达格列净联合芪苈强心胶囊治疗射血分数中间值心力衰竭的临床疗效观察
Clinical efficacy of dapagliflozin combined with QiliQiangxin Capsules in treatment of heart failure with midrange ejection fraction
陈云 1兰真真 1焦雪妍 2刘璐瑶 2刘新灿1
作者信息
- 1. 450000 郑州,河南中医药大学第一附属医院心脏中心
- 2. 450000 郑州,河南中医药大学
- 折叠
摘要
目的 回顾性研究分析钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂达格列净联合芪苈强心胶囊治疗射血分数中间值(40%～49%)心力衰竭(HFmr EF)患者的临床效果及安全性.方法 选择2022年8月至2023年9月期间于河南中医药大学第一附属医院心内科 接受治疗的患者进行筛选,将西医诊断为射血分数中间值心力衰竭、中医诊断为心衰病(阳气亏虚血瘀证)的70例患者作为研究对象.按治疗方法不同分组,在常规治疗基础上采用达格列净治疗者作为对照组;采用达格列净联合芪苈强心胶囊者作为研究组,两组各35例,用药时间≥4周.比较两组患者治疗前后NYHA功能分级、6 min步行试验(6MWT)、明尼苏达心力衰竭生活质量问卷(MLHFQ)评分、心率、超声心动图心功能相关指标[左室舒张末期内径(LVEDd)、左室射血分数(LVEF)]、N末端脑钠肽前体(NT-proBNP)、30 d内再入院率等指标变化,进行统计学分析.结果 与对照组比较,治疗后研究组患者NYHA分级明显减低(P＜0.05),MLHFQ评分明显减低(P＜0.01),6MWT较前明显升高(P＜0.01),研究组的治疗总有效率较对照组明显升高(P＜0.01),研究组治疗后NT-proBNP水平降低幅度更为明显(P＜0.01),LVIDd减少程度明显低于对照组(P＜0.01),LVEF升高幅度明显高于对照组(P＜0.01);两组治疗前后比较,平均基础心率均有不同程度减慢(P＜0.05),与对照组相比,研究组治疗后平均心率指标改善程度更为明显(P＜0.01);随访用药期间两组具有较好的安全性与耐受性,30 d再入院率及就诊比较,差异无统计学意义.结论 达格列净片联合芪苈强心胶囊能够明显改善HFmrEF患者(阳气亏虚血瘀证)的症状和心功能,对于HFmrEF患者治疗方案选择,可供临床参考.
Abstract
Objective To study retrospectively the clinical efficacy and safety of dapagliflozin(ainhibitor of sodium-glucose cotransporter 2,SGLT2)combined with QiliQiangxin Capsules in patients with heart failure with midrange ejection fraction(40%～49%,HFmrEF).Methods The patients with HFmrEF and blood stasis pattern with yang-qi deficiency(n=70)were chosen from Heart Center of the First Affiliated Hospital of Henan University of Chinese Medicine from Aug.2022 to Sept.2023.The patients were divided,according to different therapies,into control group treated with routine therapy and dapagliflozin and study group treated with dapagliflozin combined with QiliQiangxin Capsules(each n=35)for more than 4 weeks.The indexes of NYHA grades,6-minute walk test(6MWT),scores of Minnesota Living with Heart Failure Questionnaire(MLHFQ),heart rate(HR),indexes related to heart function by echocardiogram[left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP)]and re-hospitalization rate within 30 d were compared between 2 groups,and given statistical analysis.Results Compared with control group,NYHA grades decreased significantly(P＜0.05),MLHFQ scores decreased significantly(P＜0.01)and 6MWT increased significantly(P＜0.01)in study group.The total effective rate was significantly higher(P＜0.01),NT-proBNP level was lower(P＜0.01),LVIDd and LVEF were significantly lower(P＜0.01,P＜0.01)in study group than those in control group after treatment.The mean basic heart rate decreased in varying degrees in 2 groups after treatment compared with before(P＜0.05).The improvement of HR indexes was more significant in study group compared with control group after treatment(P＜0.01).There were higher safety and tolerance in 2 groups during follow-up and medication period,and difference in 30-d re-hospitalization rate and re-consultation had no statistical significance between 2 groups.Conclusion Dapagliflozin combined with QiliQiangxin Capsules can significantly relieve symptoms and improve heart function in HFmrEF patients with blood stasis pattern with yang-qi deficiency,which can be taken a clinical reference for the choice of therapeutical scheme in HFmrEF patients.
关键词
射血分数中间值心力衰竭/达格列净/芪苈强心胶囊Key words
Heart failure with midrange ejection fraction/Dapagliflozin/QiliQiangxin Capsules引用本文复制引用
基金项目
河南省中医药科学研究专项(2023ZXZX1156)
河南省青年人才托举工程项目(2021HYTP057)
出版年
2024
NETL
NSTL
万方数据