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目的:观察在传统药物治疗基础上采用酒石酸美托洛尔联合通心络胶囊治疗慢性充血性心力衰竭(CHF)的临床效果和安全性。方法:选取CHF患者124例,随机分为对照组和治疗组各62例,2组均给予强心、利尿、血管紧张素Ⅱ受体阻滞剂或血管紧张素转换酶抑制剂等药物对症治疗,治疗组在此基础上加服酒石酸美托洛尔片和通心络胶囊,2组均持续治疗6月,观察临床疗效、超声心动图及其他生理指标的变化。结果:经持续6月的治疗后,大部分患者的临床症状得到了有效的改善。对照组总有效率为77.4%,治疗组总有效率为95.2%,治疗组总有效率高于对照组,差异有显著性意义(P<0.05)。治疗组左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、心脏排血量(CO)、心脏排血指数(C)I、收缩压(SBP)、舒张压(DBP)、心率(HR)和心胸比率(C/T)均较治疗前改善(P<0.05);与对照组各指标比较,差异均有显著性意义(P<0.05)。除对照组5例出现胃肠道不适,治疗组3例出现心率下降过快和4例出现上腹部不适等不良反应外,其余患者均未出现其他严重的不良反应,不影响临床治疗。结论:酒石酸美托洛尔联合通心络胶囊用于治疗CHF,安全、有效、不良反应少。
Objective: To observe the clinical efficacy and safety of metoprolol tartrate combined with Tongxinluo capsule in the treatment of chronic congestive heart failure (CHF) based on traditional medical therapy. Methods: A total of 124 CHF patients were randomly divided into control group and treatment group (n = 62). The patients in both groups were given symptomatic treatment with cardiotonic, diuretic, angiotensin Ⅱ receptor blocker or angiotensin converting enzyme inhibitor On the basis of this, the treatment group added metoprolol tartrate tablets and Tongxinluo capsule. Both groups continued treatment for 6 months, and the changes of clinical curative effect, echocardiography and other physiological indexes were observed. Results: The clinical symptoms of most patients were effectively improved after 6 months of treatment. The total effective rate of the control group was 77.4%, the total effective rate of the treatment group was 95.2%, the total effective rate of the treatment group was higher than that of the control group, the difference was significant (P <0.05). The left ventricular end-systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), cardiac output (CO), cardiac output index (C), systolic blood pressure (SBP), diastolic blood pressure (DBP) (P <0.05). Compared with those in the control group, the differences were significant (P <0.05). In addition to 5 cases of gastrointestinal discomfort in the control group, 3 cases of the treatment group had too rapid decline in heart rate and 4 cases of upper abdominal discomfort and other adverse reactions, the other patients did not appear other serious adverse reactions, does not affect the clinical treatment. Conclusion: Metoprolol tartrate combined with Tongxinluo capsule for the treatment of CHF, safe, effective, fewer adverse reactions.