目的 探討復(fù)方丹參滴丸聯(lián)合沙庫(kù)巴曲纈沙坦治療冠心病慢性心力衰竭患者的臨床療效。方法 選取山東省立第三醫(yī)院2021年1月—2021年12月收治的冠心病慢性心力衰竭患者104例，按照隨機(jī)數(shù)字表法分成對(duì)照組和治療組，每組各52例。對(duì)照組口服沙庫(kù)巴曲纈沙坦鈉片，起始劑量為50mg/次，2次/d，根據(jù)患者耐受情況，可逐步調(diào)整至200mg/次維持量。治療組在對(duì)照組的基礎(chǔ)上口服復(fù)方丹參滴丸，10丸/次，3次/d。兩組患者均治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者心功能指標(biāo)6min步行距離（6MWT）、左室射血分?jǐn)?shù)（LVEF）和血清N末端B型利鈉肽前體（NT-proBNP），血清超敏C反應(yīng)蛋白（hs-CRP）、血清磷脂酶A2（Lp-PLA2）和內(nèi)臟脂肪特異性絲氨酸蛋白酶抑制劑（Vaspin）水平，及不良反應(yīng)。結(jié)果 治療后，治療組臨床有效率明顯高于對(duì)照組（90.38%vs73.08%，P＜0.05）。治療后，兩組6MWT、LVEF及血清Vaspin水平均較治療前明顯升高（P＜0.01），兩組血清NT-proBNP、hs-CRP及Lp-PLA2水平較治療前明顯降低（P＜0.01）；且治療后，治療組的6MWT、LVEF及血清Vaspin水平均較對(duì)照組顯著提高（P＜0.01），血清NT-proBNP、hs-CRP和Lp-PLA2水平均較對(duì)照組顯著下降（P＜0.01）。結(jié)論 復(fù)方丹參滴丸聯(lián)合沙庫(kù)巴曲纈沙坦治療冠心病慢性心力衰竭患者具有較好的臨床療效，能有效改善患者的心功能狀態(tài)。

Objective To investigate the clinical effect of Compound Danshen Dripping Pills combined with sacubitril-valsartan in treatment of coronary heart disease and chronic heart failure. Methods Patients (104 cases) with coronary heart disease and chronic heart failure in Shandong Provincial Third Hospital from January 2021 to December 2021 were randomly divided into control and treatment group, and each group had 52 cases. Patients in the control group were po administered with Sacubitril Valsartan Sodium Tablets, the initial dose was 50 mg/time, twice daily, according to the patient's tolerance, the dose was gradually adjusted to 200 mg/time for maintenance. Patients in the treatment group were po administered with Compound Danshen Dripping Pills on the basis of the control group, 10 pills/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluation was evaluated, the cardiac function indexes of 6MWT, LVEF and NT-proBNP, the levels of serum factors hs-CRP, Lp-PLA2 and Vaspin, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (90.38% vs 73.08%, P<0.05). After treatment, the levels of 6MWT, LVEF, and serum Vaspin in two groups were significantly higher than those before treatment (P<0.01), and the levels of NT-proBNP, hs-CRP, and Lp-PLA2 in two groups were significantly lower than those before treatment (P<0.01). After treatment, the levels of 6MWT, LVEF, and serum Vaspin in the treatment group were significantly higher than those in the control group (P<0.01), and the levels of serum NT-proBNP, hs-CRP, and Lp-PLA2 were significantly lower than those in the control group (P<0.01). Conclusion Compound Danshen Dripping Pills combined with sacubitril-valsartan in treatment of coronary heart disease and chronic heart failure has good clinical effect, can effectively improve the patients' cardiac function.

R972

山東省醫(yī)藥衛(wèi)生科技發(fā)展計(jì)劃項(xiàng)目（2018WS287）