目的 探討冠心康膠囊聯(lián)合鹽酸伊伐布雷定片治療頑固性心力衰竭的臨床療效。方法 選取2020年5月—2022年6月在衡水市中醫(yī)醫(yī)院就診的128例頑固性心力衰竭患者，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各64例。對(duì)照組口服鹽酸伊伐布雷定片，5 mg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服冠心康膠囊，4粒/次，3次/d。兩組連續(xù)治療3個(gè)月。觀察兩組的臨床療效，比較兩組患者心功能指標(biāo)和血清因子水平。結(jié)果 治療后，治療組患者的總有效率為92.19%，明顯高于對(duì)照組的總有效率79.69%，差異有顯著意義（P＜0.05）。治療后，兩組的左心室射血分?jǐn)?shù)（LVEF）高于治療前，左心室舒張末期后壁厚度（LVPWT）低于治療前（P＜0.05）；治療組的LVEF高于對(duì)照組，LVPWT低于對(duì)照組差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的血清血管緊張素-2（Ang-2）、血管緊張素轉(zhuǎn)換酶2（ACE2）、N末端腦鈉肽前體（NT-proBNP）水平明顯降低（P＜0.05），且治療組血清Ang-2、ACE2、NT-proBNP水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 冠心康膠囊聯(lián)合鹽酸伊伐布雷定片治療頑固性心力衰竭的療效確切，可改善心功能，調(diào)節(jié)血清Ang-2、ACE2、NT-proBNP水平，安全性較好。

Objective To investigate the clinical efficacy of Guanxinkang Capsules combined with Ivabradine Hydrochloride Tablets in treatment of refractory heart failure. Methods Patients (128 cases) with refractory heart failure in Hengshui Hospital of Traditional Chinese Medicine from May 2020 to June 2022 were divided into control and treatment groups according to the random number table method, and each group had 64 cases. Patients in the control group were po administered with Ivabradine Hydrochloride Tablets, 5 mg/time, twice daily. Patients in the treatment group were po administered with Guanxinkang Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and cardiac function indexes and serum factor levels in two groups were compared. Results After treatment, the total effective rate of patients in the treatment group was 92.19%, which was significantly higher than the total effective rate of 79.69% in the control group, with significant difference between two groups (P < 0.05). After treatment, LVEF in two groups was higher than before treatment, but LVPWT in two groups was lower than before treatment (P < 0.05). LVEF in the treatment group was higher than that in the control group, but LVPWT in the treatment group was lower than that in the control group (P < 0.05). After treatment, the serum levels of Ang-2, ACE2, and NT-proBNP in two groups were significantly reduced (P < 0.05), and the serum levels of Ang-2, ACE2, and NT-proBNP in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Guanxinkang Capsules combined with Ivabradine Hydrochloride Tablets has clinical curative effect in treatment of refractory heart failure, can improve heart function and regulate the serum levels of Ang-2, ACE2, and NT-proBNP, with good safety.

R972

衡水市科技計(jì)劃項(xiàng)目（2021014067Z）