留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的效果观察

夏益 李学龙 乔凤婕 董文彬

夏益, 李学龙, 乔凤婕, 董文彬. 麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的效果观察[J]. 中华全科医学, 2023, 21(11): 1876-1879. doi: 10.16766/j.cnki.issn.1674-4152.003247
引用本文: 夏益, 李学龙, 乔凤婕, 董文彬. 麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的效果观察[J]. 中华全科医学, 2023, 21(11): 1876-1879. doi: 10.16766/j.cnki.issn.1674-4152.003247
XIA Yi, LI Xuelong, QIAO Fengjie, DONG Wenbin. The effect of Shexiang Baoxin Pills combined with recombinant human brain natriuretic peptide in the treatment of ischemic heart failure[J]. Chinese Journal of General Practice, 2023, 21(11): 1876-1879. doi: 10.16766/j.cnki.issn.1674-4152.003247
Citation: XIA Yi, LI Xuelong, QIAO Fengjie, DONG Wenbin. The effect of Shexiang Baoxin Pills combined with recombinant human brain natriuretic peptide in the treatment of ischemic heart failure[J]. Chinese Journal of General Practice, 2023, 21(11): 1876-1879. doi: 10.16766/j.cnki.issn.1674-4152.003247

麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003247
基金项目: 

浙江省医药卫生科技计划项目 2023XY022

杭州市医药卫生科技项目 B20220321

详细信息
    通讯作者:

    夏益,E-mail:13805749348xy@sina.com

  • 中图分类号: R541.6  R972.1

The effect of Shexiang Baoxin Pills combined with recombinant human brain natriuretic peptide in the treatment of ischemic heart failure

  • 摘要:   目的  探讨麝香保心丸联合重组人脑利钠肽治疗缺血性心力衰竭的临床疗效,以期为缺血性心力衰竭患者的治疗提供参考。  方法  选取2022年1月—2023年1月杭州市富阳区中医院收治的100例缺血性心力衰竭患者,采用随机数字表法随机分为2组,对照组患者(50例)在常规治疗基础上给予重组人脑利钠肽治疗,观察组患者(50例)在对照组的基础上联合麝香保心丸治疗,均连续用药3个月,比较2组治疗总有效率、治疗前后心功能、中医证候积分和不良反应。  结果  与对照组比较,观察组患者左室射血分数显著提高[(50.25±5.64)% vs. (45.58±5.47)%,t=4.203,P < 0.001],左室舒张末期内径[(52.64±4.44)mm vs. (55.38±4.07)mm,t=3.217,P=0.002]、左室收缩末期内径[(38.21±4.16)mm vs. (42.38±4.58)mm,t=4.766,P < 0.001]、中医证候积分[(8.39±2.66)分vs.(11.67±2.95)分,t=5.839,P < 0.001]显著降低;观察组中医证候整体疗效优于对照组(Z=-2.289,P=0.022);2组临床总有效率和不良反应发生率比较,差异均无统计学意义(均P>0.05)。  结论  麝香保心丸联合重组人脑利钠肽可显著提高缺血性心力衰竭患者的临床疗效,改善心功能,优于单独应用重组人脑利钠肽。

     

  • 表  1  2组缺血性心力衰竭患者临床疗效比较[例(%)]

    Table  1.   Comparison of clinical effect between two groups of patients with ischemic heart failure [cases (%)]

    组别 例数 显效 有效 无效 总有效
    观察组 50 25(50.0) 20(40.0) 5(10.0) 45(90.0)
    对照组 50 18(36.0) 21(42.0) 11(22.0) 39(78.0)
    注:2组总有效率比较,χ2=2.679,P=0.102。2组疗效比较,Z=-1.741, P=0.082。
    下载: 导出CSV

    表  2  2组缺血性心力衰竭患者中医证候疗效比较[例(%)]

    Table  2.   Comparison of TCM syndromes between two groups of patients with ischemic heart failure [cases (%)]

    组别 例数 显效 有效 无效 总有效
    观察组 50 25(50.0) 23(46.0) 2(4.0) 48(96.0)
    对照组 50 14(28.0) 27(54.0) 9(18.0) 41(82.0)
    注:2组中医证候总有效率比较,χ2=5.005,P=0.025。2组中医证候疗效比较,Z=-2.289,P=0.022。
    下载: 导出CSV

    表  3  2组缺血性心力衰竭患者心功能指标比较(x±s)

    Table  3.   Comparison of cardiac function indexes between two groups of patients with ischemic heart failure (x±s)

    组别 例数 左室射血分数(%) 左室舒张末期内径(mm) 左室收缩末期内径(mm)
    治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
    观察组 50 36.54±3.21 50.25±5.64a 59.19±3.68 52.64±4.44a 47.79±3.56 38.21±4.16a
    对照组 50 36.06±3.15 45.58±5.47a 60.45±3.46 55.38±4.07a 48.15±3.29 42.38±4.58a
    t 0.755 4.203 1.764 3.217 0.525 4.766
    P 0.452 <0.001 0.081 0.002 0.601 <0.001
    注:与同组治疗前比较,aP<0.05。
    下载: 导出CSV

    表  4  2组缺血性心力衰竭患者治疗前后中医证候积分比较(x±s,分)

    Table  4.   Comparison of TCM syndrome scores between two groups of patients with ischemic heart failure before and after treatment (x±s, points)

    组别 例数 治疗前 治疗后
    观察组 50 16.86±4.81 8.39±2.66a
    对照组 50 16.27±4.58 11.67±2.95a
    t 0.628 5.839
    P 0.531 <0.001
    注:与同组治疗前比较,aP<0.05。
    下载: 导出CSV
  • [1] 李柏红, 施恒荷, 刘斌. 新型抗心力衰竭药物的研究进展[J]. 中国医药, 2021, 16(1): 142-144.

    LI B H, SHI H H, LIU B. Research progress of novel anti-heart failure drugs[J]. China Medicine, 2021, 16(1): 142-144.
    [2] 叶明, 王鑫, 孙悦, 等. 芪苈强心胶囊联合重组人脑利钠肽对急性心力衰竭患者的临床疗效观察[J]. 中华内科杂志, 2023, 62(4): 422-426.

    YE M, WANG X, SUN Y, et al. Clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide on patients with acute heart failure[J]. Chinese Journal of Internal Medicine, 2023, 62(4): 422-426.
    [3] 崔建国, 梁淑芹, 齐洁, 等. 小剂量联合重组人脑利钠肽和沙库巴曲缬沙坦治疗老年急性心力衰竭的短期疗效[J]. 实用医学杂志, 2020, 36(21): 2984-2989. doi: 10.3969/j.issn.1006-5725.2020.21.020

    CUI J G, LIANG S Q, QI J, et al. Short-term efficacy of low dose combined with recombinant human brain natriuretic peptide and sackubatrol valsartan in the treatment of acute heart failure in elderly patients[J]. The Journal of Practical Medicine, 2020, 36(21): 2984-2989. doi: 10.3969/j.issn.1006-5725.2020.21.020
    [4] BURCH G E, TSUI C Y, HARB J M. Ischemic cardiomyopathy[J]. Am Heart J, 1972, 83(3): 340-350. doi: 10.1016/0002-8703(72)90435-8
    [5] YANCY C W, JESSUP M, BOZKURT B, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines[J]. Circulation, 2013, 128(16): 1810-1852. doi: 10.1161/CIR.0b013e31829e8807
    [6] 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10): 760-789. doi: 10.3760/cma.j.issn.0253-3758.2018.10.004

    Heart failure Group, Chinese Society of Cardiology, Heart Failure Professional Committee, Chinese Medical Doctor Association, Editorial Committee of Chinese Journal of Cardiology. Chinese guidelines for diagnosis and treatment of heart failure 2018[J]. Chinese Journal of Cardiolog, 2018, 46(10): 760-789. doi: 10.3760/cma.j.issn.0253-3758.2018.10.004
    [7] 郑筱萸. 中药新药临床研究指导原则[S]. 北京: 中国医药科技出版社, 2002: 253-258.

    ZHENG X Y. Guiding principles for clinical research of new Chinese medicine[S]. Beijing: China Medical Science and Technology Press, 2002: 253-258.
    [8] 林果为, 王吉耀, 葛均波. 实用内科学[M]. 北京: 人民卫生出版社, 2017.

    LIN G W, WANG J Y, GE J B. Practical Internal Medicine[M]. Beijing: People's Medical Publishing House, 2017.
    [9] MEHRA M R, VADUGANATHAN M, FU M, et al. A comprehensive analysis of the effects of rivaroxaban on stroke or transient ischaemic attack in patients with heart failure, coronary artery disease, and sinus rhythm: the COMMANDER HF trial[J]. Eur Heart J, 2019, 40(44): 3593-3602. doi: 10.1093/eurheartj/ehz427
    [10] 许顶立. 应重视心力衰竭的临床新分类和药物治疗新策略[J]. 中华心血管病杂志, 2023, 51(4): 335-337.

    XU D L. Clinical value of the new clinical classification and medical treatment strategy of heart failure[J]. Chinese Journal of Cardiology, 2023, 51(4): 335-337.
    [11] 靳海斌. 慢性心力衰竭的神经调节治疗及沙库巴曲缬沙坦钠应用新进展[J]. 心血管病学进展, 2019, 40(2): 283-286.

    JIN H B. Recent progress in neuromodulation therapy of chronic heart failure and application of sackubactril valsartan sodium[J]. Advances in Cardiovascular Diseases, 2019, 40(2): 283-286.
    [12] 刘敏, 王秋林. 重组人脑利钠肽在心血管病中的应用研究进展[J]. 成都医学院学报, 2020, 15(5): 673-676.

    LIU M, WANG Q L. Research progress on application of recombinant human brain natriuretic peptide in cardiovascular disease[J]. Journal of Chengdu Medical College, 2019, 15(5): 673-676.
    [13] 曾繁宇, 文子尹, 叶文捷. 重组人脑利钠肽对急性重症心力衰竭患者的治疗效果及预后的影响[J]. 临床医学工程, 2019, 26(5): 635-636.

    ZENG F Y, WEN Z Y, YE W J. Effect of recombinant human brain natriuretic peptide on treatment and prognosis of patients with acute severe heart failure[J]. Clinical Medical & Engineering, 2019, 26(5): 635-636.
    [14] 丁文虹, 崔胜男, 扈春丽, 等. 冻干重组人脑利钠肽联合米力农治疗老年慢性肺心病合并心力衰竭的临床疗效[J]. 中国老年学杂志, 2022, 42(6): 1295-1298.

    DING W H, CUI S N, HU C L, et al. Clinical effect of freeze-dried recombinant human brain natriuretic peptide combined with Milrinone in treatment of chronic pulmonary heart disease complicated with heart failure in elderly patients[J]. Chinese Journal of Gerontology, 2022, 42(6): 1295-1298.
    [15] 孙莉, 荀平. 重组人脑利钠肽对慢性心衰急性发作期患者的用药不良反应发生率及疗效分析[J]. 中西医结合心血管病电子杂志, 2020, 8(31): 50, 54.

    SUN L, XUN P. Incidence and efficacy of recombinant human brain natriuretic peptide in patients with chronic heart failure at acute stage of adverse drug reactions[J]. Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine(Electronic), 2020, 8(31): 50, 54.
    [16] 姚久秀, 戴国华. 中医药干预慢性心力衰竭系统评价的研究进展[J]. 中医药学报, 2021, 49(4): 84-87.

    YAO J X, DAI G H. Research progress of systematic evaluation of Chinese medicine intervention in chronic heart failure[J]. Acta Chinese Medicine and Pharmacology, 2021, 49(4): 84-87.
    [17] 尹红伟, 王慈, 王帅, 等. 心力衰竭发生发展的自噬机制及中医药干预研究进展[J]. 天津中医药大学学报, 2021, 40(6): 685-690.

    YIN H W, WANG C, WANG S, et al. Research progress of autophagy mechanism in the occurrence and development of heart failure and TCM intervention[J]. Journal of Tianjin University of Traditional Chinese Medicine, 2021, 40(6): 685-690.
    [18] 张芳, 陈国藩, 任开涵, 等. 麝香保心丸对老年慢性心力衰竭患者心功能、心室重构及血管内皮因子的影响[J]. 中华全科医学, 2022, 20(12): 2006-2009. doi: 10.16766/j.cnki.issn.1674-4152.002756

    ZHANG F, CHEN G F, REN K H, et al. Effects of Shexiang Baoxin Pills on cardiac function, ventricular remodeling and vascular endothelial factors in elderly patients with chronic heart failure[J]. Chinese Journal of General Practice, 2022, 20(12): 2006-2009. doi: 10.16766/j.cnki.issn.1674-4152.002756
    [19] 廖丛娟, 张旭升, 黄战军, 等. 麝香保心丸下调代谢综合征大鼠心肌组织尾加压素Ⅱ及其受体表达的实验研究[J]. 中西医结合心脑血管病杂志, 2020, 18(15): 2414-2417.

    LIAO C J, ZHANG X S, HUANG Z J, et al. Effect of Shexiang Baoxin Pill on the expression of tail vasopressin Ⅱ and its receptor in myocardial tissue of rats with metabolic syndrome[J]. Chinese Journal of Integrative Medicine on Cardio/Cerebrovascular Disease, 2020, 18(15): 2414-2417.
    [20] 高天辉, 陈志鸿. 麝香保心丸辅助治疗稳定性冠心病的疗效观察[J]. 中西医结合心脑血管病杂志, 2021, 19(21): 3807-3808.

    GAO T H, CHEN Z H. Observation on the curative effect of Shexiang Baoxin Pill in the treatment of stable coronary heart disease[J]. Chinese Journal of Integrative Medicine on Cardio/Cerebrovascular Disease, 2021, 19(21): 3807-3808.
  • 加载中
表(4)
计量
  • 文章访问数:  98
  • HTML全文浏览量:  46
  • PDF下载量:  6
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-05-24
  • 网络出版日期:  2024-01-13

目录

    /

    返回文章
    返回