目的 探讨心通颗粒联合沙库巴曲缬沙坦钠片治疗射血分数保留慢性心力衰竭的临床效果。方法 选取2021年3月—2024年2月在巴中市恩阳区人民医院就诊的80例射血分数保留慢性心力衰竭患者，按计算机随机排列法将患者分为对照组和治疗组，每组40例。对照组口服沙库巴曲缬沙坦钠片，初始剂量1片/次，2次/d，根据个体耐受逐步增加剂量，维持剂量4片/次，2次/d。治疗组在对照组基础上口服心通颗粒，2袋/次，3次/d。两组持续治疗2个月。比较两组的临床疗效、病情状态、心功能指标、血清指标。结果 治疗2个月后，治疗组的总有效率为95.00%，对照组的总有效率为77.50%，组间比较差异显著（P＜0.05）。治疗后，两组的心衰计分系统（LEE）评分显著减小（P＜0.05），且治疗组LEE评分明显低于对照组（P＜0.05）。治疗后，治疗组的左室射血分数（LVEF）显著升高，舒张早期二尖瓣流速/延长速度（E/e'）、等容舒张时间（IVRT）显著降低（P＜0.05）；治疗组的LVEF高于对照组，E/e'、IVRT低于对照组（P＜0.05）。治疗后，两组的血清脂联素（APN）、半乳糖凝集素3（galectin 3）、可溶性肿瘤生成抑制因子2（sST2）、N末端脑钠肽（NT-proBNP）水平显著降低（P＜0.05）；治疗组的血清APN、galectin 3、sST2、NT-proBNP水平显著低于对照组（P＜0.05）。结论 心通颗粒联合沙库巴曲缬沙坦钠片有助于提高射血分数保留慢性心力衰竭的临床疗效，控制病情发展，改善心功能，降低心肌损伤。

Objective To investigate the effect of Xintong Granules combined with Sacubitril Valsartan Sodium Tablets in treatment of chronic heart failure with ejection fraction preservation. Methods A total of 80 patients with chronic heart failure with ejection fraction preservation who were treated in Enyang District People’s Hospital of Bazhong from March 2021 to February 2024 were selected and divided into control group and treatment group according to computer random arrangement method, with 40 cases in each group. Patients in the control group took Sacubitril Valsartan Sodium Tablets orally, the initial dose was 1 tablet/time, 2 times daily, the dose was gradually increased according to individual tolerance, and the maintenance dose was 4 tablets/time, 2 times daily. Patients in the treatment group were given Xintong Granules orally on the basis of the control group, 2 bags/time, 3 times daily. Patients of two groups were treated for 2 months. The clinical efficacy, disease status, cardiac function index, and serum index of the two groups were compared. Results After 2 months of treatment, the total effective rate in the treatment group (95.00%) was higher than 77.50% in the control group, and the difference between groups was significant (P < 0.05). LEE score of the two groups was significantly decreased after treatment (P < 0.05), and LEE score in the treatment group was higher than that of the control group (P < 0.05). After treatment, LVEF of two groups was higher than that before treatment, but E/e' and IVRT of two groups were lower than that before treatment (P < 0.05). VEF in treatment group was higher than that in control group, but E/e' and IVRT were lower than that in control group (P < 0.05). The levels of APN, galectin 3, sST2, and NT-proBNP in two groups were lower than those before treatment (P < 0.05). The levels of APN, galectin 3, sST2, and NT-proBNP in the treatment group were lower than those in the control group (P < 0.05). Conclusion Xintong Granules combined with Sacubitril Valsartan Sodium Tablets can improve the efficacy of chronic heart failure with ejection fraction preservation, control the progression of disease, improve heart function, and reduce myocardial damage.

R972

四川省中医药标准化研究项目(2020080)