目的 探讨心脉隆注射液联合比索洛尔治疗冠心病心力衰竭的临床疗效。方法 选取2014年5月-2015年7月在湖北省建始县中医院心血管内科接受医治的冠心病心力衰竭患者84例,随机分为对照组和治疗组,每组各42例。对照组患者在常规治疗的基础上口服富马酸比索洛尔片,5mg/次,1次/d,可根据患者情况进行剂量调整。治疗组在对照组基础上静脉输注心脉隆注射液,5mg/kg加入0.9%氯化钠注射液250~500mL,20~40滴/min,2次/d。两组均治疗10d,观察两组的临床疗效,比较治疗前后两组血流动力学、左心室功能、血清B型尿钠肽(BNP)、血清高敏C反应蛋白(hsCRP)和血管内皮生长因子(VEGF)改变情况。结果 治疗后,对照组和治疗组治疗的有效率分别为76.19%和92.86%,两组比较差异具有统计学意义(P<0.05);两组患者血流动力学指标均降低,同组比较差异具有统计学意义(P<0.05),且治疗组降低的更明显,两组比较差异具有统计学意义(P<0.05);两组患者左心室功能比治疗前均有所改善,同组比较差异具有统计学意义(P<0.05),但治疗组改善得更明显,两组比较差异具有统计学意义(P<0.05);两组患者血清BNP、hsCRP水平均降低,血VEGF水平升高,同组比较差异具有统计学意义(P<0.05),且治疗组上述水平的改善更明显,两组比较差异具有统计学意义(P<0.05)。结论 心脉隆注射液联合比索洛尔治疗冠心病心力衰竭,具有明显改善患者心功能、血液流变学指标和阻断冠状动脉粥样硬化炎症反应的作用,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Xinmailong Injection combined with bisoprolol in treatment of coronary heart disease patients with heart failure. Methods Patients (84 cases) with coronary heart disease and heart failure in Jianshi Hospital of TCM in Hubei from May 2014 to July 2015 were randomly divided into control (n = 42 ) and treatment (n = 42 ) groups. The patients in the control group were po administered with Bisoprolol Fumarate Tablets on the basis of conventional treatment, 5 mg/time, once daily, and the dose can be adjusted according to the patient's condition. The patients in the treatment group were iv administered with Xinmailong Injection on the basis of the control group, 5 mg/kg added into 0.9% Sodium Chloride Injection 250-500 mL, 20-40 drops/min, twice daily. The patients in two groups were treated for 10 d. After treatment, the efficacy was evaluated, and the changes of blood rheology indexes, left ventricular functions, BNP, hsCRP and VEGF in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 76.19% and 92.86%, respectively, and there were differences between two groups (P< 0.05). After treatment, The observation indexes of blood rheology in two groups were decreased, and the difference was statistically significant in the same group (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Compared with those before treatment, left ventricular functions were improved in two groups after treatment, and the difference was statistically significant in the same group (P < 0.05), furthermore the improvement in the treatment group was more significant, with significant difference between two groups (P < 0.05); Serum BNP, hsCRP levels in two groups were decreased, and VEGF level were increased, and the difference was statistically significant in the same group (P < 0.05), simultaneously the levels of them in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xinmailong Injection combined with bisoprolol has clinical curative effect in the treatment of coronary heart disease patients with heart failure, which significantly improved the patients with cardiac function and blood rheology indexes and blocked inflammatory reaction of coronary atherosclerosis, and it has a certain clinical application value