温阳通络方联合磷酸肌酸钠治疗老年缺血性心肌病心力衰竭的疗效观察及其对BNP、Hcy水平的影响

摘要

目的:观察中药温阳通络方联合磷酸肌酸钠治疗老年缺血性心肌病继发心力衰竭的疗效及其对血清BNP、Hcy水平的影响.方法:选择缺血性心肌病继发心力衰竭的老年患者90例,随机数字表法分为两组,每组45例.2组患者均采用常规抗心衰治疗方法,对照组应用磷酸肌酸钠治疗,观察组在对照组基础上加用温阳通络方治疗,治疗2周后,评定疗效;治疗前后进行超声心动图检测及6 min步行距离测试,并检测血清BNP、Hcy含量.结果:对照组有效率为71.1％,观察组有效率为91.1％,2组间比较,差异有统计学意义(P＜0.05).治疗前,两组患者的LVESD、LVEDD、LVEF和6MWD水平相近,差异无统计学意义(P＞0.05),治疗后,2组患者的LVESD、LVEDD明显下降,LVEF和6 mWD水平均明显升高,观察组患者的LVESD、LVEDD下降及LVEF、6 mWD升高更为明显,差异有统计学意义(P＜0.05).治疗后2组患者血清BNP、Hcy水平均明显下降,与治疗前比较差异有统计学意义(P＜0.05);观察组患者血清BNP、Hcy含量明显低于对照组(P＜0.05).两组患者治疗期间均未出现明显明显不良反应.结论:中药温阳通络方联合磷酸肌酸钠治疗老年缺血性心肌病继发心力衰竭可以明显提高临床疗效,降低血清BNP、Hcy水平,改善患者的心功能.%Objective:To observe the curative effect of Wenyang Tongluo Fang combined with creatine phosphate sodium in the treatment of senile ischemic cardiomyopathy (ICM) heart failure and impacts on serum BNP,Hcy Levels.Methods:90 senile patients with ischemic cardiomyopathy and congestive heart failure were divided into two groups according to the random number table method,each group with 45 cases.Patients of the two groups were treated with conventional anti heart failure therapy,patients in the control group were treated with creatine phosphate sodium,while the observation group was treated with Wenyang Tongluo Fang on the basis of control.The curative effect was evaluated after treated for 2 weeks,cardiogram was carried and 6 min walk distance was recorded,serum BNP and Hcy levels were determined before and after treatment.Results:The total effective rate of observation group was 91.1％,that was mech better than that of control (71.1％),the difference was statistically significant (P ＜ 0.05).The LVESD,LVEDD of the two groups were significantly lowered after treatment,LVEF was raised and 6 mWD was prolonged,all these changes were more significant in observation group than those in control group.Serum BNP and Hey levels of the two groups patients were decreased obviously after treatment,the effects of the observation group were better than those of the control group (P ＜ 0.05).There was no obvious adverse reaction in the two groups during the treatment.Conclusion:Wenyang Tongluo Fang combined with creatine phosphate sodium can effectively treat ICM heart failure,reduce serum BNP and Hcy levels,improve cardiac function.