2020 年第 3 期 第 15 卷

参附注射液联合地尔硫治疗慢性肺源性心脏病合并心力衰竭的临床效果及安全性分析

Clinical efficacy and safety of Shenfu injection combined with diltiazem in treatment of chronic pulmonary heart disease complicated with heart failure

作者：陈思刘恺丰朱卫华

英文作者：

单位：郑州颐和医院呼吸内科450000

英文单位：

关键词：慢性肺源性心脏病；心力衰竭；参附注射液；地尔硫；心功能

英文关键词：

• 摘要：

• 【摘要】目的    探究参附注射液联合地尔硫治疗慢性肺源性心脏病（肺心病）合并心力衰竭的临床效果及安全性。方法    选取2017年3月至2019年3月郑州颐和医院收治的慢性肺心病合并心力衰竭患者72例，完全随机分为对照组和观察组，各36例。对照组给予常规基础治疗，观察组在此基础上给予参附注射液联合地尔硫治疗，2组均连续治疗2周。观察临床疗效，测定治疗前后C反应蛋白（CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、左心室射血分数（LVEF）、N末端B型脑钠肽前体（NT-proBNP）、6 min步行距离（6MWD）、动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2），比较不良反应发生情况。结果    观察组总有效率明显高于对照组［94.4%（34/36）比77.8%（28/36）］，差异有统计学意义（P＝0.041）。治疗2周后，2组患者CRP、IL-6、TNF-α、NT-proBNP、PaCO2均明显降低，且观察组明显低于对照组［（2.8±0.6）mg/L比（4.3±0.7）mg/L、（68±7）ng/L比（83±8）ng/L、（2.2±0.6）ng/L比（4.1±1.0）ng/L、（0.81±0.08）μg/L比（2.03±0.19）μg/L、（6.0±1.0）kPa比（7.6±1.0）kPa］；2组患者LVEF、6MWD、PaO2均增高，且观察组明显高于对照组［（54±5）%比（44±4）%、（373±37）m比（290±30）m、（8.4±1.6）kPa比（7.3±1.3）kPa］，差异均有统计学意义（均P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P＝0.496）。结论    参附注射液联合地尔硫治疗慢性肺心病合并心力衰竭效果明显，能够有效缓解患者临床症状，改善患者心功能，安全性高。

  
  

• 【Abstract】Objective    To explore the clinical efficacy and safety of Shenfu injection combined with diltiazem in treatment of chronic pulmonary heart disease complicated with heart failure. Methods    Seventy-two patients with chronic pulmonary heart disease and heart failure admitted to Zhengzhou Yihe Hospital from March 2017 to March 2019 were randomly divided into control group and observation group, with 36 cases in each group. The control group was treated with routine basic treatment. The observation group was treated with Shenfu injection and diltiazem tablets on the basis of routine treatment. Both groups were treated for 2 weeks. Clinical efficacy, changes of C-reactive protein（CRP）, interleukin-6（IL-6）, tumor necrosis factor-α（TNF-α）, left ventricular ejection fraction（LVEF）, N-terminal pro-B-type brain natriuretic peptide（NT-proBNP）, 6 min walking distance（6MWD）, arterial partial pressure of oxygen（PaO2） and arterial partial pressure of carbon dioxide（PaCO2） were analyzed before and after treatment, including adverse reactions. Results    Total clinical effective rate in the observation group was significantly higher than that in the control group［94.4%（34/36） vs 77.8%（28/36）］（P＝0.041）. After 2 weeks of treatment, CRP, IL-6, TNF-α, NT-proBNP and PaCO2 significantly decreased and the indexes in the observation group were lower than those in the control group［（2.8±0.6）mg/L vs （4.3±0.7）mg/L, （68±7）ng/L vs （83±8）ng/L, （2.2±0.6）ng/L vs （4.1±1.0）ng/L, （0.81±0.08）μg/L vs （2.03±0.19）μg/L, （6.0±1.0）kPa vs （7.6±1.0）kPa］； LVEF, 6MWD and PaO2 significantly increased and they were higher in the observation group than those in the control group［（54±5）% vs （44±4）%, （373±37）m vs （290±30）m, （8.4±1.6）kPa vs （7.3±1.3）kPa］（all P＜0.05）. There was no significant difference in the incidence of adverse reactions between groups(P＝0.496). Conclusion    Shenfu injection combined with diltiazem treating chronic pulmonary heart disease with heart failure can effectively alleviate clinical symptoms and improve cardiac function; the side effects are tolerable.