心悦胶囊与艾司西酞普兰联合常规抗心衰治疗对慢性心力衰竭患者“双心”治疗研究

Effectiveness of Xinyue capsule and escitalopram combined with routine treatment in treating chronic heart failure with anxiety and depression

摘要:

目的 探讨心悦胶囊联合常规抗心衰治疗与艾司西酞普兰联合常规抗心衰治疗在慢性心力衰竭合并焦虑抑郁患者中的有效性及安全性。方法 选取2021年3月—2022年1月在赣南医学院第一附属医院确诊的慢性心力衰竭患者150例，按照简单随机分组方法分为常规治疗组（给予沙库巴曲缬沙坦等药物）、心悦胶囊组、艾司西酞普兰组，每组50例。分别在患者入院时、服药第3个月、服药第6个月对患者进行随访，观察3组患者心功能、焦虑抑郁评分变化，同时观察患者不良反应的发生情况，比较心悦胶囊与艾司西酞普兰在慢性心力衰竭合并焦虑抑郁患者中的有效性及安全性。结果 3组患者治疗前后纽约心功能分级（NYHA）、左室舒张末内径、射血分数、氨基末端脑钠肽前体、收缩压差值比较，差异均无统计学意义（P >0.05）。3组患者治疗前后明尼苏达心力衰竭生活质量量表（MLHFQ）、PHQ-9健康问卷（PHQ-9）、7项广泛性焦虑障碍量表（GAD-7）评分差值比较，差异均有统计学意义（P <0.05），治疗后心悦胶囊组和艾司西酞普兰组MLHFQ评分、PHQ-9评分、GAD-7评分差值降低幅度大于常规治疗组（P <0.05），心悦胶囊组与艾司西酞普兰组治疗前后MLHFQ评分、PHQ-9评分、GAD-7评分差值比较，差异均无统计学意义（P >0.05）。3组患者治疗前后肌酐、尿素氮、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总蛋白、钠离子、钾离子水平差值比较，差异均无统计学意义（P >0.05）。常规治疗组不良反应发生率最低、艾司西酞普兰组不良反应发生率最高（P <0.05）。结论 心悦胶囊联合常规抗心衰治疗在改善慢性心力衰竭患者心功能的同时还可进一步改善患者焦虑抑郁症状、提高生活质量，且副作用少，有很好的有效性和安全性。

Abstract:

Objective To evaluate the efficacy and safety of Xinyue capsule combined with conventional heart failure therapy and escitalopram combined with conventional therapy in patients with chronic heart failure (CHF) complicated by anxiety and depression.Methods From March 2021 to January 2022, 150 patients diagnosed with CHF at the First Affiliated Hospital of Gannan Medical University were retrospectively analyzed. Patients were randomly divided into a conventional treatment group (receiving medications like Sacubitril/Valsartan), a Xinyue capsule group, and an escitalopram group, with 50 patients in each group. Follow-up assessments were conducted at admission, the third month, and the sixth month to observe changes in cardiac function, anxiety, and depression scores, as well as the occurrence of adverse reactions among the three groups. The efficacy and safety of Xinyue capsule and Escitalopram in patients with CHF and concurrent anxiety and depression were compared.Results There were no significant differences in the New York Heart Association (NYHA) functional class, left ventricular end-diastolic diameter, ejection fraction, N-terminal pro b-type natriuretic peptide, or systolic blood pressure change before and after treatment among the three groups (P >0.05). However, significant differences were observed in the Minnesota Living with Heart Failure Questionnaire (MLHFQ), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) score changes (P <0.05). Post-treatment, the reduction in MLHFQ, PHQ-9, and GAD-7 scores in the Xinyue capsule and escitalopram groups was greater than in the conventional treatment group (P <0.05). No significant differences were found between the Xinyue capsule and escitalopram groups in terms of MLHFQ, PHQ-9, and GAD-7 score changes (P >0.05). Changes in creatinine, blood urea nitrogen, alanine transaminase, aspartate transaminase, total protein, sodium, and potassium levels before and after treatment showed no significant differences (P >0.05). The incidence of adverse reactions was lowest in the conventional treatment group and highest in the escitalopram group (P < 0.05).Conclusion Xinyue capsule combined with conventional heart failure therapy not only improves cardiac function in patients with chronic heart failure but also ameliorates symptoms of anxiety and depression and enhances quality of life, with fewer side effects, demonstrating good efficacy and safety.