,2017,32(3):419-422.
[16]景增秀,赵玉娟.苦碟子注射液联合磷酸肌酸钠对老年冠心病心力衰竭患者心功能的改善作用[J].中医药信息,2014,(4):116-117.
[17]Guo-han C,Jian-hua G,Xuan H,et al. Role of creatine phosphate as a myoprotective agent during coronary artery bypass graft in elderly patients[J]. Coron Artery Dis,2013,24(1):48-53.
[18]Miyazaki C,Redfield MM,Powell BD,et al. Dyssynchrony indices to predict response to cardiac resynchronization therapy:a comprehensive prospective single-center study[J]. Circ Heart Fail,2010,3(5):565-573.
[19]谢延娟.磷酸肌酸钠联合苦碟子注射液改善老年冠心病心力衰竭患者心功能的应用研究[J].世界临床医学,2015,9(10):155.
[20]王波,欧阳艳红,方小丽,等.苦碟子联合磷酸肌酸钠对冠心病合并心力衰竭患者血清脂联素水平及心功能的影响[J].中国老年学杂志,2015,35(19):5510-5512.
[2]Nakamura Y,Turin T C,Rumana N,et al. Risk factors for heart failure and coronary heart disease mortality over 24-year follow-up period in Japan:NIPPON DATA80[J]. Cvd Prevention&Control,2010,5(3):97-103.
[3]王爱琴.磷酸肌酸钠治疗51例冠心病合并心力衰竭的疗效观察[J].中国医学创新,2013,10(3):130-131.
[4]邓恩平,黄汉光,李艳.磷酸肌酸钠治疗冠心病合并心力衰竭疗效观察[J].海南医学,2011,22(3):88-89.
[5]徐茂凤,李永杰,代生厚,等.苦碟子对老年冠心病心力衰竭患者心功能的改善作用[J].中国老年学杂志,2010,30(16):2362-2363.
[6]卢永昕.慢性心力衰竭的临床评估和治疗原则--2005 ACC/AHA慢性心力衰竭治疗指南简介[J].临床心血管病杂志,2005,21(11):691-695.
[7]夏铁崖.冠心病心力衰竭的诊断及治疗临床效果观察[J].中外医疗,2012,31(16):82-83.
[8]Muntner P,Whittle J,Lynch AI,et al. Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease,Stroke,Heart Failure,and Mortality:A Cohort Study[J]. Ann Intern Med,2015,163(5):329-338.
[9]高继梅,汤诺.冠心病慢性心衰的中医辨证治疗近况[J].环球中医药,2015,8(s2):272.
[10]王贤良,毛静远,赵志强,等.冠心病心力衰竭的中医药治疗研究概况[J].中西医结合心脑血管病杂志,2013,11(2):202-203.
[11]梁涛.加味椒目瓜蒌汤治疗冠心病心力衰竭气虚痰瘀、水饮内停证的临床观察[D].长沙:湖南中医药大学,2015.
[12]李湘玉,喻正科,蔡光先.冠心病舒张性心力衰竭的中医药研究进展[J].湖南中医杂志,2010,26(3):123-124.
[13]张锦茹,阎红梅,马宝情.苦碟子注射液联合美托洛尔治疗慢性心力衰竭的疗效观察[J].临床医学,2010,30(9):116-117.
[14]Liao X,Zeng X B,Xie Y M,et al. Use propensity score method to analyze data about effectiveness of coronary heart disease treated by kudiezi injection[J]. China Journal of Chinese Materia Medica,2013,38(18):3172-3179.
[15]刁克,逯艺,郭德刚.磷酸肌酸钠联合丹参多酚酸盐治疗冠心病心绞痛的疗效观察[J].现代药物与临床,2017,32(3):419-422.
[16]景增秀,赵玉娟.苦碟子注射液联合磷酸肌酸钠对老年冠心病心力衰竭患者心功能的改善作用[J].中医药信息,2014,(4):116-117.
[17]Guo-han C,Jian-hua G,Xuan H,et al. Role of creatine phosphate as a myoprotective agent during coronary artery bypass graft in elderly patients[J]. Coron Artery Dis,2013,24(1):48-53.
[18]Miyazaki C,Redfield MM,Powell BD,et al. Dyssynchrony indices to predict response to cardiac resynchronization therapy:a comprehensive prospective single-center study[J]. Circ Heart Fail,2010,3(5):565-573.
[19]谢延娟.磷酸肌酸钠联合苦碟子注射液改善老年冠心病心力衰竭患者心功能的应用研究[J].世界临床医学,2015,9(10):155.
[20]王波,欧阳艳红,方小丽,等.苦碟子联合磷酸肌酸钠对冠心病合并心力衰竭患者血清脂联素水平及心功能的影响[J].中国老年学杂志,2015,35(19):5510-5512.
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