不同剂量参附注射液对心力衰竭患者中医证候积分及BNP水平的影响

张 涛,曾永胜

摘要:目的 探讨不同剂量参附注射液对心力衰竭患者中医证候积分及N端B型利钠肽前体(NT proBNP)水平的影响。方法 收集2014年5月—2015年2月我院心内科收治的慢性心力衰竭患者84例,随机分为对照组、观察组1、观察组2,每组28例。对照组进行基础治疗,观察组在对照组基础上加用参附注射液。观察组1以参附注射液40 mL加入5%葡萄糖注射液250 mL中静脉输注,每日1次,14 d为1个疗程;观察组2以参附注射液80 mL加入5%葡萄糖注射液250 mL中静脉输注,每日1次,14 d为1个疗程。治疗结束后,对比各组中医证候积分、生活质量评分及血清N端B型利钠肽前体(NT proBNP)水平。结果 治疗后,3组患者中医证候积分、明尼苏达生活质量积分、NT proBNP水平均有明显下降(P<0.05),观察组1、观察组2治疗后中医证候积分、生活质量积分、NT proBNP水平均较对照组明显下降,且观察组2下降更为明显,差异有统计学意义(P<0.05)。结论 参附注射液对心力衰竭患者中医证候积分改善及血清NT proBNP水平降低有着重要的作用,随着剂量的加大,其治疗作用随之增强。

关键词:心力衰竭;参附注射液;中医证候积分;B型利钠肽;生活质量积分

中图分类号:R541.6 R289.5

文献标识码:A

doi:10.3969/j.issn.1672-1349.2015.12.002

文章编号:1672-1349(2015)12-1364-03

基金项目:陕西省西安市科技计划项目,编号:2011(HM1115)

Abstract:Objective To investigate the effects of Shenfu injection(SFI)on traditional Chinese medicine(TCM)symptom integral and Nterminal prohormone of brain natriuretic peptide(NT proBNP)level in patients with heart failure(HF).Methods Eightyfour patients in heart failure were selected and divided into 3 groups:Control group treated by routine treatment,experiment group 1 treated by routine treatment plus SFI 40 mL diluted in 5% glucose injection 250 mL,and experiment group 2 treated by routine treatment plus SFI 80 mL diluted in 5% glucose injection 250 mL.TCM syndrome efficacy,quality of life score and serum NTproBNP level were compared after treatment.Results Compared with before treatment,TCM symptom integral and Minnesota life quality integral were lower in three groups(P<0.05).Compared with control group,TCM symptom integral and Minnesota life quality integral were lower in both experiment groups(P<0.05).Compared with experiment group1,TCM symptom integral and Minnesota life quality integral were lower in experiment group 2(P<0.05).Conclusion SFI can improve TCM symptoms and decrease the serum NT proBNP level in patients with HF.Its therapeutic effect is enhanced with the increase of dose.

收稿日期:(2015 06 07)

作者单位:陕西省西安市中心医院(西安710000),E mail:zt951029@ sina.com

Influences of Different Dosage Shenfu Injection on TCM Symptom Integral and NT proBNP Level in Patients with Heart Failure Zhang Tao,Zeng Yongsheng

The Central Hospital of Xi’an,Xi’an 710000,Shaanxi,China

Key words:heart failure;Shenfu injection;traditional Chinese medicine symptom integral;Nterminal prohormone of brain natriuretic peptide;quality of life score

慢性心力衰竭(chronic heart failure,CHF)是各种心脏病的终末阶段,有症状的心力衰竭发生率在1.3%~ 1.8%,若将无症状但心脏彩超有指征的心力衰竭计算在内,则发生率可达3%[1]。因此,寻求一种有效治疗心力衰竭的方法就显得尤为重要。中医可将心力衰竭归于胸痹、水肿、怔忡等范畴,多认为其为心阳虚衰或阴气耗竭,而致气机不畅,脉络瘀阻,发为心力衰竭。参附注射液主要成分为人参、附子,有益气回阳,扶正固脱之功效。……