麝香保心丸对2型糖尿病合并慢性收缩性心力衰竭患者心功能及BNP的影响

摘要

目的 观察麝香保心丸对2型糖尿病(T2DM)合并慢性收缩性心力衰竭患者心功能和血浆脑钠肽(BNP)水平的影响.方法 纳入78例T2DM合并慢性收缩性心力衰竭患者,随机分为常规治疗组(对照组,n=38)和常规治疗+麝香保心丸组(观察组,n=40),治疗6个月后观察临床总有效率,6 min步行试验和血浆BNP浓度以及心功能超声检查各项参数的改善情况.结果 观察组总有效率90.0%,对照组总有效率78.9%,两组比较差异有统计学意义(P＜0.05).治疗后两组血浆BNP浓度均值较治疗前均有下降,但观察组下降较对照组更加明显(P＜0.05).6 min步行试验运动耐量观察组较对照组增强(P＜0.05).两组治疗后心功能各项参数较治疗前均有改善(P＜0.05);而治疗后观察组心功能指标改善较对照组更加明显,差异有统计学意义(P＜0.05～0.01).结论 麝香保心丸能显著提高T2DM合并慢性收缩性心力衰竭患者的运动耐量,降低血浆BNP浓度,改善心功能.%Objective To observe the influences of Shexiang Baoxin Wan on cardiac function and B-type natriuretic peptide ( BNP ) in patients with type 2 diabetes mellitus ( T2DM ) complicating chronic systolic heart failure. Methods The patients with T2DM complicating chronic systolic heart failure ( n = 78 ) were selected and randomly divided into control group ( n = 38 , treated with routine therapy ) and observation group ( n = 40, treated with routine therapy and Shexiang Baoxin Wan). After 6 months, the total effective rate,6-minute walk distance test( 6MWD ), plasma BNP level, and ultrasonography parameters of cardiac function were observed. Results The total effective rate was 90. 0% in observation group and 78. 9% in control group ( P <0.05 ). The level of plasma BNP decreased in two groups after the treatment, which was more significant in observation group ( P <0. 05 ). 6MWD was improved in observation group compared with control group ( P < 0. 05 ). The ultrasonography parameters of cardiac function were improved in two groups after the treatment ( P <0. 05 ), while the improvement of cardiac function indexes was more significant in observation group compared with control group ( P < 0.05 to P < 0.01 ). Conclusion Shexiang Baoxin Wan can significantly increase exercise tolerance, reduce the level of plasma BNP and improve cardiac function in the patients with T2DM complicating chronic systolic heart failure.