目的 探討參松養(yǎng)心膠囊聯(lián)合螺內(nèi)酯片治療慢性心力衰竭的臨床療效。方法 選取2016年2月-2017年2月北京同仁醫(yī)院收治的慢性心力衰竭患者106例為研究對(duì)象，所有患者隨機(jī)分為對(duì)照組和治療組，每組各53例。對(duì)照組口服螺內(nèi)酯片，40 mg/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服參松養(yǎng)心膠囊，4粒/次，3次/d。兩組患者均連續(xù)治療1個(gè)月。觀察兩組的臨床療效，比較兩組的心電圖指標(biāo)、心率變異性指標(biāo)、心功能指標(biāo)、血清N端前腦鈉肽（NT-proBNP）和超敏C-反應(yīng)蛋白（hs-CRP）水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為69.81%、86.79%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組QT離散度（QTd）、校正QT離散度（QTcd）和QRS顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組全程竇性心搏NN間期的標(biāo)準(zhǔn)差（SDNN）、全程每5分鐘NN間期平均值的標(biāo)準(zhǔn)差（SDANN）、全部相鄰NN之差的均方根（rMSSD）和相鄰NN之差>50 ms的個(gè)數(shù)占總竇性心搏個(gè)數(shù)的百分比（PNN50）均顯著升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組左心室射血分?jǐn)?shù)（LVEF）顯著升高，而左室舒張末期內(nèi)徑（LVEDD）顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組NT-proBNP和CRP水平顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 參松養(yǎng)心膠囊聯(lián)合螺內(nèi)酯片治療慢性心力衰竭具有較好的臨床療效，可改善心功能，降低心率變異性，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the clinical effect of Shensong Yangxin Capsules combined with Spironolactone Tablets in treatment of chronic heart failure. Methods Patients (106 cases) with chronic heart failure in Beijing Tongren Hospital from February 2016 to February 2017 were randomly divided into control and treatment groups, and each group had 53 cases. Patients in the control group were po administered with Spironolactone Tablets, 40 mg/time, once daily. Patients in the treatment group were po administered with Shensong Yangxin Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and electrocardiographic indexes, heart rate variability indexes, heart function indexes, NT-proBNP, and CRP levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 69.81% and 86.79%, respectively, and there was difference between two groups (P<0.05). After treatment, QTd, QTcd, and QRS in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, SDNN, SDANN, rMSSD, and PNN50 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the LVEF in two groups were significantly increased, but the LVEDD in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NT-proBNP and CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Shensong Yangxin Capsules combined with Spironolactone Tablets has clinical curative effect in treatment of chronic heart failure, can improve heart function, decrease heart rate variability, with good safety, which has a certain clinical application value.