标题：芪参益气滴丸辅助治疗冠心病伴心力衰竭的疗效及对患者心功能指标、血液流变学和血清NT-proBNP、Hcy水平的影响

      作者：常建 1，平英瑶 1，苏志祥 2    1.榆林市中医医院心血管内科，陕西 榆林 719000；2.神木市医院中医科，陕西 榆林 719300

      卷次： 2023年34卷15期

      【摘要】 目的 探究芪参益气滴丸辅助治疗冠心病(CHD)伴心力衰竭的疗效及对患者心功能指标、血液流变学和血清N-末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)水平的影响。方法 选取2019年3月至2022年5月榆林市中医医院收治的84例CHD伴心力衰竭患者作为研究对象，采用随机数表法分为观察组和对照组各42例，对照组患者给予常规抗心衰治疗，观察组患者给予常规治疗联合芪参益气滴丸辅助治疗，两组均治疗2周，比较两组患者的治疗效果，以及治疗前后的心功能指标、血液流变学指标和血清NT-proBNP、Hcy水平。结果 观察组患者的治疗总有效率为95.24%，明显高于对照组的80.95%，差异有统计学意义(P<0.05)；治疗后，两组患者的心室射血分数(LVEF)、每分钟排血量(CO)均升高，且观察组患者的LVEF、CO分别为(47.60±5.50)%、(5.30±0.30) L/min，明显高于对照组的(43.50±4.40)%、(4.90±0.40) L/min，差异均有统计学意义(P<0.05)；治疗后，两组患者的左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)均降低，且观察组患者的LVEDD、LVESD分别为(53.20±2.50) mm、(39.10±3.7) mm，明显低于对照组的(57.10±3.40) mm、(42.60±4.10) mm，差异均有统计学意义(P<0.05)；治疗后，两组患者的血液流变学指标均降低，且观察组患者的血浆黏度、红细胞压积、全血黏度高切、全血黏度低切水平明显低于对照组，差异均有统计学意义 (P<0.05)；治疗后，两组患者的血清 NT-proBNP、Hcy水平均降低，且观察组患者的NT-proBNP、Hcy分别为(1 367.24±91.55) pg/mL、(14.31±4.55) μmol/L，明显低于对照组的(1 864.51±96.37) pg/mL、(17.37±4.82) μmol/L，差异均有统计学意义(P<0.05)。结论 芪参益气滴丸辅助常规治疗CHD伴心力衰竭可改善患者的心功能及血液流变学指标，降低血清NT-proBNP、Hcy水平，从而提高治疗效果，具有临床应用价值。
      【关键词】 冠心病；心力衰竭；芪参益气滴丸；心功能；血液流变学
      【中图分类号】 R541.4 【文献标识码】 A 【文章编号】 1003—6350（2023）15—2150—05

Efficacy of Qishen Yiqi Dripping Pills as adjuvant treatment for coronary heart disease with heart failure and theinfluence on cardiac function indicators, hemorheology, serum NT-proBNP, and Hcy levels.
CHANG Jian 1, PINGYing-yao 1, SU Zhi-xiang 2. 1. Department of Cardiovascular Medicine, Yulin Traditional Chinese Medicine Hospital, Yulin719000, Shaanxi, CHINA; 2. Department of Traditional Chinese Medicine, Shenmu Hospital, Yulin 719300, Shaanxi, CHINA
【Abstract】 Objective To investigate the efficacy of Qishen Yiqi Dripping Pills as adjuvant treatment for coro-nary heart disease (CHD) with heart failure, and its influence on cardiac function indicators, hemorheology, serum N-ter-minal pro-brain natriuretic peptide (NT-proBNP), and homocysteine (Hcy) levels. Methods A total of 84 patients withCHD and heart failure who were admitted to Yulin Traditional Chinese Medicine Hospital from March 2019 to May2022 were selected as the study subjects. They were divided into the control group (treated with conventional anti-heartfailure therapy) and the observation group (treated with anti-heart failure therapy combined with Qishen Yiqi DrippingPills) by random number table method, with 42 cases in each group. All patients underwent 2 weeks of treatment. Thetwo groups were compared in terms of therapeutic effect, cardiac function indicators, hemorheological indicators, serumNT-proBNP, and Hcy levels before and after treatment. Results The total treatment response rate in the observationgroup was significantly higher than that in the control group (95.24% vs 80.95%, P<0.05). After treatment, left ventricu-lar ejection fraction (LVEF) and cardiac output (CO) in the two groups increased; LVEF and CO in the observationgroup were (47.60±5.50)% and (5.30±0.30) L/min, significantly higher than (43.50±4.40)% and (4.90±0.40) L/min inthe control group; the differences were statistically significant (P<0.05). After treatment, left ventricular end-diastolic di-ameter (LVEDD) and left ventricular end-systolic diameter (LVESD) in the two groups decreased; LVEDD and LVESDin the observation group were (53.20±2.50) mm and (39.10±3.70) mm, significantly smaller than (57.10±3.40) mm and(42.60±4.10) mm in the control group; the differences were statistically significant (P<0.05). After treatment, hemorheo-logical indicators in the two groups decreased; plasma viscosity, hematocrit, whole blood high-shear viscosity, andlow-shear viscosity in the observation group were significantly lower than those in the control group; the differenceswere statistically significant (P<0.05). After treatment, serum NT-proBNP and Hcy levels in the two groups decreased;the levels of NT-proBNP and Hcy in the observation group were (1 367.24±91.55) pg/mL and (14.31±4.55) μmol/L, sig-nificantly lower than (1 864.51±96.37) pg/mL and (17.37±4.82) μmol/L in the control group; the differences were statisti-cally significant (P<0.05). Conclusion Qishen Yiqi Dripping Pills as adjuvant treatment for conventional treatment canimprove cardiac function and hemorheological indicators, and lower serum NT-proBNP and Hcy levels in patients withCHD and heart failure, thereby improving the therapeutic effect.
      【Key words】 Coronary heart disease; Heart failure; Qishen Yiqi Dripping Pills; Cardiac function; Hemorheology