目的 探讨复方丹参滴丸联合沙库巴曲缬沙坦治疗冠心病慢性心力衰竭患者的临床疗效。方法 选取山东省立第三医院2021年1月—2021年12月收治的冠心病慢性心力衰竭患者104例，按照随机数字表法分成对照组和治疗组，每组各52例。对照组口服沙库巴曲缬沙坦钠片，起始剂量为50mg/次，2次/d，根据患者耐受情况，可逐步调整至200mg/次维持量。治疗组在对照组的基础上口服复方丹参滴丸，10丸/次，3次/d。两组患者均治疗3个月。观察两组患者临床疗效，比较治疗前后两组患者心功能指标6min步行距离（6MWT）、左室射血分数（LVEF）和血清N末端B型利钠肽前体（NT-proBNP），血清超敏C反应蛋白（hs-CRP）、血清磷脂酶A2（Lp-PLA2）和内脏脂肪特异性丝氨酸蛋白酶抑制剂（Vaspin）水平，及不良反应。结果 治疗后，治疗组临床有效率明显高于对照组（90.38%vs73.08%，P＜0.05）。治疗后，两组6MWT、LVEF及血清Vaspin水平均较治疗前明显升高（P＜0.01），两组血清NT-proBNP、hs-CRP及Lp-PLA2水平较治疗前明显降低（P＜0.01）；且治疗后，治疗组的6MWT、LVEF及血清Vaspin水平均较对照组显著提高（P＜0.01），血清NT-proBNP、hs-CRP和Lp-PLA2水平均较对照组显著下降（P＜0.01）。结论 复方丹参滴丸联合沙库巴曲缬沙坦治疗冠心病慢性心力衰竭患者具有较好的临床疗效，能有效改善患者的心功能状态。

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

山东省医药卫生科技发展计划项目（2018WS287）