目的 探讨血塞通滴丸联合盐酸伊伐布雷定片治疗慢性心力衰竭的临床疗效。方法 选取唐山市丰润区中医医院2022年10月—2024年9月收治的慢性心力衰竭患者共160例，按随机数字表法将160例患者分为对照组和治疗组，各组有80例。对照组早晚口服盐酸伊伐布雷定片，1片/次，治疗组在对照组基础上口服血塞通滴丸20丸/次，3次/d。两组患者完成3个月治疗后统计治疗效果。比较两组的治疗疗效、心功能指标、运动耐力和血清指标。结果 对照组的总有效率为73.75%，治疗组的总有效率为86.25%，组间差异显著（P＜0.05）。治疗后，两组的射血分数（EF）、心排血量（CO）、左室短轴缩短率（FS）、6分钟步行距离（6MWD）均升高（P＜0.05），治疗组的EF、CO、FS、6WMD高于对照组（P＜0.05）。治疗后，两组的血清肌酸激酶同工酶（CK-MB）、B型钠尿肽（BNP）、巨噬细胞炎症蛋白-1α（MIP-1α）、可溶性生长刺激表达基因2蛋白（sST2）、单核细胞趋化蛋白1（MCP-1）水平均降低（P＜0.05），治疗组的血清CK-MB、BNP、MIP-1α、sST2、MCP-1水平低于对照组（P＜0.05）。结论 血塞通滴丸联合盐酸伊伐布雷定片可提高慢性心力衰竭的临床疗效，改善心功能和运动耐力，减轻心肌炎性损伤。

Objective To explore the clinical efficacy of Xuesaitong Dropping Pills combined with Ivabradine Hydrochloride Tablets in treatment of chronic heart failure. Methods A total of 160 patients with chronic heart failure admitted to Tangshan Fengrun District Hospital of Traditional Chinese Medicine from October 2022 to September 2024 were divided into control and treatment groups according to the random number table method, with 80 patients in each group. Patients in the control group took Ivabradine Hydrochloride Tablets orally in the morning and evening, 1 tablets/time. On the basis of the control group, patients in the treatment group took Xuesaitong Dropping Pills orally, 20 pills/time, 3 times daily. Two groups of patients completed three months of treatment and the treatment effect was statistically analyzed. The clinical efficacy, cardiac function indicators, exercise endurance, and serum indicators were compared between the two groups. Results The total effective rate in the control group was 73.75%, that of the treatment group was 86.25%, and the difference between the groups was significant (P < 0.05). EF, CO, FS, and 6MWD of the two groups were increased after treatment (P < 0.05), and EF, CO, FS, and 6MWD of the treatment group were higher than those of the control group (P < 0.05). The serum levels of CK-MB, BNP, MIP-1α, sST2, and MCP-1 in the two groups were decreased after treatment (P < 0.05). After treatment, serum levels of CK-MB, BNP, MIP-1α, sST2, and MCP-1 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Xuesaitong Dropping Pills combined with Ivabradine Hydrochloride Tablets can improve the efficacy of chronic heart failure, further improve cardiac function and exercise tolerance, reduce myocardial inflammatory damage.

R972

河北省中医药管理局科研计划项目（2016268）