目的 研究复方丹参滴丸联合注射用重组人脑利钠肽治疗充血性心力衰竭的临床疗效。方法 选取2017年12月-2019年12月在天津市中医药研究院附属医院治疗的84例充血性心力衰竭患者为研究对象，将所有患者随机分为对照组和治疗组，每组各42例。对照组患者入院后给予注射用重组人脑利钠肽，首先以1.5 μg/kg静脉冲击后，以0.007 5 μg/（kg·min）连续静脉滴注。治疗组在对照组基础上口服复方丹参滴丸，10丸/次，3次/d。两组患者接受治疗时间为10 d。观察两组的临床疗效，比较两组的心功能指标、左心室肥厚指标、明尼苏达心衰生活质量量表（MLHFQ）评分、血清学指标水平。结果 治疗后，对照组和治疗组的总有效率分别为80.95%、95.24%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者心排血量（CO）、每搏量（SV）和左心室射血分数（LVEF）值均显著升高（P<0.05）；且治疗组CO、SV和LVEF值升高较多（P<0.05）。治疗后，两组左室舒张末期内径（LVDD）、左室后壁舒张末期厚度（LVPWT）和室间隔舒张末期厚度（IVST）值均显著降低（P<0.05）；并且治疗组LVDD、LVPWT和IVST值降低较多（P<0.05）。治疗后，两组BNP和cTnI水平均显著降低（P<0.05），且治疗组BNP和cTnI水平降低较多（P<0.05）。治疗后，两组患者MLHFQ评分显著降低（P<0.05），且治疗组MLHFQ评分降低较多（P<0.05）。结论 复方丹参滴丸联合注射用重组人脑利钠肽治疗充血性心力衰竭具有较好的临床疗效，能够改善心功能指标，提高生活质量，安全性较高，值得在临床上推广应用。

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