顾嘉霖　叶　康　王肖龙　周　华　薛金贵（上海中医药大学附属曙光医院，上海 201203）



养心氏片干预冠心病心衰的临床观察*

顾嘉霖叶康王肖龙周华薛金贵△
（上海中医药大学附属曙光医院，上海 201203）

目的 观察养心氏片对冠心病心衰患者的临床疗效。方法 将120例患者按随机数字表法分为对照组和治疗组各60例，对照组给予西药标准治疗，治疗组在标准治疗基础上给予养心氏口服。两组治疗半年。观察患者心超指标左心室射血分数（LVEF）、左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）；血浆BNP水平和中医症状积分变化。结果 两组治疗后LVEF、LVEDD与治疗前比较均改善（P＜0.01），而LVESD与治疗前比较差别不大（P＞0.05）。治疗后两组LVEF、LVEDD、LVESD比较差别不大（P＞0.05）。治疗前两组血浆BNP水平差别不大（P＞0.05）。治疗后两组血浆BNP水平与治疗前比较，明显降低（P＜0.01），且治疗组降低优于对照组（P＜0.01）。治疗前两组NYHA分级差别不大（P＞0.05）。治疗后两组NYHA分级与治疗前比较明显改善（P＜0.01），治疗后治疗组与对照组NYHA分级差别不大（P＞0.05）。治疗后两组胸闷、气短、神疲乏力、自汗和懒言等中医症状与治疗前比较，均明显改善（P＜0.01），且治疗组主要症状胸闷和气短以及次要症状懒言改善优于对照组（P＜0.05）。治疗组总有效率86.67%优于对照组的71.67%（P＜0.05）。结论 养心氏加载治疗冠心病心绞痛患者能够进一步降低患者的血浆BNP水平，改善中医症状和患者心功能状态。

冠心病心衰养心氏中西医结合

【Abstract】Objective：To observe the clinical effect of Yangxinshi Tablets on heart failure in patients with coronary heart disease.Methods：120 cases were randomly divided into the control group（60 cases）and the treatment group（60 cases）.The control group received standard treatment of Western medicine，while the treatment group on the basis of standard therapy were given Yangxinshi Tablets orally.Duration of treatment was six months. Super indexes of left ventricular ejection fraction（LVEF），left ventricular end-diastolic diameter（LVEDD），left ventricular end-systolic diameter（LVESD），variation of plasma BNP levels and TCM symptom score were observed.Results：Compared with before treatment，LVEF and LVEDD of both groups improved after treatment（P＜0.01），while there was little difference in the change of LVESD（P＞0.05）.After treatment，there was little difference in the comparision of LVEF，LVEDD and LVESD（P＞0.05）.Before treatment，there was little difference in plasma BNP levels（P＞0.05）.After treatment，plasma BNP levels of both groups dropped obviously，compared with before treatment（P＜0.01），and the treatment group was suprior to the control group（P＜0.01）.Before treatment，there was little difference in NYHA functional classification between the two groups（P＞0.05）.After treatment，NYHA functional classification improved obviously，compared with before treatment（P＜0.01）.After treatment，there was little difference in NYHA functional classification between the two groups（P＞0.05）.Before treatment，there was little difference in TCM symptoms，such as chest tightness，shortness of breath，General lassitude，sweating and lazy statement.After treatment，chest tightness，shortness of breath，General lassitude，sweating and lazy statement and other symptoms were significantly improved（P＜0.01）.Compared with the control group，the main symptoms of the treatment group，such as chest tightness and shortness of breath and minor symptoms，for example lazyness were significantly improveed（P＜0.05）.The total effective rate in the treatment group was 86.67%and the control group was 71.67%，with significant difference（P＜0.05）.Conclusion：Yangxinshi Tablets on patients with heart failure of coronary heart disease can further reduce the patient′s plasma BNP levels andimprove symptoms and heart function.

【Key words】Coronary heart disease；Heart failure；Yangxinshi Tablets；Combination of Chinese traditional and western medicine

冠状动脉硬化性心脏病（CAD）是引起死亡的主要原因。2014年中国心血管疾病报告［1］指出，2013年中国城市居民冠心病死亡率为100.86/10万，农村居民冠心病死亡率为98.68/10万，与上一年（93.17/10万、68.62/10万）相比均有所上升。……