2020 年第 1 期 第 15 卷

厄贝沙坦联合芪苈强心胶囊治疗缺血性心肌病并慢性心力衰竭患者的临床效果研究

Clinical effect of irbesartan combined with Qiliqiangxin capsule on ischemic cardiomyopathy complicated with chronic heart failure

作者：吕俊刚1逄瑷博2翟莉1曹甜甜1王松涛3王振国4赵琳5

英文作者：

单位：1中国人民武装警察部队北京市总队医院内三科100027；2中国人民武装警察部队北京市总队执勤第十一支队卫生队100190；3中国人民武装警察部队北京市总队医院院长办公室100027；4中国人民武装警察部队特色医学中心心内科，天津300162；5同济大学附属上海市第四人民医院老年医学科200081

英文单位：

关键词：缺血性心肌病；慢性心力衰竭；芪苈强心胶囊；厄贝沙坦

英文关键词：

• 摘要：

• 【摘要】目的    探讨厄贝沙坦联合芪苈强心胶囊治疗缺血性心肌病并慢性心力衰竭患者的临床效果。方法    选取2017年8月至2019年2月中国人民武装警察部队北京市总队医院收治的缺血性心肌病并慢性心力衰竭患者88例，按照随机数字表法分为对照组（44例）与观察组（44例）。对照组在常规治疗基础上口服厄贝沙坦治疗，观察组在对照组基础上联合芪苈强心胶囊治疗，2组均治疗1个月。治疗后观察患者的临床疗效。比较2组治疗前后左心室射血分数（LVEF）、左心室舒张末期内径(LVEDD)和血清B型脑钠肽（BNP）、心肌肌钙蛋白I（cTnI）水平以及6 min步行距离，并观察患者的不良反应发生情况。结果    治疗后观察组总有效率明显高于对照组［90.9%(40/44)比75.0%(33/44)］，差异有统计学意义（P＜0.05）。治疗后，2组患者LVEDD、LVEF和血清BNP、cTnI水平及6 min步行距离均较治疗前改善，且观察组LVEDD和血清BNP、cTnI水平明显低于对照组［（48.7±2.4）mm比（52.6±2.6）mm、（366±23）ng/L比（596±21）ng/L、（0.30±0.10）μg/L比（0.35±0.07）μg/L］，LVEF和6 min步行距离明显高于/长于对照组［（43.2±4.6）%比（36.5±5.4）%、（422±10）m比（379±12）m］，差异均有统计学意义(均P＜0.05)。观察组不良反应发生率低于对照组，但差异无统计学意义（P>0.05）。结论    厄贝沙坦联合芪苈强心胶囊治疗缺血性心肌病并慢性心力衰竭的效果显著，可明显改善心功能状况，且不增加患者不良反应发生率。

• 【Abstract】Objective    To investigate the clinical effect of irbesartan combined with Qiliqiangxin capsule on ischemic cardiomyopathy with chronic heart failure. Methods    Totally 88 patients with ischemic cardiomyopathy and chronic heart failure admitted to Beijing General Hospital of the Chinese People′s Armed Police Force from August 2017 to February 2019 were randomly divided into control group(44 cases) and observation group(44 cases). On the basis of routine treatment, the control group took irbesartan while the observation group took irbesartan plus Qiliqiangxin capsule. Both groups were treated for 1 month. Clinical efficacy, left ventricular ejection fraction（LVEF）, left ventricular end-diastolic diameter(LVEDD), serum B-type natriuretic peptide(BNP) and cardiac troponin I(cTnI) levels, 6 min walking distance and adverse reactions were analyzed. Results    The total effective rate in observation group was significantly higher/longer than that in control group［90.9%(40/44) vs 75.0%(33/44)］(P＜0.05). There were no significant differences in LVEDD, LVEF, BNP, cTnI and 6 min walking distance between groups before treatment(all P＞0.05). After treatment, LVEDD, LVEF, BNP, cTnI and 6 min walking distance were improved in both groups; LVEDD, BNP and cTnI in observation group were significantly lower than those in control group［（48.7±2.4）mm vs （52.6±2.6）mm, （366±23）ng/L vs （596±21）ng/L, （0.30±0.10）μg/L vs （0.35±0.07）μg/L］; LVEF and 6 min walking distance in observation group were significantly higher/longer than those in control group［（43.2±4.6）% vs （36.5±5.4）%, （422±10）m vs （379±12）m］(all P＜0.05). The incidence of adverse reactions in observation group was lower than that in control group, but the difference was not statistically significant(P>0.05). Conclusion    Irbesartan combined with Qiliqiangxin capsule treating ischemic cardiomyopathy with chronic heart failure can effectively improve cardiac function without increasing the incidence of adverse reactions.