目的 探討腦心通膠囊聯(lián)合沙庫巴曲纈沙坦鈉片治療缺血性心肌病的臨床療效。方法 選取2021年4月—2024年2月在邯鄲二八五醫(yī)院就診的92例缺血性心肌病，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組46例。對照組口服沙庫巴曲纈沙坦鈉片，2次/d，初始劑量25 mg/次，每2周增加1倍劑量，持續(xù)劑量100 mg/次。治療組在對照組基礎(chǔ)上飯后溫水服用腦心通膠囊，4粒/次，3次/d。兩組患者持續(xù)治療3個月。統(tǒng)計兩組的治療效果、心功能、心室重構(gòu)指標、血清指標水平。結(jié)果 治療后，治療組的總有效率為93.48%，對照組的總有效率為78.26%，組間比較差異顯著（P＜0.05）。治療后，兩組的左室射血分數(shù)（LVEF）高于治療前，左心室收縮末期容積指數(shù)（LVESVI）、左室舒張末期容積（LVEDV）低于治療前（P＜0.05）；治療后，治療組的LVEF高于對照組，LVESVI、LVEDV低于對照組（P＜0.05）。治療后，兩組的左心室質(zhì)量指數(shù)（LVMI）、左心室重構(gòu)指數(shù)（LVRI）、左心室后壁厚度（LVPW）低于治療前（P＜0.05）；治療組的LVMI、LVRI、LVPW低于對照組（P＜0.05）。治療后，兩組的血清D-二聚體（D-D）、血清淀粉樣蛋白A（SAA）、心型脂肪酸結(jié)合蛋白（H-FABP）水平低于治療前（P＜0.05）；治療組的血清D-D、SAA、H-FABP水平低于對照組（P＜0.05）。結(jié)論 腦心通膠囊聯(lián)合沙庫巴曲纈沙坦鈉片可提高缺血性心肌病的治療效果，改善心功能，延緩心室重構(gòu)，降低心肌損傷。

Objective To investigate the clinical effect of Naoxintong Capsules combined with Sacubitril Valsartan Sodium Tablets in treatment of ischemic cardiomyopathy. Methods Patients (92 cases) with ischemic cardiomyopathy treated in Handan 285th Hospital from April 2021 to February 2024 were selected and divided into control group and treatment group according to random number table method, with 46 cases in each group. Patients in control group took Sacubitril Valsartan Sodium Tablets orally, twice daily, the initial dose was 25 mg/ time, the dose was doubled every 2 weeks, and the continuous dose was 100 mg/ time. Patients in the treatment group were po administered with Naoxintong Capsules with warm water after meals on the basis of the control group, 4 capsules/times, 3 times daily. Patients in two groups were treated for 3 months. The therapeutic effect, cardiac function and ventricular remodeling indexes and serum indexes of the two groups were analyzed. Results After treatment, the total effective rate was 93.48% in the treatment group and 78.26% in the control group, and the difference was significant (P < 0.05). After treatment, LVEF in two groups was higher than before treatment, but LVESVI and LVEDV in two groups were lower than before treatment (P < 0.05). After treatment, LVEF in the treatment group was higher than that in the control group, but LVESVI and LVEDV in the treatment group were lower than that in the control group (P < 0.05). After treatment, LVMI, LVRI, and LVPW in two groups were lower than before treatment ( P < 0.05). And LVMI, LVRI, and LVPW in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of D-D, SAA, and H-FABP of the two groups were lower than these before treatment (P < 0.05), and the serum levels of D-D, SAA, and H-FABP in the treatment group were lower than those in the control group (P < 0.05). Conclusion Naoxintong Capsules combined with Sacubitril Valsartan Sodium Tablets can improve the therapeutic effect of ischemic cardiomyopathy, improve cardiac function, delay ventricular remodeling and reduce myocardial injury.

R972

石家莊市科技計劃項目（171462143）