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参附注射液治疗慢性心力衰竭急性加重期(阳气虚衰证)患者的随机、双盲、多中心、安慰剂对照试验

Randomized, Double-Blinded, Multicenter, Placebo-Controlled Trial of Shenfu Injection for Treatment of Patients with Chronic Heart Failure during the Acute Phase of Symptom Aggravation (Yang and Qi Deficiency Syndrome).

作者信息

Wang Xianliang, Zhao Zhiqiang, Mao Jingyuan, Du Tinghai, Chen Yuanping, Xu Hao, Liu Nan, Wang Xiaolong, Wu Jianguang, Li Rong, Xu Yong, Zhao Yingqiang, Wang Lei, He Jingsong, Zhang Junhua, Zhai Jingbo, Zhao Guoyuan, Hou Yazhu, Wang Shuai, Liu Chunxiang

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (TCM), Tianjin, 300193, China.

The First Affiliated Hospital of Henan University of T.C.M., Henan, 450000, China.

出版信息

Evid Based Complement Alternat Med. 2019 Feb 25;2019:9297163. doi: 10.1155/2019/9297163. eCollection 2019.

Abstract

BACKGROUND

Shenfu injection (SFI) has shown a remarkable therapeutic effect in patients with chronic heart failure (CHF) during the acute phase of symptom aggravation since it became commercially available in 1987. However, the therapeutic effect of SFI has not been validated in a standard clinical study. As a pilot clinical trial, this study aimed to evaluate the safety and efficacy of SFI for treatment of CHF patients during the acute phase.

METHODS

A total of 160 patients experiencing acute phase CHF were enrolled in this study and randomly assigned to receive the placebo (placebo group, 150 ml glucose (GS)) or SFI (SFI group, 50 ml SFI + 100 ml GS) in addition to their standard medications for CHF treatment. The treatment lasted for 7 ± 1 days, and the follow-up continued for 28 ± 3 days after treatment. The primary endpoints were New York Heart Association (NYHA) classification and Traditional Chinese Medicine (TCM) syndrome scores.

RESULTS

After 7±1 days of treatment, the efficacy of SFI according to improvements in NYHA and TCM syndrome scores in the SFI group (78.38% and 89.19%, respectively) was significantly higher than that in the placebo group (61.43% and 60.00%, respectively; P<0.05). The SFI group had a longer increase in amplitude than the placebo group (113.00 m versus 82.99 m, P<0.05). The incidence of adverse events and other safety indices showed no significant differences between the two groups.

CONCLUSION

SFI combined with conventional therapy for treatment of CHF during acute symptom aggravation ameliorated the cardiac dysfunction and clinical symptoms and improved the patients' quality of life without any significant AEs compared with the conventional therapy alone.

摘要

背景

自1987年上市以来,参附注射液(SFI)在慢性心力衰竭(CHF)患者症状加重的急性期显示出显著的治疗效果。然而,SFI的治疗效果尚未在标准临床研究中得到验证。作为一项试点临床试验,本研究旨在评估SFI治疗CHF急性期患者的安全性和有效性。

方法

本研究共纳入160例CHF急性期患者,除接受CHF标准治疗药物外,随机分为接受安慰剂(安慰剂组,150ml葡萄糖(GS))或SFI(SFI组,50ml SFI + 100ml GS)治疗。治疗持续7±1天,治疗后随访持续28±3天。主要终点为纽约心脏协会(NYHA)分级和中医证候评分。

结果

治疗7±1天后,SFI组根据NYHA和中医证候评分改善情况的疗效(分别为78.38%和89.19%)显著高于安慰剂组(分别为61.43%和60.00%;P<0.05)。SFI组的增幅比安慰剂组更长(113.00m对82.99m,P<0.05)。两组不良事件发生率和其他安全性指标无显著差异。

结论

与单纯常规治疗相比,SFI联合常规治疗在急性症状加重期治疗CHF可改善心脏功能障碍和临床症状,提高患者生活质量,且无任何显著不良事件。

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