目的 探討心脈隆注射液聯(lián)合比索洛爾治療冠心病心力衰竭的臨床療效。方法 選取2014年5月-2015年7月在湖北省建始縣中醫(yī)院心血管內(nèi)科接受醫(yī)治的冠心病心力衰竭患者84例,隨機分為對照組和治療組,每組各42例。對照組患者在常規(guī)治療的基礎上口服富馬酸比索洛爾片,5mg/次,1次/d,可根據(jù)患者情況進行劑量調整。治療組在對照組基礎上靜脈輸注心脈隆注射液,5mg/kg加入0.9%氯化鈉注射液250~500mL,20~40滴/min,2次/d。兩組均治療10d,觀察兩組的臨床療效,比較治療前后兩組血流動力學、左心室功能、血清B型尿鈉肽(BNP)、血清高敏C反應蛋白(hsCRP)和血管內(nèi)皮生長因子(VEGF)改變情況。結果 治療后,對照組和治療組治療的有效率分別為76.19%和92.86%,兩組比較差異具有統(tǒng)計學意義(P<0.05);兩組患者血流動力學指標均降低,同組比較差異具有統(tǒng)計學意義(P<0.05),且治療組降低的更明顯,兩組比較差異具有統(tǒng)計學意義(P<0.05);兩組患者左心室功能比治療前均有所改善,同組比較差異具有統(tǒng)計學意義(P<0.05),但治療組改善得更明顯,兩組比較差異具有統(tǒng)計學意義(P<0.05);兩組患者血清BNP、hsCRP水平均降低,血VEGF水平升高,同組比較差異具有統(tǒng)計學意義(P<0.05),且治療組上述水平的改善更明顯,兩組比較差異具有統(tǒng)計學意義(P<0.05)。結論 心脈隆注射液聯(lián)合比索洛爾治療冠心病心力衰竭,具有明顯改善患者心功能、血液流變學指標和阻斷冠狀動脈粥樣硬化炎癥反應的作用,具有一定的臨床推廣應用價值。

Objective To investigate the clinical efficacy of Xinmailong Injection combined with bisoprolol in treatment of coronary heart disease patients with heart failure. Methods Patients (84 cases) with coronary heart disease and heart failure in Jianshi Hospital of TCM in Hubei from May 2014 to July 2015 were randomly divided into control (n = 42 ) and treatment (n = 42 ) groups. The patients in the control group were po administered with Bisoprolol Fumarate Tablets on the basis of conventional treatment, 5 mg/time, once daily, and the dose can be adjusted according to the patient's condition. The patients in the treatment group were iv administered with Xinmailong Injection on the basis of the control group, 5 mg/kg added into 0.9% Sodium Chloride Injection 250-500 mL, 20-40 drops/min, twice daily. The patients in two groups were treated for 10 d. After treatment, the efficacy was evaluated, and the changes of blood rheology indexes, left ventricular functions, BNP, hsCRP and VEGF in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 76.19% and 92.86%, respectively, and there were differences between two groups (P< 0.05). After treatment, The observation indexes of blood rheology in two groups were decreased, and the difference was statistically significant in the same group (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Compared with those before treatment, left ventricular functions were improved in two groups after treatment, and the difference was statistically significant in the same group (P < 0.05), furthermore the improvement in the treatment group was more significant, with significant difference between two groups (P < 0.05); Serum BNP, hsCRP levels in two groups were decreased, and VEGF level were increased, and the difference was statistically significant in the same group (P < 0.05), simultaneously the levels of them in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xinmailong Injection combined with bisoprolol has clinical curative effect in the treatment of coronary heart disease patients with heart failure, which significantly improved the patients with cardiac function and blood rheology indexes and blocked inflammatory reaction of coronary atherosclerosis, and it has a certain clinical application value