目的 探討麝香通心滴丸聯(lián)合沙庫巴曲纈沙坦治療缺血性心力衰竭的臨床療效。方法 選擇2018年4月—2020年10月洛陽市第三人民醫(yī)院收治的86例缺血性心力衰竭患者，采用隨機數(shù)字表法分為對照組（43例）和治療組（43例）。對照組口服沙庫巴曲纈沙坦鈉片，50 mg/次，2次/d，治療組在對照組的基礎(chǔ)上口服麝香通心滴丸，70 mg/次，3次/d。兩組均治療30 d。觀察兩組的臨床療效，比較兩組治療前后心功能指標、血清炎性因子和心率變異性指標的變化情況。結(jié)果 治療后，治療組總有效率為93.02 %，顯著高于對照組的72.09%（P<0.05）。治療后，兩組左心室射血分數(shù)（LVEF）、短軸縮短率（FS）水平較治療前升高，但左心室質(zhì)量指數(shù)（LVMI）、平均室壁應(yīng)力（MWS）水平較治療前降低（P<0.05）；治療后，治療組心功能指標改善優(yōu)于對照組（P<0.05）。治療后，兩組腫瘤壞死因子-α（TNF-α）、超敏-C反應(yīng)蛋白（hs-CRP）、腦自然肽N端前體蛋白（NT-Pro BNP）、核轉(zhuǎn)錄因子NF-κB（NF-κB）水平與治療前比較均明顯降低（P<0.05）；且治療組炎癥細胞因子水平均顯著低于對照組（P<0.05）。治療后，兩組全部竇性心搏NN間期（SDNN）、相鄰NN期間差值的均方根（RMSSD）、相鄰正常R-R間期差值>50 ms心搏數(shù)占分析心搏數(shù)總數(shù)的百分比（PNN50）、連續(xù)5 min正常竇性R-R期間平均值（SDANN）水平均顯著升高（P<0.05）；且治療后，治療組心率變異性指標水平高于對照組（P<0.05）。結(jié)論 麝香通心滴丸聯(lián)合沙庫巴曲纈沙坦治療缺血性心力衰竭療效良好，可改明顯善患者心功能、炎癥細胞因子和心率變異性指標，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with salkubatrov in treatment of ischemic heart failure. Methods A total of 86 patients with ischemic heart failure admitted to the Third People's Hospital of Luoyang from April 2018 to October 2020 were selected and divided into control group (43 cases) and treatment group (43 cases) by random number table method. Patients in the control group were po administered with Sacubatrovalsartan Sodium Tablets, 50 mg/time, twice daily. Patients in the treatment group were po administered with Shexiang Tongxin Dropping Pills on the basis of the control group, 70 mg/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the changes of cardiac function indexes, serum inflammatory factors and heart rate variability indexes were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 93.02%, which was significantly higher than that of the control group (72.09%, P<0.05). After treatment, left ventricular ejection fraction (LVEF) and short-axis shorting rate (FS) were increased, but left ventricular mass index (LVMI) and mean ventricular wall stress (MWS) were decreased (P<0.05). After treatment, the improvement of heart function indexes in treatment group was better than that in control group (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), brain natural peptide N-terminal precursor protein (NT-pro BNP), and nuclear transcription factor NF-κB (NF-κB) in two groups were significantly decreased compared with before treatment (P<0.05). The levels of inflammatory cytokines in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, total sinus heart beat NN interval (SDNN), root mean square of difference between adjacent NN periods (RMSSD), percentage of adjacent normal R-R interval difference>50 ms in total heart beats analyzed (PNN50), and mean of normal sinus R-R period for 5 min (SDANN) was significantly increased (P<0.05); After treatment, the heart rate variability of treatment group was higher than that of control group (P<0.05). Conclusion Shexiang Tongxin Dropping Pills combined with salkubatrov has a good curative effect in treatment of ischemic heart failure, and can significantly improve the cardiac function, inflammatory cytokines and heart rate variability indexes of patients, which has a certain clinical application value.

R972

洛陽市科技計劃醫(yī)療衛(wèi)生項目（1603002A-5）