参附注射液对老年气虚血瘀症型舒张性心力衰竭的影响

摘要

Objective To investigate the effect of Shenfu injection on left ventricular diastolic dysfunction in old patients with qi-deficiency blood-stasis syndrome.Methods Eighty-six old patients with left ventricular diastolic dysfunction (LVDD)and qi-deficiency blood-stasis syndrome were randomly divided into controul group and Shenfu group.Controul group were treated with routine treatment and Shenfu group were treated with Shenfu injection on the base of routine way.The period of both groups was two weeks.The left ventricular functions (including Emas,Amas,E/A,DT,IVRT)were evaluated by Doppler echocardiography.Clinical effectiveness,the level of NT-proBNP and 6 min walking distance were observed.Results After treatment,compared with the control group,the Emas (76.37 ± 10.29 vs 58.74 ±9.66),E/A(1.438 ±0.381 vs 58.74 ± 9.66),6 min walking distance increased(437.78 ± 56.06 vs 351.05 ± 60.01),while Amas(48.13 ± 10.65 vs 60.43 ± 19.93),DT(158.81 ±20.66 sed 206.24 ±25.97),IVRT(86.3 ± 13.58 vs 93.61 ± 10.54),the level of NT-proBNP(398.97 ±255.13 vs 601.04 ±238.61) were decreased significantly in Shenfu group(P ＜ 0.05).Conclusions Shenfu injection with qi-enriching blood-activating actions shows favorable effect in treating old patients with LVDD and qi-deficiency blood-stasis syndrome.%目的 观察参附注射液对老年气虚血瘀症型舒张性心力衰竭患者的疗效. 方法 中医辨证为气虚血瘀症型舒张性心力衰竭患者86例,随机分成对照组和参附组.对照组采取基础药物对症治疗.参附组在此基础上加用参附注射液,观察治疗前后心脏超声左室舒张功能指标,舒张早期二尖瓣血流峰值(Emas)、舒张晚期二尖瓣血流峰值(Amas)、E峰减速时间(DT)、等容舒张时间(IVRT)、血浆NT-proBNP水平、测量6 min步行距离、临床疗效及中医症候群变化. 结果 参附组患者Emas(76.37±10.29) cm/s较对照组(58.74±9.66) cm/s升高、E/A(1.438±0.381)较对照组(58.74±9.66)升高,Amas (48.13±10.65) cm/s较对照组(60.43±19.93) cm/s及DT(158.81±20.66) ms较对照组(206.24±25.97) ms和IVRT(86.3±13.58)ms较对照组(93.61±10.54)ms下降,6 min步行距离(437.78±56.06)m较对照组(351.05±60.01)m增加,血浆NT-proBNP水平(398.97±255.13)较对照组(601.04±238.61)降低.舌质暗紫和脉象结代改善,组间比较有统计学差异(P＜0.05). 结论 参附注射液的益气活血功能辅助治疗老年气虚血瘀症型舒张性心力衰竭效果确切.