目的 探讨益心舒胶囊联合重组人脑利钠肽治疗慢性充血性心力衰竭的临床疗效和安全性。方法 选取2014年2月-2015年12月延安市人民医院收治的慢性充血性心力衰竭患者112例,随机分为对照组和治疗组,每组各56例,对照组患者静脉滴注冻干重组人脑利钠肽,首次静脉冲击剂量1.5μg/kg,之后以7.5μg/(kg∙min^?1)的速度静脉滴注。治疗组患者在对照组患者的治疗基础上口服益心舒胶囊,3粒/次,3次/d。两组均连续治疗14d。观察两组的临床疗效,比较患者左心室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室内径(LADD)、心指数(CI)、左室射血分数(LVEF)等指标,检测治疗前后去甲肾上腺素(NE)、内皮素-1(ET-1)和抗利尿激素(ADH)指标,并观察两组患者不良反应发生情况。结果 治疗后,对照组和治疗组的总有效率分别为78.57%、91.07%,两组比较差异具有统计学意义(P<0.05);两组患者LVESD、LVEDD、LADD明显降低,CI和LVEF明显升高,同组治疗前后差异有统计学意义(P<0.05);与对照组相比,治疗组患者观察指标改善更明显,差异具有统计学意义(P<0.05)。治疗后,两组患者NE、ADH、ET-1水平显著下降,同组治疗前后差异有统计学意义(P<0.05);且治疗组患者NE、ADH和ET-1水平改善程度更优于对照组,两组比较差异有统计学意义(P<0.05)。结论 益心舒胶囊联合重组人脑利钠肽治疗慢性充血性心力衰竭具有较好的临床疗效,安全性高,具有一定的临床推广应用价值

Objective To investigate the clinical efficacy and safety of Yixinshu Capsules combined with recombinant human brain natriuretic peptide in treatment of chronic congestive heart failure. Methods Patients (112 cases) with chronic congestive heart failure in the Yan'an People's Hospital from February 2014 to December 2015 were divided into control and treatment groups, and each group had 56 cases. Patients in the control group were iv administered with lyophilized recombinant human brain natriuretic peptide, first dose of intravenous pulse was 1.5 μg/kg, then at the rate of 7.5 μg/(kg∙min^?1). The patients in the treatment group were po administered with Yixinshu Capsules on the basis of control group, 3 grains/time, three times daily. he patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, the indicators of LVESD, LVEDD, LADD, CI, LVEF, NE, ET-1 and ADH were compared in two groups before and after treatment, and the adverse events were observed. Results After treatment, the efficacies in the control and treatment groups were 78.57% and 91.07%, respectively, and there were differences between two groups (P< 0.05). After treatment, LVESD, LVEDD and LADD levels were significantly decreased, CI and LVEF levels were significantly increased, and the difference was statistically significant in the same group (P < 0.05); The observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, NE, ADH, ET-1 were obviously decreased, and the difference was statistically significant in the same group (P < 0.05); Furthermore, the differences of NE, ET-1 and ADH levels between two groups were statistically significant (P< 0.05). Conclusion Yixinshu Capsules combined with recombinant human brain natriuretic peptide has clinical curative effect in treatment of chronic congestive heart failure with higher security, which has a certain clinical application value.