黄芪注射液治疗充血性心力衰竭的疗效研究

作者	单位
周智林	浙江省杭州市第三人民医院杭州310009
俞娉	浙江省杭州市第三人民医院杭州310009
林玎	浙江省杭州市第三人民医院杭州310009
梁丽贞	浙江省杭州市第三人民医院杭州310009
林萍	浙江省杭州市第三人民医院杭州310009

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中文摘要:

目的 :探讨黄芪注射液静脉滴注治疗充血性心力衰竭 (简称CHF)的临床疗效及副作用。方法 :属NYHA心功能分级为 2～ 4级的住院CHF患者 83例随机分为两组 :治疗组用黄芪注射液 4 0ml(生药80 g)加入 5 %葡萄糖注射液 5 0 0ml中静脉滴注 ,每日 1次 ,疗程为 2周 ,并随访 1～ 6个月。对照组用硝酸甘油 15mg加入 5 %葡萄糖注射液 5 0 0ml中静脉滴注 ,每日 1次 ,疗程亦为 2周 ,同样随访 1～ 6个月。结果 :治疗组用黄芪治疗后 1个月、6个月临床心功能改善显效率及总有效率分别为 2 6 2 %、78 6% ,34 2 %、81 6% ,明显优于对照组 (P <0 0 5 ,P <0 0 1)。两组治疗后的左室射血分数 (LVEF)、左室短轴缩短率(FS)、二尖瓣快速充血期和心房收缩期血流速度 (E/A)、每搏出量 (SV)、心输出量 (CO)及心脏指数 (CI)均较治疗前有明显改善 (P <0 0 5 ,P <0 0 1) ,但治疗组更优于对照组 (P <0 0 5 )。随访 1～ 6个月治疗组心脏性事件发生率少于对照组 (P <0 0 5 )。结论 :黄芪注射液可作为CHF尤其重症CHF抢救的重要辅助药物之一。

英文摘要:

To observe the clinical efficacy and side effects of Astragalus Injection (AI) in treating congestive heart failure (CHF). Methods: Eighty three patients of CHF with heart function of Ⅱ-Ⅳ grade assessed by NYHA (New York Heart Association) classification were randomly divided into 2 groups. The 42 patients in the treated group were treated with AI 40 ml (equivalent to 80g crude drug) by adding in 5% glucose solution 500 ml for intravenous dripping, once a day and the 41 patients in the control group were treated by nitrolingual injection 15 mg by adding in 5% glucose solution 500 ml for intravenous dripping once a day. The therapeutic course in both groups was 2 weeks and the patients were followed up for 1-6 months. Results: The clinical heart function improvement rate and the total effective rate in the treated group after 1 month treatment were 26.2% and 78.6%, and after 6 months were 34.2% and 81.6% respectively, which were superior to those in the control group significantly (P<0 05 or P<0 01). The levels of left ventricular ejection fraction (LVEF), fractional shortening of left ventricular short axis (FS), the ratio of maximum blood flow between the advanced and early atrial systole (E/A), stroke volume (SV), cardiac output (CO) and the cardiac index (CI) were all improved in both groups (P<0 01 or P<0 05), but better improvement was shown in the treated group. Follow up study showed that the incidence of cardiac event was lower in the treated group than that in the control group (P<0 05). Conclusion: AI can be took as one of the important auxiliary drugs for treatment of CHF especially in severe cases.

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