目的 探討益心舒膠囊聯(lián)合沙庫巴曲纈沙坦治療慢性心力衰竭的療效。方法 選擇西安交通大學(xué)附屬西安市中心醫(yī)院2021年11月—2023年7月收治的86例慢性心力衰竭患者，隨機(jī)分為對照組（43例）和治療組（43例）。對照組口服沙庫巴曲纈沙坦鈉片，起始劑量為50 mg/次，2次/d，2周后若未發(fā)現(xiàn)異常則調(diào)整為100 mg/次，2次/d，后續(xù)再次加量，目標(biāo)劑量為200 mg/次，2次/d。治療組在對照組基礎(chǔ)上口服益心舒膠囊，3粒/次，3次/d。兩組患者治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者心功能指標(biāo)左室舒張末期內(nèi)徑（LVEDD）、左心房內(nèi)徑（LAD）和N末端B型利鈉肽原（NT-proBNP）水平，中醫(yī)癥狀積分及6 min步行試驗(yàn)（6MWT）和生活質(zhì)量評分。結(jié)果 治療后，治療組患者總有效率為93.02%，明顯高于對照組臨床總有效率76.74%（P＜0.05）。治療后，兩組患者LVEDD、LAD、NT-proBNP水平明顯降低（P＜0.05），且與對照組相比，治療組患者降低更為明顯（P＜0.05）。治療后，兩組患者心悸、氣短、下肢浮腫積分明顯降低（P＜0.05），且與對照組相比，治療組積分降低更為明顯（P＜0.05）。治療后，兩組患者6MWT距離明顯增加，而MLHFQ評分明顯降低（P＜0.05），且與對照組相比，治療組6MWT和MLHFQ評分改善更為明顯（P＜0.05）。結(jié)論 益心舒膠囊聯(lián)合沙庫巴曲纈沙坦治療慢性心力衰竭可獲得較為理想的療效，對患者的心功能和生活質(zhì)量、6MWT距離有更好的改善作用，且安全性較高。

Objective To explore the therapeutic effect of Yixinshu Capsules combined with sacubitril valsartan in treatment of chronic heart failure. Methods Patients (86 cases) with chronic heart failure in Xi’an Central Hospital Affiliated to Xi’an Jiaotong University from November 2021 to July 2023 were randomly divided into control (43 cases) and treatment (43 cases) group. Patients in the control group were po administered with Sacubitril Valsartan Sodium Tablets, the starting dose was 50 mg/time, twice daily, after 2 weeks, if there were no abnormalities, the dose would be adjusted to 100 mg/time, twice daily. The dose would be increased again in the future and the target dose was 200 mg/time, twice daily. Patients in the treatment group were po administered with Yixinshu Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, the levels of cardiac function indicators LVEDD, LAD and NT-proBNP, TCM symptom scores, 6MWT and quality of life scores in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 93.02%, significantly higher than 76.74% of the control group (P < 0.05). After treatment, the levels of LVEDD, LAD, and NT proBNP in two groups were significantly reduced (P < 0.05), and compared with the control group, the treatment group showed a more significant decrease (P < 0.05). After treatment, the scores of palpitations, shortness of breath, and lower limb edema were significantly reduced in two groups of patients (P < 0.05), and compared with the control group, the decrease in scores was more significant in the treatment group (P < 0.05). After treatment, the 6MWT distance between two groups of patients was significantly increased, while the MLHFQ score was significantly decreased (P < 0.05), and compared with the control group, the treatment group showed more significant improvement in 6MWT and MLHFQ scores (P < 0.05). Conclusion Yixinshu Capsules combined with sacubitril valsartan in treatment of chronic heart failure can achieve more ideal therapeutic effects, better improve the patient’s heart function and quality of life, increase the distance between 6MWT, and have higher safety.

R972

陜西省重點(diǎn)研發(fā)計(jì)劃項(xiàng)目（2019SF-189）