CAJ | 학술논문

目的：观察芪苈强心胶囊治疗慢性心力衰竭（CHF）合并临床特殊情况患者的疗效。方法80例CHF合并临床特殊情况患者，其中合并慢性肾功能不全30例，低血压状态16例，急性心肌梗死10例，窦性心动过缓12例，难治性心力衰竭12例。各组患者均随机分为治疗组和对照组。对照组接受常规抗心力衰竭治疗，治疗组加用芪苈强心胶囊1.2 g，每日3次，共3个月，观察心功能及血浆N末端B型利钠肽（NT-proBNP）水平变化。结果治疗组总有效率为92％，高于对照组的75％，差异有统计学意义（P＜0.05）；治疗后2组血浆NT-proBNP水平均较治疗前显著降低（P＜0.01），治疗组NT-proBNP水平显著低于对照组（P＜0.01）；治疗后2组每搏输出量（SV）、心输出量（CO）、心指数（CI）和左室射血分数（LVEF）均较治疗前增加（P＜0.05），治疗组LVEF高于对照组（P＜0.05）；两组左室舒张末内径（LVEDD）和左房内径（LAD）均较治疗前降低，治疗组前后比较，差异有统计学意义（P＜0.05），对照组前后比较，差异无统计学意义（P＞0.05），2组治疗后比较，差异无统计学意义（P＞0.05）。结论芪苈强心胶囊可改善CHF合并临床特殊情况患者的心功能，降低NT-proBNP水平，为医生提供更多治疗选择。
목적：관찰기력강심효낭치료만성심력쇠갈（CHF）합병림상특수정황환자적료효。방법80례CHF합병림상특수정황환자，기중합병만성신공능불전30례，저혈압상태16례，급성심기경사10례，두성심동과완12례，난치성심력쇠갈12례。각조환자균수궤분위치료조화대조조。대조조접수상규항심력쇠갈치료，치료조가용기력강심효낭1.2 g，매일3차，공3개월，관찰심공능급혈장N말단B형리납태（NT-proBNP）수평변화。결과치료조총유효솔위92％，고우대조조적75％，차이유통계학의의（P＜0.05）；치료후2조혈장NT-proBNP수평균교치료전현저강저（P＜0.01），치료조NT-proBNP수평현저저우대조조（P＜0.01）；치료후2조매박수출량（SV）、심수출량（CO）、심지수（CI）화좌실사혈분수（LVEF）균교치료전증가（P＜0.05），치료조LVEF고우대조조（P＜0.05）；량조좌실서장말내경（LVEDD）화좌방내경（LAD）균교치료전강저，치료조전후비교，차이유통계학의의（P＜0.05），대조조전후비교，차이무통계학의의（P＞0.05），2조치료후비교，차이무통계학의의（P＞0.05）。결론기력강심효낭가개선CHF합병림상특수정황환자적심공능，강저NT-proBNP수평，위의생제공경다치료선택。
Objective To investigate the efficacy of Qili cardiotonic capsules in patients with chronic heart fail-ure (CHF) and special clinical condition. Methods Eighty patients with CHF and special clinical condition were in-cluded. There were 30 cases with combined chronic renal failure, 16 with low blood pressure status, 10 with acute my-ocardial infarction, 12 with sinus bradycardia and 12 with refractory heart failure. And patients in each group were randomly divided into the treatment group and control group. The treatment group and the control group received rou-tine anti-heart failure therapy, while the former was additionally given 1.2 g Qili cardiotonic capsules 3 times daily for 3 months. The changes of cardiac function and the levels of plasma N-terminal pro-brain natriuretic peptide (NT-pro BNP) were investigated. Results The total effective rate in the treatment group was 92%, which was higher than the 75%in the control group, with statistically significant differences (P<0.05). The levels of plasma NT-proBNP after the treatment were significantly decreased compared with those before the treatment in both groups ( P<0.01). However, the level of NT-proBNP in treatment group was significantly lower than that in the control group after treatment ( P<0.01). The stroke volume (SV), cardiac output (CO), cardiac index (CI) and left ventricular ejection fraction (LVEF) after the treatment were increased compared with those before the treatment in both groups ( P<0.05). The LVEF in the treat-ment group was higher than that in the control group after the treatment ( P<0.05). The left ventricular end-diastolic di-ameter (LVEDD) and left atrial diameter (LAD) were decreased after the treatment compared with those before the treatment in both groups. And there were statistically significant differences in the treatment group between before and after treatment (P<0.05). No statistically significant differences were found in the control group between before and af-ter treatment (P>0.05) as well as those in both groups after the treatment (P>0.05). Conclusion Qili cardiotonic cap-sules can improve the cardiac function and reduce the level of NT-proBNP in patients with CHF and special clinical, providing more treatment choices for doctors.