目的 探讨益心舒胶囊联合沙库巴曲缬沙坦治疗慢性心力衰竭的疗效。方法 选择西安交通大学附属西安市中心医院2021年11月—2023年7月收治的86例慢性心力衰竭患者，随机分为对照组（43例）和治疗组（43例）。对照组口服沙库巴曲缬沙坦钠片，起始剂量为50 mg/次，2次/d，2周后若未发现异常则调整为100 mg/次，2次/d，后续再次加量，目标剂量为200 mg/次，2次/d。治疗组在对照组基础上口服益心舒胶囊，3粒/次，3次/d。两组患者治疗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左室舒张末期内径（LVEDD）、左心房内径（LAD）和N末端B型利钠肽原（NT-proBNP）水平，中医症状积分及6 min步行试验（6MWT）和生活质量评分。结果 治疗后，治疗组患者总有效率为93.02%，明显高于对照组临床总有效率76.74%（P＜0.05）。治疗后，两组患者LVEDD、LAD、NT-proBNP水平明显降低（P＜0.05），且与对照组相比，治疗组患者降低更为明显（P＜0.05）。治疗后，两组患者心悸、气短、下肢浮肿积分明显降低（P＜0.05），且与对照组相比，治疗组积分降低更为明显（P＜0.05）。治疗后，两组患者6MWT距离明显增加，而MLHFQ评分明显降低（P＜0.05），且与对照组相比，治疗组6MWT和MLHFQ评分改善更为明显（P＜0.05）。结论 益心舒胶囊联合沙库巴曲缬沙坦治疗慢性心力衰竭可获得较为理想的疗效，对患者的心功能和生活质量、6MWT距离有更好的改善作用，且安全性较高。

Objective To explore the therapeutic effect of Yixinshu Capsules combined with sacubitril valsartan in treatment of chronic heart failure. Methods Patients (86 cases) with chronic heart failure in Xi’an Central Hospital Affiliated to Xi’an Jiaotong University from November 2021 to July 2023 were randomly divided into control (43 cases) and treatment (43 cases) group. Patients in the control group were po administered with Sacubitril Valsartan Sodium Tablets, the starting dose was 50 mg/time, twice daily, after 2 weeks, if there were no abnormalities, the dose would be adjusted to 100 mg/time, twice daily. The dose would be increased again in the future and the target dose was 200 mg/time, twice daily. Patients in the treatment group were po administered with Yixinshu Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, the levels of cardiac function indicators LVEDD, LAD and NT-proBNP, TCM symptom scores, 6MWT and quality of life scores in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 93.02%, significantly higher than 76.74% of the control group (P < 0.05). After treatment, the levels of LVEDD, LAD, and NT proBNP in two groups were significantly reduced (P < 0.05), and compared with the control group, the treatment group showed a more significant decrease (P < 0.05). After treatment, the scores of palpitations, shortness of breath, and lower limb edema were significantly reduced in two groups of patients (P < 0.05), and compared with the control group, the decrease in scores was more significant in the treatment group (P < 0.05). After treatment, the 6MWT distance between two groups of patients was significantly increased, while the MLHFQ score was significantly decreased (P < 0.05), and compared with the control group, the treatment group showed more significant improvement in 6MWT and MLHFQ scores (P < 0.05). Conclusion Yixinshu Capsules combined with sacubitril valsartan in treatment of chronic heart failure can achieve more ideal therapeutic effects, better improve the patient’s heart function and quality of life, increase the distance between 6MWT, and have higher safety.

R972

陕西省重点研发计划项目（2019SF-189）