摘要
目的 分析心宝丸联合美托洛尔缓释片治疗慢性心力衰竭(CHF)患者效果及对左心室重塑的影响.方法 回顾性选取2019年4月至2023年4月滁州市中西医结合医院收治的70例CHF患者进行研究,依据治疗方法不同将其分为3组,美托洛尔缓释片组(n=20)、心宝丸组(n=20)和联合组(n=30).美托洛尔缓释片组给予单纯美托洛尔缓释片治疗,心宝丸组给予单纯心宝丸治疗,联合组给予心宝丸+美托洛尔缓释片治疗.记录3组患者的临床疗效,分别在治疗前和治疗4周后检测与比较3组患者的左心室重塑[左室内舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左室射血分数(LVEF)]、心脏相关指标[血清心型脂肪酸结合蛋白(H-FABP)、脑钠肽]、血清学指标[血清内皮细胞生长因子(VEGF)、细胞间黏附分子-1(ICAM-1)、胰岛素样生长因子-1(IGF-1)],并比较3组的不良反应.结果 联合组总有效率为93.33％,高于美托洛尔缓释片组(65.00％)、心宝丸组(70.00％),差异均有统计学意义(P＜0.05).治疗4周后,联合组LVEDd、LVESd水平分别为(44.63±4.12)、(33.26±4.25)mm,均低于美托洛尔缓释片组[(449.52±4.58)、(39.15±4.25)mm]、心宝丸组[(48.12±4.25)、(37.89±4.12)mm],LVEF 水平为(56.84 ±5.15)％,高于美托洛尔缓释片组[(50.68±5.58)％]、心宝丸组[(52.68±5.45)％],差异均有统计学意义(P＜0.05).治疗4周后,联合组脑钠肽、H-FABP水平分别为(362.54±30.58)ng/L、(25.46±3.65)pg/mL,均低于美托洛尔缓释片组[(489.68±30.58)ng/L、(38.69±4.58)pg/mL]、心宝丸组[(478.59±30.58)ng/L、(36.84±4.25)pg/mL],差异均有统计学意义(P＜0.05).治疗4周后,联合组ICAM-1水平为(33.16±4.58)ng/L,低于美托洛尔缓释片组[(42.69±5.12)ng/L]、心宝丸组[(41.12±5.18)ng/L],VEGF、IGF-1 水平分别为(564.26±40.84)ng/L、(150.69 ±15.47)ng/mL,均高于美托洛尔缓释片组[(468.59±40.84)ng/L、(130.69±15.25)ng/mL]、心宝丸组[(478.65± 40.58)ng/L、(133.69±15.88)ng/mL],差异均有统计学意义(P＜0.05).联合组不良反应发生率为20.00％,美托洛尔缓释片组为15.00％,心宝丸组为10.00％,3组比较差异无统计学意义(P＞0.05).结论 心宝丸联合美托洛尔缓释片联合治疗CHF,可帮助患者逆转左心室重塑,并改善其心功能,同时促进心肌细胞修复,有利于进一步提高患者的临床治疗效果.
Abstract
Objective To analyze the effect of Xinbao Pills combined with metoprolol sustained release tablets in the treatment of patients with chronic heart failure(CHF)and its effect on left ventricular remodeling.Methods This study was a retrospective analysis,70 cases of CHF patients admitted to Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2019 to April 2023 were selected for the study,and they were divided into 3 groups based on the treatment method,metoprolol sustained release tablets group(n=20),Xinbao Pills group(n=20),and the combined group(n=30).The metoprolol sustained release tablets group was given simple metoprolol sustained release tablets treatment,the Xinbao Pills group was given simple Xinbao Pills treatment,and the combination group was given Xinbao Pills+metoprolol sustained release tablets treatment.The clinical efficacy in the three groups were recorded,and left ventricular remodeling[left ventricular end-diastolic internal diameter(LVEDd),left ventricular end-systolic internal diameter(LVESd),and left ventricular ejection fraction(LVEF)],cardiac-related indexes[serum heart-type fatty acid-binding protein(H-FABP),and brain natriuretic peptide],and serological indexes[serum endothelial growth factor(VEGF),intercellular adhesion molecule-1(ICAM-1),insulin-like growth factor-1(IGF-1)]were de-tected and compared among three groups of patients before treatment and after 4 weeks of treatment,respectively.The adverse reactions of the three groups were compared.Results The total effective rate of the combined group was 93.33％,which was higher than that of the metoprolol sus-tained release tablets group(65.00％)and the Xinbao Pills group(70.00％),and the difference was statistically significant(P＜0.05).After 4 weeks of treatment,the levels of LVEDd,LVESd in the combined group were(44.63±4.12),(33.26±4.25)mm,respectively,which were lower than those in the metoprolol sustained release tablets group[(449.52±4.58),(39.15±4.25)mm]and the Xinbao Pills group[(48.12 ±4.25),(37.89±4.12)mm],and the level of LVEF in the combined group was(56.84±5.15)％,which was higher than that in the meto-prolol sustained release tablet group[(50.68±5.58)％]and the Xinbao Pills group[(52.68±5.45)％],the differences were statistically sig-nificant(P＜0.05).After 4 weeks of treatment,the levels of brain natriuretic peptide,H-FABP in the combined group were(362.54±30.58)ng/L,(25.46±3.65)pg/mL,respectively,which were lower than those in the metoprolol sustained release tablet group[(489.68±30.58)ng/L,(38.69±4.58)pg/mL]and the Xinbao Pills group[(478.59±30.58)ng/L,(36.84±4.25)pg/mL],and the differences were sta-tistically significant(P＜0.05).After 4 weeks of treatment,the level of ICAM-1 in the combination group was(33.16±4.58)ng/L,which was lower than that in the metoprolol sustained release tablets group[(42.69±5.12)ng/L]and the Xinbao Pills group[(41.12±5.18)ng/L],and the levels of VEGF and IGF-1 in the combination group were(564.26±40.84)ng/L,(150.69±15.47)ng/mL,respectively,which were higher than those in the metoprolol sustained release tablets group[(468.59±40.84)ng/L,(130.69±15.25)ng/mL],the Xinbao Pills group[(478.65±40.58)ng/L,(133.69±15.88)ng/mL],and the differences were statistically significant(P＜0.05).The incidence rate of adverse reactions of the combination group was 20.00％,the metoprolol sustained release tablets group was 15.00％,and the Xinbao Pills group was 10.00％,there was no statistically significant difference among the three groups(P＞0.05).Conclusion The Xinbao Pills com-bined with metoprolol sustained release tablets in the treatment of patients with CHF can help reverse left ventricular remodeling and improve their cardiac function,as well as promote cardiomyocyte repair,which is conducive to further improving the clinical outcome 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