目的 探討麝香保心丸聯(lián)合卡維地洛治療缺血性心臟病心力衰竭的臨床療效。方法 選取2015年1月-2015年6月上海市閔行區(qū)龍柏社區(qū)衛(wèi)生服務(wù)中心收治的缺血性心臟病心力衰竭患者300例,隨機(jī)分為對(duì)照組和治療組,每組各150例。對(duì)照組患者在對(duì)癥治療的基礎(chǔ)上口服卡維地洛片,初始劑量為5 mg/次,2次/d,5 d后以5 mg/d遞增,總量不超過(guò)50 mg/d。治療組患者在對(duì)照組的基礎(chǔ)上口服麝香保心丸,2粒/次,3次/d。兩組均連續(xù)治療3個(gè)月。觀察兩組的臨床療效,同時(shí)比較治療前后兩組心率(HR)、心排血量(CO)、左心室射血分?jǐn)?shù)(LVEF)、左室舒張末期內(nèi)徑(LVEDD)及收縮末期內(nèi)徑(LVESD)的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為74.0%、87.3%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者HR、LVEDD、LVESD均顯著降低,CO、LVEF顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 麝香保心丸聯(lián)合卡維地洛治療缺血性心臟病心力衰竭具有良好的療效,能夠明顯改善患者心功能,且安全性較高,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Shexiang Baoxin Pills combined with carvedilol in treatment of heart failure caused by ischemic heart disease. Methods Patients (300 cases) with heart failure caused by ischemic heart disease in Longbai Community Health Service Center of Minhang District in Shanghai from January 2015 to June 2015 were randomly divided into control (n=150) and treatment (n=150) groups. The patients in the control group were po administered with Carvedilol Tablets on the basis of symptomatic treatment, and the initial dosage was 5 mg/time, twice daily. After 5 days, the dosage was increased with 5 mg/d, and the total dosage was not exceed 50 mg/d. The patients in the treatment group were po administered with Shexiang Baoxin Pills on the basis of the control group, 2 grains/time, three times daily. The patients in two groups were treated for 3 months. After treatment, the efficacy was evaluated, and the changes of HR, CO, LVEF, LVEDD, and LVESD in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 74.0% and 87.3%, respectively, and there were differences between two groups (P < 0.05). After treatment, HR, LVEDD, and LVESD in two groups were significantly decreased, and CO and LVEF were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shexiang Baoxin Pills combined with carvedilol has clinical curative effect in treatment of heart failure caused by ischemic heart disease, and can significantly improve cardiac function with higher security, which has a certain clinical application value.