芪苈强心胶囊联合左卡尼汀注射液对慢性心力衰竭的疗效探讨

摘要 目的：研究芪苈强心胶囊联合左卡尼汀注射液对慢性心力衰竭的疗效。方法：选择2016年1月～2019年1月我院收治的85例慢性心力衰竭患者，随机分为两组。对照组静脉滴注左卡尼汀注射液，观察组联合口服芪苈强心胶囊。检测两组治疗前后的心功能、心室重构、血浆脑钠素 N 端前体肽(N-terminal pro peptide of brain natriuretic peptide，NT-pro BNP)、高敏 C 反应蛋白(High sensitive C-reactive protein，hs-CRP)水平。结果：观察组治疗的总有效率为88.09 %（37/42），明显高于对照组的67.44%（29/43）(P<0.05)。治疗前，两组的左心室舒张末期内径（End diastolic diameter of left ventricle，LVEDd）、心率（heart rate，HR）、左心室收缩末内径（Left ventricular end systolic diameter，LVESd）、左室射血分数（Left ventricular ejection fraction，LVEF）、心排血量（Cardiac output，CO）和E峰/A峰的比值（E peak /A peak，E/A）均无显著差异（P>0.05）；治疗后，两组的LVEDd、HR和LVESd均明显降低(P<0.05)，LVEF、CO和E/A均明显升高(P<0.05)，且观察组上述指标明显优于对照组(P<0.05)。治疗前，两组的血浆NT- pro BNP、hs- CRP水平比较无差异（P>0.05）；治疗后，两组的血浆NT- pro BNP、hs- CRP水平均明显降低（P<0.05），且观察组明显低于对照组（P<0.05）。对照组发生胃肠道反应3例，头痛3例，不良反应的发生率为13.95 %；观察组发生胃肠道反应4例，头痛3例，不良反应的发生率为16.67 %。两组不良发应的发生情况无统计学意义（P>0.05）。结论：芪苈强心胶囊联合左卡尼汀注射液能改善慢性心力衰竭患者的心室重构及心功能，降低炎症标志物和神经内分泌激素水平，值得进行推广。

Effect of Qiliqiangxin Capsule Combined with Levocarnitine Injection on Chronic Heart Failure

ABSTRACT Objective: To study the effect of Qiliqiangxin capsule combined with Levocarnitine injection on chronic heart failure. Methods: Selected 85 cases of patients with chronic heart failure who were treated in our hospital from January 2016 to January 2019, divided into two groups randomly. The control group was given levocarnitine injection, and the observation group was given Qiliqiangxin capsule. The cardiac function, ventricular remodeling, N-terminal pro peptide of brain natural peptide (NT Pro BNP) and high sensitive C-reactive protein (hs CRP) were measured before and after treatment. Results: The total effective rate of the observation group was 88.09 % (37/42), significantly higher than that of the control group (67.44 %)(29/43)(P<0.05). Before treatment, the LVEDd, HR,LVESd, and LVEF, CO and (E/A) were not significantly different(P>0.05). After treatment, LVEDd, HR and LVESd were significantly decreased in two groups(P<0.05), and LVEF, CO and E/A were significantly increased(P<0.05). The above indicators in the observation group were significantly better than the control group(P<0.05). Before treatment, there was no difference in plasma NT-pro BNP and hs-CRP levels between the two groups(P>0.05). After treatment, the levels of NT-Pro BNP and hs-CRP in the two groups were significantly reduced (P<0.05), and the observation group were significantly lower than those in the control group (P<0.05). In the control group, gastrointestinal reactions occurred in 3 cases, and headache occurred in 3 cases, and the incidence of adverse reactions was 13.95 %. In the observation group, 4 cases of gastrointestinal reactions, 3 cases of headache, and the incidence of adverse reactions was 16.67 %. The incidence of adverse reactions in the two groups was not statistically significant (P>0.05). Conclusion: Qiliqiangxin capsule combined with Levocarnitine injection can improve the ventricular remodeling and cardiac function in patients with chronic heart failure, reduce the level of inflammatory markers and neuroendocrine hormones, which is worthy of promotion.