目的 研究復(fù)方丹參滴丸聯(lián)合注射用重組人腦利鈉肽治療充血性心力衰竭的臨床療效。方法 選取2017年12月-2019年12月在天津市中醫(yī)藥研究院附屬醫(yī)院治療的84例充血性心力衰竭患者為研究對(duì)象，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各42例。對(duì)照組患者入院后給予注射用重組人腦利鈉肽，首先以1.5 μg/kg靜脈沖擊后，以0.007 5 μg/（kg·min）連續(xù)靜脈滴注。治療組在對(duì)照組基礎(chǔ)上口服復(fù)方丹參滴丸，10丸/次，3次/d。兩組患者接受治療時(shí)間為10 d。觀察兩組的臨床療效，比較兩組的心功能指標(biāo)、左心室肥厚指標(biāo)、明尼蘇達(dá)心衰生活質(zhì)量量表（MLHFQ）評(píng)分、血清學(xué)指標(biāo)水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.95%、95.24%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者心排血量（CO）、每搏量（SV）和左心室射血分?jǐn)?shù)（LVEF）值均顯著升高（P<0.05）；且治療組CO、SV和LVEF值升高較多（P<0.05）。治療后，兩組左室舒張末期內(nèi)徑（LVDD）、左室后壁舒張末期厚度（LVPWT）和室間隔舒張末期厚度（IVST）值均顯著降低（P<0.05）；并且治療組LVDD、LVPWT和IVST值降低較多（P<0.05）。治療后，兩組BNP和cTnI水平均顯著降低（P<0.05），且治療組BNP和cTnI水平降低較多（P<0.05）。治療后，兩組患者M(jìn)LHFQ評(píng)分顯著降低（P<0.05），且治療組MLHFQ評(píng)分降低較多（P<0.05）。結(jié)論 復(fù)方丹參滴丸聯(lián)合注射用重組人腦利鈉肽治療充血性心力衰竭具有較好的臨床療效，能夠改善心功能指標(biāo)，提高生活質(zhì)量，安全性較高，值得在臨床上推廣應(yīng)用。

Objective To study the effect of Compound Danshen Dropping Pills combined with Recombinant Human Brain Natriuretic Peptide for injection in treatment of congestive heart failure. Methods Patients (84 cases) with congestive heart failure in the Affiliated Hospital of Tianjin Institute of Chinese Medicine from December 2017 to December 2019 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were administered with Recombinant Human Brain Natriuretic Peptide for injection, first intravenous infusion of 1.5 μg/kg, then continuous intravenous infusion of 0.007 5 μg/(kg·min). Patients in the treatment group were po administered with Compound Danshen Dropping Pills on the basis of the control group, 10 pills/time, three times daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and cardiac function index, left ventricular hypertrophy index, Minnesota heart failure quality of life scale (MLHFQ) scores, and serological index level in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.95% and 95.24%, respectively, and there was difference between two groups (P<0.05). After treatment, cardiac output (CO), SV, and LVEF values in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And CO, SV, and LVEF values in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, left ventricular end-diastolic diameter (LVDD), left ventricular posterior wall end-diastolic thickness (LVPWT), and ventricular septum end-diastolic thickness (IVST) in two groups were significantly decreased (P<0.05). And LVDD, LVPWT, and IVST in the treatment group were significantly lower than those in the control group (P<0.05). MLHFQ scores in the two groups were significantly lower (P<0.05), and the MLHFQ score in the treatment group improved significantly (P<0.05). The levels of B-type natriuretic peptide (BNP) and cardiac troponin I (cTnI) were significantly decreased in the two groups (P<0.05), and the levels of BNP and cTnI in the treatment group were significantly lower (P<0.05). Conclusion Danshen Dropping Pills combined with Recombinant Human Brain Natriuretic Peptide for injection has good clinical efficacy in treatment of congestive heart failure, can improve cardiac function index and improve the quality of life, with good safety, which is worthy of clinical application.

R972