摘要
目的 探讨地奥心血康软胶囊联合沙库巴曲缬沙坦治疗缺血性心肌病的疗效及对心室重构、生存质量的影响.方法 回顾性选取2018年9月到2023年9月滁州市中西医结合医院收治的80例缺血性心肌病患者,依据治疗方法的不同将其分为对照组与观察组,每组各40例.对照组应用沙库巴曲缬沙坦治疗,观察组应用地奥心血康软胶囊联合沙库巴曲缬沙坦治疗.治疗3个月后,比较两组患者临床疗效,比较两组患者治疗前、治疗3个月后的血液生化指标[B型脑钠肽(BNP)、高敏C反应蛋白(hs-CPP)、超氧化物歧化酶(SOD)]、Killip心功能分级、心室重构相关指标[左心室重构指数(LVRI)、左心室质量指数(LVMI)]水平,以及明尼苏达心力衰竭生存质量问卷(MLHFQ)评分.结果 治疗3个月后,观察组治疗总有效率为95.00％,高于对照组(75.00％),差异有统计学意义(P＜0.05).治疗3个月后,两组患者BNP、hs-CPP水平均较治疗前降低,SOD水平均较治疗前升高,且观察组BNP、hs-CPP水平分别为(93.28± 8.62)pg/L、(29.12±4.12)mg/L,均明显低于对照组[(125.61±10.69)pg/L、(37.12±4.25)mg/L],SOD 水平为(108.27±10.69)nU/mL,高于对照组[(93.67±15.45)nU/mL],差异均有统计学意义(P＜0.05).观察组治疗3个月后,患者Ⅰ级比率为47.50％,高于对照组(25.00％),Ⅲ级、Ⅳ级比率为7.50％、0,明显低于对照组(25.00％、10.00％),差异均有统计学意义(P＜0.05).观察组LVRI、LVMI为(2.52±0.43)g/mL、(93.43±7.17)g/m2,均低于对照组[(2.94±0.24)g/mL、(110.31±11.28)g/m2],差异有统计学意义(P＜0.05).治疗3个月后,两组患者MLHFQ中身体领域、情绪领域、其他领域各分值及MLHFQ总分均较治疗前升高,且观察组身体领域、情绪领域、其他领域各分值及MLHFQ 总分分别为(32.56±7.11)、(20.36±4.25)、(33.93±5.13)、(86.87±8.37)分,均高于对照组[(27.87±5.13)、(17.56±4.46)、(30.01±4.05)、(75.44±5.66)分],差异均有统计学意义(P＜0.05).结论 地奥心血康软胶囊联合沙库巴曲缬沙坦治疗缺血性心肌病临床疗效显著,可降低BNP表达水平,同时能够抑制脂质过氧化反应,减轻机体炎症反应水平,提升心功能,改善心室重构情况,进而提升患者生存质量.
Abstract
Objective To explore the therapeutic effect of Di'ao Xinxuekang soft capsule combined with Shakubaqu valsartan in the treat-ment of ischemic cardiomyopathy,as well as their impact on ventricular remodeling and quality of life.Methods This study was a retrospective a-nalysis,80 patients with ischemic cardiomyopathy admitted to Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine from Sep-tember 2018 to September 2023 were selected.According to the different treatment methods,they were divided into the control group and the ob-servation group,with 40 cases in each group.The control group were treated with Shakubaqu valsartan,while the observation group were treated with Di'ao Xinxuekang soft capsule combined with Shakubaqu valsartan.The clinical efficacy of two groups of patients was compared,the levels of blood biochemical indicators[B-type natriuretic peptide(BNP),high sensitivity C-reactive protein(hs-CPP),superoxide dismutase(SOD)],Killip cardiac function grading,left ventricular remodeling indexs[left ventricular remodeling index(LV RI)and left ventricular mass index(LVMI)],and Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ)of the two groups of patients before treatment and after 3 months of treatment were compared.Results After 3 months of treatment,the total effective rate of the observation group was 95.00％,which was higher than that of the control group(75.00％),and the difference was statistically significant(P＜0.05).After 3 months of treatment,the levels of BNP and hs-CPP in two groups of patients were lower than those before treatment,while the levels of SOD were higher than those before treatment,and the levels of BNP and hs-CPP in the observation group were(93.28±8.62)pg/L and(29.12±4.12)mg/L,respectively,which were significantly lower than those in the control group[(125.61±10.69)pg/L and(37.12±4.25)mg/L],and the level of SOD was(108.27±10.69)nU/mL,which was higher than that in the control group[(93.67±15.45)nU/mL],and the differences were statistical-ly significant(P＜0.05).After 3 months of treatment,there was a significant improvement in the cardiac function grading of the two groups of patients compared to before treatment,LVRI and LVMI in the observation group were(2.52±0.43)g/mL,(93.43±7.17)g/m2,respective-ly,which were lower than those in the control group[(2.94±0.24)g/mL,(110.31±11.28)g/m2],and the difference were statistically sig-nificant(P＜0.05).After 3 months of treatment,the MLHFQ scores in the physical,emotional,and other domains as well as the total MLHFQ scores in two groups of patients were higher than those before treatment,the physical,emotional,and other domains scores,the total MLHFQ scores of the observation group were(32.56±7.11),(20.36±4.25),(33.93±5.13),and(86.87±8.37)points,respectively,which were higher than those in the control group[(27.87±5.13),(17.56±4.46),(30.01±4.05),and(75.44±5.66)points],the differences were statistically significant(P＜0.05).Conclusion The combination of Di'ao Xinxuekang soft capsule and Shakubaqu valsartan has a significant clinical efficacy in the treatment of ischemic cardiomyopathy,reducing the expression level of BNP,inhibiting lipid peroxidation,reducing the lev-el of inflammatory response,improving heart function,improving ventricular remodeling,and ultimately improving the quality of life of patients.
基金项目
安徽省中医药传承创新科研项目(2020ccyb27)
维普
万方数据