目的 探討心通顆粒聯(lián)合沙庫巴曲纈沙坦鈉片治療射血分數(shù)保留慢性心力衰竭的臨床效果。方法 選取2021年3月—2024年2月在巴中市恩陽區(qū)人民醫(yī)院就診的80例射血分數(shù)保留慢性心力衰竭患者，按計算機隨機排列法將患者分為對照組和治療組，每組40例。對照組口服沙庫巴曲纈沙坦鈉片，初始劑量1片/次，2次/d，根據(jù)個體耐受逐步增加劑量，維持劑量4片/次，2次/d。治療組在對照組基礎(chǔ)上口服心通顆粒，2袋/次，3次/d。兩組持續(xù)治療2個月。比較兩組的臨床療效、病情狀態(tài)、心功能指標、血清指標。結(jié)果 治療2個月后，治療組的總有效率為95.00%，對照組的總有效率為77.50%，組間比較差異顯著（P＜0.05）。治療后，兩組的心衰計分系統(tǒng)（LEE）評分顯著減小（P＜0.05），且治療組LEE評分明顯低于對照組（P＜0.05）。治療后，治療組的左室射血分數(shù)（LVEF）顯著升高，舒張早期二尖瓣流速/延長速度（E/e'）、等容舒張時間（IVRT）顯著降低（P＜0.05）；治療組的LVEF高于對照組，E/e'、IVRT低于對照組（P＜0.05）。治療后，兩組的血清脂聯(lián)素（APN）、半乳糖凝集素3（galectin 3）、可溶性腫瘤生成抑制因子2（sST2）、N末端腦鈉肽（NT-proBNP）水平顯著降低（P＜0.05）；治療組的血清APN、galectin 3、sST2、NT-proBNP水平顯著低于對照組（P＜0.05）。結(jié)論 心通顆粒聯(lián)合沙庫巴曲纈沙坦鈉片有助于提高射血分數(shù)保留慢性心力衰竭的臨床療效，控制病情發(fā)展，改善心功能，降低心肌損傷。

Objective To investigate the effect of Xintong Granules combined with Sacubitril Valsartan Sodium Tablets in treatment of chronic heart failure with ejection fraction preservation. Methods A total of 80 patients with chronic heart failure with ejection fraction preservation who were treated in Enyang District People’s Hospital of Bazhong from March 2021 to February 2024 were selected and divided into control group and treatment group according to computer random arrangement method, with 40 cases in each group. Patients in the control group took Sacubitril Valsartan Sodium Tablets orally, the initial dose was 1 tablet/time, 2 times daily, the dose was gradually increased according to individual tolerance, and the maintenance dose was 4 tablets/time, 2 times daily. Patients in the treatment group were given Xintong Granules orally on the basis of the control group, 2 bags/time, 3 times daily. Patients of two groups were treated for 2 months. The clinical efficacy, disease status, cardiac function index, and serum index of the two groups were compared. Results After 2 months of treatment, the total effective rate in the treatment group (95.00%) was higher than 77.50% in the control group, and the difference between groups was significant (P < 0.05). LEE score of the two groups was significantly decreased after treatment (P < 0.05), and LEE score in the treatment group was higher than that of the control group (P < 0.05). After treatment, LVEF of two groups was higher than that before treatment, but E/e' and IVRT of two groups were lower than that before treatment (P < 0.05). VEF in treatment group was higher than that in control group, but E/e' and IVRT were lower than that in control group (P < 0.05). The levels of APN, galectin 3, sST2, and NT-proBNP in two groups were lower than those before treatment (P < 0.05). The levels of APN, galectin 3, sST2, and NT-proBNP in the treatment group were lower than those in the control group (P < 0.05). Conclusion Xintong Granules combined with Sacubitril Valsartan Sodium Tablets can improve the efficacy of chronic heart failure with ejection fraction preservation, control the progression of disease, improve heart function, and reduce myocardial damage.

R972

四川省中醫(yī)藥標準化研究項目(2020080)