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目的观察美托洛尔联合通心络胶囊治疗冠心病患者心力衰竭的效果。方法选择2016年5月—2017年2月收治的冠心病心力衰竭患者160例,根据随机数字表法分为观察组和对照组各80例。两组均给予硝酸酯类、血管紧张素转换酶抑制剂、利尿剂等进行治疗,美托洛尔口服,起始剂量6.25 mg/次,2次/d;后根据患者耐受情况每次递增6.25mg/次,至目标剂量50 mg/次,2次/d。观察组在以上治疗基础上加通心络胶囊口服治疗,每次3粒/次,3次/d。两组均治疗4周。对比两组疗效,治疗前后检测两组心排血量(cardiac output,CO)、左心室收缩末期内径(left ventricular endsystolic dimension,LVESD)、左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心室射血分数(left ventricular ejection fraction,LVEF),记录两组心电图正常时间、治愈时间及治疗期间发生的不良反应。计量资料比较采用t检验;计数资料比较采用χ~2检验。P<0.05为差异有统计学意义。结果两组总有效率(对照组75.00%,观察组9 2.50%)比较差异有统计学意义(P<0.05)。治疗后观察组CO、LVESD、LVEDD、LVEF各指标[(5.29±0.69)L/min、(38.01±0.12)mm、(51.81±0.35)mm、(60.13±5.12)%]优于对照组[(4.78±0.32)L/min、(41.45±0.25)mm、(58.56±0.36)mm、(50.21±3.67)%](均P<0.05)。观察组心电图正常时间(14.24±2.13)d、治愈时间(16.11±1.41)d短于对照组[(18.39±3.52)、(20.39±2.71)d],比较差异有统计学意义(均P<0.05)。观察组不良反应发生率与对照组比较差异无统计学意义(均P>0.05)。结论美托洛尔联合通心络胶囊治疗冠心病心力衰竭疗效确切,可有效改善患者心脏功能,缩短症状改善时间,安全性高。
Objective To observe the effect of metoprolol combined with Tongxinluo capsule in the treatment of heart failure in patients with coronary heart disease. Methods 160 patients with heart failure of coronary heart disease admitted from May 2016 to February 2017 were divided into observation group and control group according to random number table. Both groups were given nitrates, angiotensin converting enzyme inhibitors, diuretics and other treatment, metoprolol orally, the initial dose of 6.25 mg / time, 2 times / d; according to patient tolerance each increment 6.25mg / time to the target dose of 50 mg / time, 2 times / d. Observation group in the above treatment plus Tongxinluo capsule oral treatment, each 3 capsules / time, 3 times / d. Both groups were treated for 4 weeks. The changes of cardiac output (CO), left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD) were compared between the two groups before and after treatment. , Left ventricular ejection fraction (LVEF). The normal time of electrocardiogram, the healing time and the adverse reactions during the treatment were recorded. Measurement data were compared using t test; count data were compared using χ ~ 2 test. P <0.05 for the difference was statistically significant. Results The total effective rate (75.00% in the control group, 9 2.50% in the observation group) showed significant difference (P <0.05). The levels of CO, LVESD, LVEDD and LVEF in the observation group after treatment were significantly higher than those in the control group [(5.29 ± 0.69) L / min, (38.01 ± 0.12) mm, (51.81 ± 0.35) mm, (60.13 ± 5.12)%, 4.78 ± 0.32, L / min, (41.45 ± 0.25) mm, (58.56 ± 0.36) mm, (50.21 ± 3.67)%] (all P <0.05). The duration of electrocardiogram was 14.24 ± 2.13 days in observation group and 16.11 ± 1.41 days in observation group were shorter than those in control group [(18.39 ± 3.52) and (20.39 ± 2.71) d, respectively) (all P <0.05 ). There was no significant difference in the incidence of adverse reactions between the observation group and the control group (all P> 0.05). Conclusion Metoprolol combined with Tongxinluo Capsule is effective in treating heart failure due to coronary heart disease. It can effectively improve the cardiac function, shorten the time for symptom improvement and have high safety.