目的 探讨脑心通胶囊联合沙库巴曲缬沙坦钠片治疗缺血性心肌病的临床疗效。方法 选取2021年4月—2024年2月在邯郸二八五医院就诊的92例缺血性心肌病，按随机数字表法将所有患者分为对照组和治疗组，每组46例。对照组口服沙库巴曲缬沙坦钠片，2次/d，初始剂量25 mg/次，每2周增加1倍剂量，持续剂量100 mg/次。治疗组在对照组基础上饭后温水服用脑心通胶囊，4粒/次，3次/d。两组患者持续治疗3个月。统计两组的治疗效果、心功能、心室重构指标、血清指标水平。结果 治疗后，治疗组的总有效率为93.48%，对照组的总有效率为78.26%，组间比较差异显著（P＜0.05）。治疗后，两组的左室射血分数（LVEF）高于治疗前，左心室收缩末期容积指数（LVESVI）、左室舒张末期容积（LVEDV）低于治疗前（P＜0.05）；治疗后，治疗组的LVEF高于对照组，LVESVI、LVEDV低于对照组（P＜0.05）。治疗后，两组的左心室质量指数（LVMI）、左心室重构指数（LVRI）、左心室后壁厚度（LVPW）低于治疗前（P＜0.05）；治疗组的LVMI、LVRI、LVPW低于对照组（P＜0.05）。治疗后，两组的血清D-二聚体（D-D）、血清淀粉样蛋白A（SAA）、心型脂肪酸结合蛋白（H-FABP）水平低于治疗前（P＜0.05）；治疗组的血清D-D、SAA、H-FABP水平低于对照组（P＜0.05）。结论 脑心通胶囊联合沙库巴曲缬沙坦钠片可提高缺血性心肌病的治疗效果，改善心功能，延缓心室重构，降低心肌损伤。

Objective To investigate the clinical effect of Naoxintong Capsules combined with Sacubitril Valsartan Sodium Tablets in treatment of ischemic cardiomyopathy. Methods Patients (92 cases) with ischemic cardiomyopathy treated in Handan 285th Hospital from April 2021 to February 2024 were selected and divided into control group and treatment group according to random number table method, with 46 cases in each group. Patients in control group took Sacubitril Valsartan Sodium Tablets orally, twice daily, the initial dose was 25 mg/ time, the dose was doubled every 2 weeks, and the continuous dose was 100 mg/ time. Patients in the treatment group were po administered with Naoxintong Capsules with warm water after meals on the basis of the control group, 4 capsules/times, 3 times daily. Patients in two groups were treated for 3 months. The therapeutic effect, cardiac function and ventricular remodeling indexes and serum indexes of the two groups were analyzed. Results After treatment, the total effective rate was 93.48% in the treatment group and 78.26% in the control group, and the difference was significant (P < 0.05). After treatment, LVEF in two groups was higher than before treatment, but LVESVI and LVEDV in two groups were lower than before treatment (P < 0.05). After treatment, LVEF in the treatment group was higher than that in the control group, but LVESVI and LVEDV in the treatment group were lower than that in the control group (P < 0.05). After treatment, LVMI, LVRI, and LVPW in two groups were lower than before treatment ( P < 0.05). And LVMI, LVRI, and LVPW in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of D-D, SAA, and H-FABP of the two groups were lower than these before treatment (P < 0.05), and the serum levels of D-D, SAA, and H-FABP in the treatment group were lower than those in the control group (P < 0.05). Conclusion Naoxintong Capsules combined with Sacubitril Valsartan Sodium Tablets can improve the therapeutic effect of ischemic cardiomyopathy, improve cardiac function, delay ventricular remodeling and reduce myocardial injury.

R972

石家庄市科技计划项目（171462143）