目的 探討注射用益氣復(fù)脈（凍干）聯(lián)合沙庫巴曲纈沙坦治療慢性心力衰竭的療效及對(duì)患者高靈敏度肌鈣蛋白（hs-cTnT）、氨基端前心鈉肽（NT-proBNP）及左心室功能的影響。方法 選取2020年1月—2022年12月東營市第五人民醫(yī)院收治的慢性心力衰竭患者200例為研究對(duì)象，根據(jù)患者治療方案不同分為對(duì)照組和試驗(yàn)組，每組各100例。對(duì)照組在常規(guī)治療基礎(chǔ)上采用沙庫巴曲纈沙坦鈉片治療，每天2次，初始劑量每次50 mg，后根據(jù)患者病情調(diào)整劑量，每天最多不超過200 mg。試驗(yàn)組在對(duì)照組治療基礎(chǔ)上，聯(lián)用注射用益氣復(fù)脈（凍干），5.2 g加入葡萄糖注射液250 mL中，靜脈滴注，每天1次。兩組均接受持續(xù)2周的治療。統(tǒng)計(jì)并比較兩組的治療效果，分別于治療前后測(cè)定血清hs-cTnT、NT-proBNP和轉(zhuǎn)化生長因子β1（TGF-β1）水平，分別于治療前后行超聲心動(dòng)圖檢查，檢測(cè)患者的左室收縮末期內(nèi)徑（LVESD）、左室舒張末期內(nèi)徑（LVEDD）、左室射血分?jǐn)?shù)（LVEF）、左室短軸縮短率（FS）。觀察治療期間兩組患者低血壓、皮疹、高血鉀癥、血管性水腫等不良反應(yīng)的發(fā)生情況。結(jié)果 試驗(yàn)組治療總有效率為98.00%，顯著高于對(duì)照組的88.00%（P＜0.05）。治療前，兩組患者血清hs-cTnT、NT-proBNP、TGF-β1水平比較，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療后，兩組患者血清hs-cTnT、NT-proBNP、TGF-β1水平均較同組治療前顯著降低，且試驗(yàn)組各指標(biāo)水平均顯著低于對(duì)照組（P＜0.05）。治療前，兩組患者左心室功能指標(biāo)LVESD、LVEDD、LVEF、FS比較，差異均無統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療后，兩組患者LVESD、LVEDD均較本組治療前顯著降低（P＜0.05），而LVEF及FS均較本組治療前顯著升高（P＜0.05），且試驗(yàn)組各指標(biāo)改善程度均優(yōu)于對(duì)照組（P＜0.05）。試驗(yàn)組發(fā)生不良反應(yīng)3例，總發(fā)生率為3.00%，顯著低于對(duì)照組的15.00%（P＜0.05）。結(jié)論 注射用益氣復(fù)脈（凍干）聯(lián)合沙庫巴曲纈沙坦治療慢性心力衰竭，可改善患者左心室功能，降低心肌受損；還可降低hs-cTnT、NT-proBNP水平，減少藥物不良反應(yīng)，增強(qiáng)臨床療效。

Objective To investigate the efficacy of Yiqi Fumai Lyophilized Injection (YQFM) combined with sacubitril/valsartan in the treatment of chronic heart failure and the effects on high-sensitivity troponin (hs-cTnT), N-terminal pro brain natriuretic peptide (NT-proBNP) and left ventricular function in patients with chronic heart failure. Methods A total of 200 patients with chronic heart failure admitted to the Fifth People's Hospital of Dongying City from January 2020 to December 2022 were selected as the research objects. According to the different treatment schemes of patients, they were divided into the control group and the experimental group, with 100 cases in each group. On the basis of routine treatment, patients in the control group were treated with Sacubitril Valsartan Sodium Tablets, which was taken twice a day on an empty stomach or with food, with an initial dose of 50 mg each time. After that, the dosage was adjusted according to the patient's condition, with a maximum of 200 mg per day. On the basis of treatment in the control group, patients in the experimental group received a combination of YQFM, and 5.2 g of YQFM was added to 250 mL of Glucose Injection, intravenous drip once a day. Both groups received treatment lasting for two weeks. The therapeutic effects of the two groups were counted and compared. Serum hs-cTnT, NT-proBNP and transforming growth factor β1 (TGF-β1) were measured before and after treatment. Horizontal echocardiography was performed before and after treatment to measure the left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), LVEF, and left ventricular short axis shortening rate (FS) of the patients. The incidence of adverse reactions such as hypotension, rash, hyperkalemia and angioedema in the two groups were observed during the treatment. Results The total effective rate of the experimental group was 98.00%, significantly higher than the 88.00% of the control group (P＜0.05). Before treatment, the serum hs-cTnT, NT-proBNP, and TGF-β1 levels of patients in both groups were measured and there were no statistically significant difference in level comparison between two groups (P＞0.05). After treatment, the serum levels of hs-cTnT, NT-proBNP, and TGF- β1 in both groups of patients were significantly lower than before treatment in the same group, and the levels of all indicators in the experimental group were significantly lower than those in the control group (P＜0.05). Before treatment, there was no statistically significant difference in left ventricular function indicators LVESD, LVEDD, LVEF, and FS between the two groups of patients (P＞0.05). After treatment, LVESD and LVEDD in both groups of patients were significantly reduced compared to before treatment in the same group (P＜0.05), while LVEF and FS were significantly increased compared to before treatment in same group (P＜0.05), and the improvement degree of all indicators in the experimental group was better than that in the control group (P＜0.05). There were three cases of adverse reactions in the experimental group, with a total incidence rate of 3.00%, significantly lower than the 15.00% in the control group (P＜0.05). Conclusion YQFM combined with sakubatrox valsartan can improve left ventricular function and reduce myocardial damage in patients with chronic heart failure. On the other hand, it can reduce the levels of hs-cTnT and NT-ProBNP, reduce adverse drug reaction, and enhance clinical efficacy.

R972