目的 分析冠心舒通胶囊联合重组人脑利钠肽治疗慢性心力衰竭的临床疗效。方法 选取2021年1月—2023年11月渭南市中心医院收治的122例慢性心力衰竭患者，按随机数字表法将患者分为对照组和治疗组，每组各61例。对照组给予冻干重组人脑利钠肽，先按1.5 μg/kg的剂量静脉冲击，继以0.007 5 μg/(kg∙min)速率持续静脉滴注3 d，之后继续常规治疗。治疗组在此基础上口服冠心舒通胶囊，3粒/次，3次/d。两组连续治疗2周。观察两组临床疗效，比较治疗前后左室射血分数（LVEF）、左室舒张末期容积（LVEDV）、Barthel指数（BI）评分、6 min步行距离（6MWD）及心率变异性指标[正常心动周期标准差（SDNN）、相邻正常心动周期差值的均方根（rMSDD）等]和血清N末端B型利钠肽原（NT-proBNP）、心肌肌钙蛋白I（cTnI）、白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）水平。结果 治疗后，治疗组总有效率是95.08%，显著高于对照组的83.61%（P＜0.05）。治疗后，两组LVEF和BI评分、6MWD均显著增加，而LVEDV均显著减小（P＜0.05）；治疗后，LVEF、LVEDV和BI评分、6MWD以治疗组改善更显著（P＜0.05）。治疗后，两组SDNN、rMSDD、SDANN均显著升高（P＜0.05），以治疗组更显著（P＜0.05）。治疗后，两组血清NT-proBNP、cTnI、IL-6和hs-CRP水平均显著下降（P＜0.05），以治疗组更显著（P＜0.05）。结论 冠心舒通胶囊联合重组人脑利钠肽治疗慢性心力衰竭的效果确切，具有较好的安全性，能有效改善患者心脏功能，促进生活能力及运动耐力恢复，减轻机体炎性损伤和心肌损害。

Objective To analyze the clinical efficacy of Guanxin Shutong Capsules combined with recombinant human brain natriuretic peptide in treatment of chronic heart failure. Methods A total of 122 patients with chronic heart failure admitted to Weinan Central Hospital from January 2021 to November 2023 were selected and divided into control group and treatment group according to random number table method, with 61 patients in each group. Patients in the control group were given Lyophilized Recombinant Human Brain Natriuretic Peptide, intravenous infusion at a dosage of 1.5 μg/kg was followed by continuous intravenous infusion at a rate of 0.007 5 μg/(kg∙min) for 3 d, after which conventional treatment was continued. Patients in the treatment group were po administered with Guanxin Shutong Capsules on the basis of the control group, 3 capsules/time, 3 times daily. Both groups were treated continuously for 2 weeks. After treatment, the clinical efficacy was evaluated, and the levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV), Barthel index (BI) score, 6-minute walking distance (6MWD), heart rate variability indicators [standard deviation of normal cardiac cycle (SDNN), root mean square difference between adjacent normal cardiac cycles (rMSDD)], and serum N-terminal B-type natriuretic peptide (NT proBNP), cardiac troponin I (cTnI), interleukin-6 (IL-6), and hypersensitive C-reactive protein (hs CRP) levels before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 95.08%, which was significantly higher than that of control group (83.61%) (P < 0.05). After treatment, LVEF and BI scores and 6MWD were significantly increased, while LVEDV was significantly decreased in both groups (P < 0.05). After treatment, LVEF, LVEDV, BI scores, and 6MWD were significantly improved in the treatment group (P < 0.05). After treatment, SDNN, rMSDD, and SDANN were significantly increased in both groups (P < 0.05), and more significantly in the treatment group (P < 0.05). After treatment, the levels of serum NT-proBNP, cTnI, IL-6, and hs-CRP in two groups were significantly decreased (P < 0.05), and more significantly in the treatment group (P < 0.05). Conclusion Guanxin Shutong Capsules combined with recombinant human brain natriuretic peptide has exact effect in treatment of chronic heart failure with good safety, and can effectively improve the heart function of patients, promote the recovery of life ability and exercise endurance, which can reduce the inflammatory injury and myocardial damage.

R972

渭南市科技计划项目（2022ZDYFJH-54）