慢衰灵口服液治疗心肾阳虚型心脏病左室舒张功能障碍患者的临床观察

作者	单位
杨丁友	中国人民解放军总医院老年心血管病研究所
王士雯	中国人民解放军总医院老年心血管病研究所
朱庆磊	中国人民解放军总医院老年心血管病研究所
徐浩	中国中医研究院西苑医院心内科
路志正	中国中医研究院广安门医院
段学忠	中国人民解放军济南军区总医院中医科

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中文摘要:

目的 :探讨慢衰灵口服液对心肾阳虚型心脏病左室舒张功能障碍的影响。方法 :将 90例心肾阳虚型心脏病左室舒张功能障碍患者随机分为常规治疗组 (简称常疗组 )和中药治疗组 (简称中疗组 ) ,每组 4 5例 ,常疗组每日给予强心、利尿、扩冠等常规抗心衰西药治疗 ,中疗组除常规治疗外每日予慢衰灵口服液2 0 0ml,早晚 2次分服 ,服药 4个月后 ,复查心力衰竭总积分 (HFC)及进行心功能测定。结果 :两组治疗后较治疗前HFC降低 (P <0 0 5或P <0 0 1) ,且中疗组优于常疗组 (P <0 0 5 ) ;左室舒张早期快速充盈峰值流速 (Emas)加快 ,左房收缩期血流峰值流速 (Amas)减慢以及Emas/Amas的比值 (E/A)升高均有改善 (P <0 0 5或P <0 0 1) ,中疗组优于常疗组 (P <0 0 5 )。中疗组治疗前后左室等容舒张时间 (IVRT)缩短差异显著 (P <0 0 1) ,明显优于常疗组 (P <0 0 5 )。 6 2例舒张、收缩功能障碍的混合性心衰 (LVSD +LVDD)患者中 ,中疗组在增加射血分数 (EF)、心输出量 (CO)和左心室后壁增厚率 (ΔT)方面均明显优于常疗组 (P <0 0 5 )。结论 :慢衰灵口服液能改善心肾阳虚型心脏病左心室舒张功能障碍患者的心功能 ,减轻临床症状。

英文摘要:

Objective: To investigate the effect of Manshuailing Oral Liquid (MSL) on left ventricular diastolic dysfunction (LVDD) in patients with heart disease. Methods: Ninety patients with LVDD were randomly divided into the conventional treated group (Group A,treated by conventional treatment with western drugs of cardiotonic, diuretic, coronary dilator, etc) and the Chinese drug treated group (Group B, treated by conventional treatment plus MSL 2 times a day, 100 ml each time), 45 in each group. After 4 months treatment, the total heart failure coefficient (HFC) and cardiac functions were re determined. Results: After treatment, in both groups, the HFC lowered significantly (P<0 05 or P<0 01), the left ventricular peak velocity of early diastolic rapid filling (Emas) quickened, the left atrial systolic peak velocity (Amas) slowed down and Emas/Amas (E/A) enhanced, the isovolumetric relaxation time shortened. However, comparison between the two groups showed significant difference (P<0 05) in either item, Group B was superior to Group A (P<0 05). In the 62 patients with mixed heart failure, i.e. both systolic and diastolic dysfunction of left ventricle, Group B was superior to Group A in increasing ejection fraction, cardiac output and thickening rate of left ventricular posterior wall (P<0 05). Conclusion: MSL could improve the heart function of patients with LVDD, and alleviate their clinical symptoms.

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