心舒宁汤联合曲美他嗪治疗尿毒症性心肌病疗效及对N末端脑钠肽前体和心脏腔室的影响
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摘要
目的观察心舒宁汤联合曲美他嗪治疗尿毒症性心肌病的疗效及对N末端脑钠肽前体和心脏腔室的影响。方法将83例尿毒症性心肌病患者随机分为观察组(42例)与对照组(41例),对照组予曲美他嗪治疗,观察组在对照组基础上加服心舒宁汤,疗程均为3个月。观察2组治疗总有效率及治疗前后血N末端脑钠肽前体水平和心脏腔室左室舒张末期内径(LEVDd)、左室收缩末期内径(LEVDs)、左室射血分数(LVEF)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)变化情况,记录不良反应发生情况。结果治疗后观察组总有效率明显高于对照组(P<0.05),不良反应发生率明显低于对照组(P<0.05);2组血N末端脑钠肽前体水平均明显降低(P均<0.05),且观察组明显低于对照组(P<0.05);2组LVEF均明显升高(P均<0.05),且观察组明显高于对照组(P均<0.05);2组LVEDs、LEVDd、LVPWT、IVST均明显降低(P均<0.05),且观察组上述指标水平均明显低于对照组(P均<0.05)。结论心舒宁汤联合曲美他嗪治疗尿毒症性心肌病具有疗效高、安全性好的优点,且能明显降低血N末端脑钠肽前体水平,提高LVEF,改善心脏腔室指标,值得推广应用。
Objective It is to observe the effect of Xinshuning decoction combined with trimetazidine on uremic cardiomyopathy and its effects on N-terminal pro-brain natriuretic peptide and cardiac chamber. Methods Eighty-three patients with uremic cardiomyopathy were randomly divided into observation group(42 cases) and control group(41 cases). The control group was treated with trimetazidine. The observation group was given Xinshuning decoction on the basis of the control group. Both the treatment courses were 3 months. The total effective rate of treatment and the changes of the levels of N-terminal pro-brain natriuretic peptide and left ventricular end-diastolic diameter(LEVDd), left ventricular end-systolic diameter(LEVDs), left ventricular ejection fraction(LVEF), and left ventricular ejection fraction(LVEF), ventricular septal thickness(IVST) and left ventricular posterior wall thickness(LVPWT) before and after treatment were observed, and adverse reactions were recorded. Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group(P<0.05), and the incidence of adverse reactions was significantly lower than that of the control group(P<0.05); The level of blood N-terminal pro-brain natriuretic peptide was significantly decreased in the two groups(P<0.05), and the decrease in the observation group was more significant than the control group(P<0.05); the LVEF of the two groups were significantly increased, and the increase in the observation group was more significant than the control group(P<0.05); LVEDs, LEVDd, LVPWT, IVST were significantly decreased in the two groups(P<0.05), and the above indicators in the observation group were significantly lower than the control group(P<0.05). Conclusion Xinshuning Decoction combined with trimetazidine has the advantages of high efficacy and good safety in the treatment of uremic cardiomyopathy, and can significantly reduce the level of blood N-terminal pro-brain natriuretic peptide, increase LVEF, reduce LVEDs, LEVDd, LVPWT, IVST, it is worth promoting in clinic.
Objective It is to observe the effect of Xinshuning decoction combined with trimetazidine on uremic cardiomyopathy and its effects on N-terminal pro-brain natriuretic peptide and cardiac chamber. Methods Eighty-three patients with uremic cardiomyopathy were randomly divided into observation group(42 cases) and control group(41 cases). The control group was treated with trimetazidine. The observation group was given Xinshuning decoction on the basis of the control group. Both the treatment courses were 3 months. The total effective rate of treatment and the changes of the levels of N-terminal pro-brain natriuretic peptide and left ventricular end-diastolic diameter(LEVDd), left ventricular end-systolic diameter(LEVDs), left ventricular ejection fraction(LVEF), and left ventricular ejection fraction(LVEF), ventricular septal thickness(IVST) and left ventricular posterior wall thickness(LVPWT) before and after treatment were observed, and adverse reactions were recorded. Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group(P<0.05), and the incidence of adverse reactions was significantly lower than that of the control group(P<0.05); The level of blood N-terminal pro-brain natriuretic peptide was significantly decreased in the two groups(P<0.05), and the decrease in the observation group was more significant than the control group(P<0.05); the LVEF of the two groups were significantly increased, and the increase in the observation group was more significant than the control group(P<0.05); LVEDs, LEVDd, LVPWT, IVST were significantly decreased in the two groups(P<0.05), and the above indicators in the observation group were significantly lower than the control group(P<0.05). Conclusion Xinshuning Decoction combined with trimetazidine has the advantages of high efficacy and good safety in the treatment of uremic cardiomyopathy, and can significantly reduce the level of blood N-terminal pro-brain natriuretic peptide, increase LVEF, reduce LVEDs, LEVDd, LVPWT, IVST, it is worth promoting in clinic.
引文
[1] 李慧晶. 尿毒症性心肌病采用曲美他嗪治疗的临床效果报道[J]. 当代医学,2016,22(30):31-32
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[3] 麻鹏磊,王祥,李冰,等. 尿毒症心肌病的研究及临床治疗进展[J]. 中国老年学杂志,2016,36(9):2294-2297
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[5] 陈灏珠. 实用内科学[M]. 北京:人民卫生出版社,2013:2098-2107
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[8] 杨可,赵景宏. 尿毒症心肌病的研究进展[J]. 局解手术学杂志,2013,22(6):656-658;662
[9] 李爱莉,王勇. 尿毒症心肌病的研究进展[J]. 中日友好医院学报,2015,29(1):47-48;51
[10] 梁俊文,郭志强,林嘉敏,等. 曲美他嗪对糖尿病性心肌病大鼠心肌损伤保护作用研究[J]. 现代中西医结合杂志,2015,24(13):1378-1380
[11] 魏新考,李亚昭,崔利锋. 曲美他嗪联合阿托伐他汀钙片治疗缺血性心肌病对心、肾功能的影响[J]. 现代中西医结合杂志,2016,25(20):2210-2212
[12] 隋世华,蔡雪峰. 苓桂术甘汤配合曲美他嗪对缺血性心肌病慢性心力衰竭患者心功能的影响[J]. 现代中西医结合杂志,2017,26(20):2214-2216
[13] 陈娟. 曲美他嗪对尿毒症性心肌病患者的疗效[J]. 医疗装备,2016,29(12):27-28
[14] 李志会,李国辉,石占利. 益气活血化瘀汤对慢性心力衰竭大鼠心肌组织AngⅡ、BNP的影响[J]. 中华中医药学刊,2013,31(2):394-396
[15] 骆明旭,赵万红,杨鑫,等. 丹参川芎嗪注射液治疗慢性肺源性心脏病Meta分析[J]. 现代医药卫生,2014,30(23):3525-3529
[16] 陈丽敏,黄峥慧. 丹参川芎嗪治疗慢性肺源性心脏病急性发作的疗效[J]. 心血管康复医学杂志,2011,20(6):593-597
[2] 蔡春钰. 曲美他嗪治疗尿毒症性心肌病30例[J]. 现代诊断与治疗,2017,28(1):74-75
[3] 麻鹏磊,王祥,李冰,等. 尿毒症心肌病的研究及临床治疗进展[J]. 中国老年学杂志,2016,36(9):2294-2297
[4] Stoumpos S,Jardine AG,Mark PB. Cardiovascular morbidity and mortality after kidney transplantation[J]. Transp Int,2015,28(1):10-21
[5] 陈灏珠. 实用内科学[M]. 北京:人民卫生出版社,2013:2098-2107
[6] 蒋先洪,罗华丽. 曲美他嗪治疗尿毒症合并慢性充血性心力衰竭患者40例疗效观察[J]. 重庆医学,2014,43(22):2923-2925
[7] Alhaj E,Alhaj N,Rahman I,et al. Uremic cardiomyopathy:an under diagnosed disease[J]. Congest Heart Fail,2013,19(4):E40-E45
[8] 杨可,赵景宏. 尿毒症心肌病的研究进展[J]. 局解手术学杂志,2013,22(6):656-658;662
[9] 李爱莉,王勇. 尿毒症心肌病的研究进展[J]. 中日友好医院学报,2015,29(1):47-48;51
[10] 梁俊文,郭志强,林嘉敏,等. 曲美他嗪对糖尿病性心肌病大鼠心肌损伤保护作用研究[J]. 现代中西医结合杂志,2015,24(13):1378-1380
[11] 魏新考,李亚昭,崔利锋. 曲美他嗪联合阿托伐他汀钙片治疗缺血性心肌病对心、肾功能的影响[J]. 现代中西医结合杂志,2016,25(20):2210-2212
[12] 隋世华,蔡雪峰. 苓桂术甘汤配合曲美他嗪对缺血性心肌病慢性心力衰竭患者心功能的影响[J]. 现代中西医结合杂志,2017,26(20):2214-2216
[13] 陈娟. 曲美他嗪对尿毒症性心肌病患者的疗效[J]. 医疗装备,2016,29(12):27-28
[14] 李志会,李国辉,石占利. 益气活血化瘀汤对慢性心力衰竭大鼠心肌组织AngⅡ、BNP的影响[J]. 中华中医药学刊,2013,31(2):394-396
[15] 骆明旭,赵万红,杨鑫,等. 丹参川芎嗪注射液治疗慢性肺源性心脏病Meta分析[J]. 现代医药卫生,2014,30(23):3525-3529
[16] 陈丽敏,黄峥慧. 丹参川芎嗪治疗慢性肺源性心脏病急性发作的疗效[J]. 心血管康复医学杂志,2011,20(6):593-597