摘要
目的 分析芪参益气滴丸联合美托洛尔治疗慢性充血性左心衰竭的临床效果.方法 收集99 例患者资料,按治疗方案分为对照组49 例(美托洛尔)、研究组50 例(芪参益气滴丸+美托洛尔).对比两组疗效,不良反应,心室重塑指标(左心室后壁舒张末期厚度、左心室舒张末期球形指数、左心室收缩末期容积),钙调神经磷酸酶-活化T细胞核因子3 通路相关蛋白(钙调神经磷酸酶、锌指转录因子、活化T细胞核因子 3),心肌损伤标志物(肌酸激酶同工酶、N-末端脑钠肽前体、肌钙蛋白I).结果 研究组总有效率高于对照组,差异有统计学意义(P<0.05);治疗4 周后,研究组左心室后壁舒张末期厚度、左心室舒张末期球形指数、左心室收缩末期容积低于对照组(P<0.05);治疗4 周后,研究组钙调神经磷酸酶、锌指转录因子、活化T细胞核因子3、肌酸激酶同工酶、N-末端脑钠肽前体、肌钙蛋白I低于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05).结论 芪参益气滴丸联合美托洛治疗慢性充血性左心衰竭可减轻心肌损伤,逆转心室重塑,效果确切,安全性好.
Abstract
Objective To analyze the clinical effect of Qishen Yiqi Guttate pills combined with metoprolol in the treatment of chronic congestive left heart failure.Methods 99 patients were collected,and divided in the control group(metoprolol,49 cases)and the study group(Qishen Yiqi Guttate pills+metoprolol,50 cases)according to the treatment regimen.The efficacy,adverse reactions,ventricular remodeling indicators(left ventricular posterior wall diastolic thickness[LVPWd],left ventricular diastolic spherical index[LVSId],left ventricular end-systolic volume[LVESV]),calcineurin-activated T cell nuclear factor 3(CaN-NFAT3)pathway-related proteins(calcineurin[CaN],zinc finger transcription factor[GATA4],activated T cell nuclear factor 3[NFAT3]),and myocardial injury markers(creatine kinase isoenzyme[CK-MB],N-terminal pro-brain natriuretic peptide[NT-proBNP],troponin I[cTnl])were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,showing a statistically significant difference(P<0.05).After 4 weeks of treatment,LVPWd,LVSId,and LVESV in the study group were lower than those in the control group(P<0.05).After 4 weeks of treatment,CaN,GATA4,NFAT3,CK-MB,NT-proBNP,and cTnl in the study group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of Qishen Yiqi Guttate Pills and Metoprolol can alleviate myocardial injury and reverse ventricular remodeling in the treatment of chronic congestive left heart failure,with a reliable efficacy and good safety profile.
维普
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