目的 探討益心舒膠囊聯(lián)合重組人腦利鈉肽治療慢性充血性心力衰竭的臨床療效和安全性。方法 選取2014年2月-2015年12月延安市人民醫(yī)院收治的慢性充血性心力衰竭患者112例,隨機(jī)分為對照組和治療組,每組各56例,對照組患者靜脈滴注凍干重組人腦利鈉肽,首次靜脈沖擊劑量1.5μg/kg,之后以7.5μg/(kg∙min^?1)的速度靜脈滴注。治療組患者在對照組患者的治療基礎(chǔ)上口服益心舒膠囊,3粒/次,3次/d。兩組均連續(xù)治療14d。觀察兩組的臨床療效,比較患者左心室收縮末期內(nèi)徑(LVESD)、左室舒張末期內(nèi)徑(LVEDD)、左室內(nèi)徑(LADD)、心指數(shù)(CI)、左室射血分?jǐn)?shù)(LVEF)等指標(biāo),檢測治療前后去甲腎上腺素(NE)、內(nèi)皮素-1(ET-1)和抗利尿激素(ADH)指標(biāo),并觀察兩組患者不良反應(yīng)發(fā)生情況。結(jié)果 治療后,對照組和治療組的總有效率分別為78.57%、91.07%,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05);兩組患者LVESD、LVEDD、LADD明顯降低,CI和LVEF明顯升高,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05);與對照組相比,治療組患者觀察指標(biāo)改善更明顯,差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者NE、ADH、ET-1水平顯著下降,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05);且治療組患者NE、ADH和ET-1水平改善程度更優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 益心舒膠囊聯(lián)合重組人腦利鈉肽治療慢性充血性心力衰竭具有較好的臨床療效,安全性高,具有一定的臨床推廣應(yīng)用價值

Objective To investigate the clinical efficacy and safety of Yixinshu Capsules combined with recombinant human brain natriuretic peptide in treatment of chronic congestive heart failure. Methods Patients (112 cases) with chronic congestive heart failure in the Yan'an People's Hospital from February 2014 to December 2015 were divided into control and treatment groups, and each group had 56 cases. Patients in the control group were iv administered with lyophilized recombinant human brain natriuretic peptide, first dose of intravenous pulse was 1.5 μg/kg, then at the rate of 7.5 μg/(kg∙min^?1). The patients in the treatment group were po administered with Yixinshu Capsules on the basis of control group, 3 grains/time, three times daily. he patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, the indicators of LVESD, LVEDD, LADD, CI, LVEF, NE, ET-1 and ADH were compared in two groups before and after treatment, and the adverse events were observed. Results After treatment, the efficacies in the control and treatment groups were 78.57% and 91.07%, respectively, and there were differences between two groups (P< 0.05). After treatment, LVESD, LVEDD and LADD levels were significantly decreased, CI and LVEF levels were significantly increased, and the difference was statistically significant in the same group (P < 0.05); 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). After treatment, NE, ADH, ET-1 were obviously decreased, and the difference was statistically significant in the same group (P < 0.05); Furthermore, the differences of NE, ET-1 and ADH levels between two groups were statistically significant (P< 0.05). Conclusion Yixinshu Capsules combined with recombinant human brain natriuretic peptide has clinical curative effect in treatment of chronic congestive heart failure with higher security, which has a certain clinical application value.