参附注射液治疗老年充血性心力衰竭疗效观察.doc

参附注射液治疗老年充血性心力衰竭疗效观察【摘要】 目的 探讨参附注射液静脉滴注治疗老年充血性心力衰竭(CHF)的临床疗效。方法 随机将88例老年心力衰竭患者分为治疗组和对照组。对照组给予常规治疗，治疗组在常规治疗基础上加用参附注射液，2周后依据心功能分级、超声心动图检测和血浆脑钠肽(BNP)浓度判定疗效，应用秩和检验、方差分析、t检验做统计学处理。结果 与对照组比较，临床疗效的差异有统计学意义(P＜0.01)，而且治疗组的左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)及E/A值(左室早期充盈E峰速率，晚期充盈A峰速率)均较治疗前明显改善，并且BNP浓度显著降低，无论与治疗前还是与对照组比较，差异均有统计学意义(P＜0.01～0.05)。结论 在常规抗心衰药物治疗基础上加用参附注射液可明显改善老年充血性心力衰竭患者的症状及心功能，疗效确切。 【关键词】 参附注射液；心力衰竭；老年 【Abstract】 ObjectiveTo explore the clinical therapeutic effect of Shenfu injection on congestive cardiac failure(CHF)in the elderly patients.Methods 88 elderly patients were randomly divided into treatment group and control group.The control group was treated with conventional therapy and the treatment group was given Shenfu injection based on conventional therapy.The therapeutic effect was assessed according to the grading of cardiac function，echocardiogram and the level of B-type natriuretic peptide(BNP)after 2 weeks of treatment.Rank sum test，analysis of variance and t-test were adopted in statistical treatment.Results There was significant difference of clinical effect between the two groups(P＜0.01).Compared with the parameters before the treatment and the control group，the left ventricular end-diastolic dimension(LVEDD)，left ventricular ejection fraction(LVEF)，E/A value were obviously improved and the level of BNP was significantly decreased in the treatment group(P＜0.01～0.05).Conclusion Shenfu injection based on conventional therapy is effectiv in improving symptom and heart function in elderly patients with CHF. 【Key words】 Shenfu injection；Congestive cardiac failure；Elderly 老年患者，尤其年龄≥60岁的患者，其住院的主要原因是心力衰竭。老年患者作为一个特殊的患病群体，由于机体的老化，器官功能的衰退，药代动力学及药效学改变，加之并发病的存在，使病情与治疗更为复杂化。老年充血性心力衰竭(CHF)的治疗困难最大，涉及的面最广，其心力衰竭比年轻患者存在更多的难题。本文对比分析88例老年心力衰竭患者，采用联合应用参附注射液治疗取得了满意疗效。 1对象与方法 1.1研究对象88例老年充血性心力衰竭患者为2005-06―2007-06住院患者，男49例，女39例；年龄60～85岁，平均(72±6)岁；其中原发性高血压31例，冠心病37例，高血压并发冠心病、糖尿病15例，扩张性心肌病5例。心力衰竭诊断根据临床症状、体征、超声心动图检查及胸片检查确诊，心功能分级按美国纽约心脏协会(NYHA)标准分级[1]，Ⅱ级26例，Ⅲ级44例，Ⅳ级18