吴波

[摘要] 目的 观察芪苈强心胶囊对慢性充血性心力衰竭（CHF）患者心功能及同型半胱氨（Hcy）的影响。 方法 2013年4月～2014年12月，将140例CHF患者随机分为观察组和对照组。两组均给予抗心力衰竭等常规西医治疗，观察组在常规西医治疗基础上加用芪苈强心胶囊，疗程为8周。观察治疗前后患者的临床症状，6 min步行试验距离（6MWD），检测血清同型半胱氨酸（Hcy）和测定左室射血分数（LVEF）。 结果 观察组的显效率、总有效率均明显高于对照组（P<0.05）；治疗后，两组患者的LVEF明显提高，血清Hcy水平明显下降，6MWD明显增加（P<0.05）；与对照组比较，观察组治疗后的LVEF显著提高，血清Hcy水平显著下降，6MWD显著增加（P<0.05）。 结论 常规西医治疗基础上加用芪苈强心胶囊治疗CHF可增加LVEF、6MWD距离，降低血清Hcy水平，明显改善心功能，提高临床疗效。

[关键词] 芪苈强心胶囊；充血性心力衰竭；心功能；同型半胱氨酸

[中图分类号] R541.6+1 [文献标识码] A [文章编号] 1674-4721（2015）09（a）-0039-03

[Abstract] Objective To observe the influence of Qiliqiangxin capsule on cardiac function and homocysteine （Hcy） in patients with chronic congestive heart failure （CHF）. Methods From April 2013 to December 2014，One hundred and forty patients CHF with were randomly divided into observation group and control group.Regular western therapy of anti-heart failure was provided in both groups.On the basis of the regular western therapy，Qiliqiangxin capsule in observation group was added，and course of treatment lasted 8 weeks.Clinical symptoms and 6-minute walking test distance （6MWTD） before and after treatment were observed.Serum Hcy and left ventricular ejection fraction （LVEF） were determined. Results The marked improvement rate and total effective rate in observation group was obviously higher than that of control group respectively （P<0.05）.After therapy，LVEF was improved，and serum Hcy level was greatly decreased and 6MWD was increased in both groups （P<0.05）.Compared with the control group，LVEF was improved，and serum Hcy level was greatly decreased and 6MWD was increased after treatment in observation group （P<0.05）. Conclusion On the basis of the regular western therapy，Qiliqiangxin capsule added can increase LVEF and of 6MWD，lower down serum Hcy level，greatly improve cardiac function，and improve clinical effect in treating CHF.

[Key words] Qiliqiangxin capsule；Congestive heart failure；Cardiac function；Homocysteine

慢性充血性心力衰竭（chronic congestive heart failure，CHF）是心血管疾病的终末期表现和最主要死因之一[1]。研究表明，CHF是一种神经激素细胞因子网络失衡状态，可能与某些体液和细胞因子改变导致心室重构有关。同型半胱氨酸（Hcy）是导致CHF发生、发展新的危险因素。本研究观察芪苈强心胶囊对CHF患者6 min步行试验距离（6MWD）、左心室射血分数（LVEF）及Hcy水平的影响，旨在探讨芪苈强心胶囊治疗CHF的效果。

1 资料与方法

1.1 一般资料

选择2013年4月～2014年12月在赣州市人民医院诊治的CHF患者140例，诊断符合CHF的诊断标准[2]。男性91例、女性49例；年龄（63.2±11.5）岁：其中缺血性心脏病86例、高血压性心脏病44例、肺源性心脏病5例、扩张性心肌病5例。140例患者均为纽约心脏病学会（NYHA）心功能分级为Ⅱ～Ⅳ级，心脏彩超证实左心室射血分数（LVEF）≤40%，血清Hcy≥15 μmol/L （我院正常参考值为0～15 μmol/L）；中医辨证为瘀血阻络、心气虚乏证；并与患者签署知情同意书。将患者随机分为观察组和对照组，其中观察组70例：男45例、女25例；……