目的 探究灯盏生脉胶囊联合伊伐布雷定治疗慢性心力衰竭的临床疗效。方法 选取2020年6月—2022年6月上海市浦东医院收治的200例慢性心力衰竭患者，按单双号将所有患者分为对照组和治疗组，每组各100例。对照组于进餐时口服盐酸伊伐布雷定片，5 mg/次，2次/d。治疗组在对照组治疗基础上口服灯盏生脉胶囊，2粒/次，3次/d。两组均持续治疗2个月。观察两组的临床疗效、临床症状得分、NYHA心功能分级、心肌重塑指标水平、血清学及血清炎症指标、明尼苏达生活质量（LiHFe）评分及6分钟步行试验（6MWT）。结果 治疗后，治疗组总有效率是94.00%，显著高于对照组的85.00%（P＜0.05）。治疗后，治疗组患者临床症状得分、NYHA分级得分、左室舒张末期内径（LVEDd）和左室收缩末期内径（LVESd）水平均显著低于同组治疗前（P＜0.05）；且治疗后，治疗组临床症状得分、心功能、心肌重塑指标显著低于对照组（P＜0.05）。治疗后，两组全血高切黏度（HBV）、全血低切黏度（LBV）、血浆黏度（PV）、纤维蛋白原（FIB）明显降低，而氧合指数（pO₂/FiO₂）明显升高（P＜0.05）；治疗后，治疗组HBV、LBV、PV、FIB低于对照组，pO₂/FiO₂明显高于对照组（P＜0.05）。治疗后，两组高灵敏度肌钙蛋白（hs-cTnT）、氨基端前心钠肽（NT-proBNP）、血清脑钠肽（BNP）水平均较同组治疗前显著降低（P＜0.05）；且治疗后，治疗组血清学指标低于对照组（P＜0.05）。治疗后，两组超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）均较同组治疗前显著降低（P＜0.05）；且治疗后，治疗组炎症指标水平显著低于对照组（P＜0.05）。治疗后，两组组患者LiHFe评分均显著降低，而6MWT显著增加（P＜0.05）；且治疗后，治疗组LiHFe评分低于对照组，6MWT高于对照组（P＜0.05）。结论 灯盏生脉胶囊联合伊伐布雷定治疗慢性心力衰竭有良好的效果，不仅能促进心肌重塑，改善心肌能量代谢，并且改善血流动力学、流变学、血清学指标，并且能够降低机体炎症水平，降低LiHFe评分，增加6MWT距离。

Objective To explore the clinical efficacy of Dengzhan Shengmai Capsules combined with ivabradine in treatment of chronic heart failure. Methods A total of 200 patients with chronic heart failure admitted to Shanghai Pudong Hospital from June 2020 to June 2022 were selected and divided into control group and treatment group according to odd-even numbers, with 100 patients in each group. Patients in the control group were po administered with Ivabradine Hydrochloride Tablets at meal time, 5 mg/time, twice daily. Patients in the treatment group were po administered with Dengzhan Shengmai Capsules on the basis of the control group, 2 capsules/time, 3 times daily. Both groups were treated for 2 months. After treatment, clinical efficacy, clinical symptom score, NYHA cardiac function grade, myocardial remodeling indexer, serological and serum inflammation index, Minnesota Quality of Life (LiHFe) score and 6-minute walking test (6MWT) were observed in two groups. Results After treatment, the total effective rate of the treatment group was 94.00%, which was significantly higher than that of the control group 85.00% (P < 0.05). After treatment, the clinical symptom score, NYHA grade score, left ventricular end-diastolic diameter (LVEDd) and left ventricular end-systolic diameter (LVESd) levels in treatment group were significantly lower than before treatment (P < 0.05). After treatment, the clinical symptom score, cardiac function and myocardial remodeling indexes in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, whole blood high shear viscosity (HBV), whole blood low shear viscosity (LBV), plasma viscosity (PV) and fibrinogen (FIB) were significantly decreased in both groups, while oxygenation index (pO₂/FiO₂) was significantly increased (P < 0.05). After treatment, HBV, LBV, PV and FIB in the treatment group were lower than those in the control group, and pO₂/FiO₂ was significantly higher than that in the control group (P < 0.05). After treatment, the levels of high-sensitivity troponin (hs-cTnT), amino-terminal procardiac natriuretic peptide (NT-proBNP) and serum brain natriuretic peptide (BNP) in 2 groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, serological indexes in the treatment group were lower than those in the control group (P < 0.05). After treatment, hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased in 2 groups compared with before treatment (P < 0.05). After treatment, the level of inflammation index in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, LiHFe score was significantly decreased in both groups, while 6MWT was significantly increased (P < 0.05). After treatment, LiHFe score in the treatment group was lower than that in the control group, and 6MWT score was higher than that in the control group (P < 0.05). Conclusion Dengzhan Shengmai Capsules combined with ivabradine has a good effect in treatment of chronic heart failure, can not only promote myocardial remodeling, improve myocardial energy metabolism, improve hemodynamics, rheology and serological indexes, but also reduce the level of inflammation in the body, reduce the LiHFe score and increase the distance of 6MWT.

R972

上海市浦东新区卫生健康委员会卫生科技项目（PW2022A-69）