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目的:研究坎地沙坦酯联合氢氯噻嗪和祛瘀活血汤治疗老年性退行性心瓣膜病心力衰竭的临床疗效和安全性。方法:选取2013年6月—2014年6月医院收治的老年性退行性心瓣膜病心力衰竭患者138例,按照随机数字表法将患者分为研究组和对照组,每组69例,所有患者均给予常规治疗,对照组在常规治疗基础上给予坎地沙坦酯治疗,研究组在对照组的基础上给予氢氯噻嗪和祛瘀活血汤治疗,比较两组临床疗效,治疗前、后脑钠肽(BNP)、每博输出量(SV)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)水平,并比较两组治疗依从性和不良反应。结果:研究组总有效率94.2%(65/69)显著高于对照组的81.2%(56/69),比较差异具有统计学意义(P<0.05);治疗前两组LVEDD、SV、LVEF和BNP比较差异无统计学意义(P>0.05),治疗后两组LVEDD和BNP均显著降低,SV和LVEF均显著升高,且研究组显著优于对照组,比较差异具有统计学意义(P<0.05);研究组治疗依从性为95.7%(66/69),对照组治疗依从性91.3%(63/69),两组比较差异无统计学意义(P>0.05);两组不良反应比较无统计学意义(P>0.05)。结论:坎地沙坦酯联合氢氯噻嗪和祛瘀活血汤治疗老年性退行性心瓣膜病心力衰竭疗效显著,能明显改善患者心功能,具有一定安全性。
Objective: To study the clinical efficacy and safety of candesartan cilexetil and hydrochlorothiazide and Quyu Huoxue Decoction in the treatment of heart failure of senile degenerative valvular heart disease. Methods: A total of 138 patients with senile degenerative valvular heart failure who were admitted to the hospital from June 2013 to June 2014 were selected and divided into study group and control group according to random number table method. Each group included 69 patients and all patients Were given routine treatment, the control group on the basis of conventional treatment given candesartan cilexetil treatment, the study group in the control group on the basis of hydrochlorothiazide and Quyuhuoxue Decoction treatment, the clinical efficacy of two groups were compared before and after treatment, brain natriuretic peptide BNP, SV, LVEF and LVEDD were measured. The compliance and adverse reactions of the two groups were compared. Results: The total effective rate of the study group was 94.2% (65/69), significantly higher than that of the control group (81.2%, 56/69), the difference was statistically significant (P <0.05) (P> 0.05). After treatment, LVEDD and BNP in both groups were significantly decreased, SV and LVEF were significantly increased, and the study group was significantly better than the control group, the difference was statistically significant (P < 0.05). The treatment compliance was 95.7% (66/69) in the study group and 91.3% (63/69) in the control group, with no significant difference between the two groups (P> 0.05). There was no significant difference in the adverse reaction between the two groups Statistical significance (P> 0.05). Conclusion: The combination of candesartan cilexetil and hydrochlorothiazide and Quyu Huoxue decoction has significant curative effect on heart failure of senile degenerative valvular heart disease, which can obviously improve the cardiac function of patients with certain safety.