麝香保心丸对射血分数正常心力衰竭患者运动耐量和心肺功能的影响

摘要

目的 探讨麝香保心丸对射血分数正常心力衰竭(HFNEF)患者运动耐量和心肺功能的影响.方法 选取2015年7月-2016年7月解放军第九四医院收治的HFNEF患者70例,其中14例患者退出本研究,实际纳入患者56例,采用随机数字表法分为A组27例与B组29例.两组患者均佩戴智能手环,A组患者第一阶段予以麝香保心丸治疗,第二阶段予以安慰剂治疗;B组患者第一阶段予以安慰剂治疗,第二阶段予以麝香保心丸治疗.比较两组患者各阶段日平均步数、日平均活动时间、6分钟步行距离、步行后呼吸困难评分、N末端脑钠肽前体(NT-proBNP)水平、血压(收缩压、舒张压)、平均动脉压、明尼苏达心力衰竭生活质量问卷(MLHFQ)评分和主观感觉.结果 第一阶段A组患者日平均步数多于B组(P<0.05),但两组患者日平均活动时间比较,差异无统计学意义(P>0.05);第二阶段两组患者日平均步数、日平均活动时间比较,差异无统计学意义(P>0.05).第一阶段A组患者6分钟步行距离长于B组,步行后呼吸困难评分低于B组(P<0.05);第二阶段两组患者6分钟步行距离、步行后呼吸困难评分比较,差异无统计学意义(P>0.05).第一阶段A组患者NT-proBNP水平、收缩压低于B组,平均动脉压高于B组(P<0.05),但两组患者舒张压比较,差异无统计学意义(P>0.05);第二阶段两组患者NT-proBNP水平、舒张压比较,差异无统计学意义(P>0.05),而A组患者收缩压高于B组,平均动脉压低于B组(P<0.05).第一阶段A组患者MLHFQ评分低于B组(P<0.05);第二阶段A组患者MLHFQ评分高于B组(P<0.05).两组患者各阶段主观感觉比较,差异有统计学意义(P<0.05).结论 麝香保心丸可有效提高HFNEF患者运动耐量,改善患者心肺功能和生活质量.%Objective To investigate impact of shexiang-baoxin pills on exercise tolerance and cardiopulmonary function of heart failure patients with normal ejection fraction(HFNEF).Methods A total of 70 patients with HFNEF were selected in the 94th Hospital of the Chinese People′s Liberation Army from July 2015 to July 2016,there into 14 cases quit midway,thus 56 patients enrolled in this study eventually;all of the 56 patients were divided into A group(n=27)and B group(n=29)according to random number table.Patients of the two groups worn smart bracelet,meanwhile patients of A group received shexiang-baoxin pills at the first stage and placebo at the second stage,while patients of B group received placebo at the first stage and shexiang-baoxin pills at the second stage.Daily mean steps,daily mean activating duration,6-minute walking distance,dyspnea score after walking,NT-proBNP,SBP,DBP,MAP,MLHFQ score and subject feeling at the first and second stage were compared between the two groups.Results At the first stage,daily mean steps of A group was statistically significantly more than that of B group(P<0.05),while no statistically significant differences of daily mean activating duration was found between the two groups(P>0.05);no statistically significant differences of daily mean steps or daily mean activating duration was found between the two groups at the second stage(P>0.05).At the first stage,6-minute walking distance of A group was statistically significantly longer than that of B group,dyspnea score after walking of A group was statistically significantly lower than that of B group(P<0.05);no statistically significant differences of 6-minute walking distance or dyspnea score after walking was found between the two groups at the second stage(P>0.05).At the first stage,NT-proBNP and SBP of A group were statistically significantly lower than those of B group,MAP of A group was statistically significantly higher than that of B group(P<0.05),while no statistically significant differences of DBP was found between the two groups(P>0.05);at the second stage,SBP of A group was statistically significantly higher than that of B group,MAP of A group was statistically significantly lower than that of B group(P<0.05),while no statistically significant differences of NT-proBNP or DBP was found between the two groups(P>0.05).MLHFQ score of A group was statistically significantly lower than that of B group at the first stage,while MLHFQ score of A group was statistically significantly higher than that of B group at the second stage(P<0.05).There was statistically significant differences of subject feeling between the two groups at the first and second stage,respectively(P<0.05).Conclusion Shexiang-baoxin pills can effectively improve the exercise tolerance,cardiopulmonary function and quality of life of patients with HFNEF.