目的 探讨通心络胶囊联合阿魏酸钠治疗慢性肺心病急性加重期的临床效果。方法 选取2017年1月-2018年6月亳州市人民医院收治的72例慢性肺心病急性加重期患者，随机分为对照组和治疗组，每组各36例。对照组静脉滴注阿魏酸钠注射液，10 mL加入250 mL生理盐水中充分稀释后给药，1次/d。治疗组在对照组治疗基础上饭后口服通心络胶囊，3粒/次，3次/d。两组均连续治疗7 d后观察疗效。观察两组患者的临床疗效，比较两组治疗前后血气指标、第1秒用力呼气容积/用力肺活量比值（FEV1/FVC）、超声心动图指标、血流变学指标和血清学指标的变化情况。结果 治疗后，对照组和治疗组的总有效率分别是77.8%、94.4%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组动脉血氧分压（pO₂）、第1秒用力呼气容积/用力肺活量（FEV1/FVC）比值均显著增高，但二氧化碳分压（pCO₂）值均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组pO₂、FEV1/FVC值高于对照组，pCO₂值低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组右室舒张末期内径（RVEDD）、右心室前壁厚度（RVAWT）、肺动脉收缩压（PASP）、血浆黏度（PV）、红细胞沉降率（ESR）较治疗前均显著减小，而红细胞变形指数（EDI）均显著增加，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组RVEDD、RVAWT、PASP、PV、ESR显著小于对照组，而EDI值高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清C反应蛋白（CRP）、B型利钠肽（BNP）水平均显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组CRP、BNP水平低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 通心络胶囊联合阿魏酸钠治疗慢性肺心病急性加重期具有较好的临床疗效，可有效改善患者血气状况，纠正血液高凝状态，提高心肺功能，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Tongxinluo Capsules combined with sodium ferulate in treatment of acute exacerbation of elderly chronic pulmonary heart disease Methods Patients (72 cases) with acute exacerbation of elderly chronic pulmonary heart disease in Bozhou People's Hospital from January 2017 to June 2018 were randomly divided into control (36 cases) and treatment (36 cases) groups. Patients in the control group were iv administered with Sodium Ferulate Injection, 10 mL added into 250 mL normal saline, once daily. Patients in the treatment group were po administered with Tongxinluo Capsules, 3 grains/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the changes of blood gas indexes, FEV1/FVC, echocardiographic indexes, hemorheological indexes and serological indexes in two groups before and after treatment were compared.Results After treatment, the clinical efficacy in the control and treatment group were 77.8% and 94.4%, respectively, and there were differences between two groups (P<0.05). After treatment, pO₂ and FEV1/FVC in the two groups were significantly increased, but pCO₂ was significantly decreased, and there were differences in the same group (P<0.05). After treatment, pO₂ and FEV1/FVC in the treatment group were higher than those in the control group, but pCO₂ was significantly lower than that in the control group, and there were differences between two groups (P<0.05). After treatment, RVEDD, RVAWT, PASP, PV, and ESR in the two groups were significantly decreased, but EDI was significantly increased, and there were differences in the same group (P<0.05). After treatment, RVEDD, RVAWT, PASP, PV, and ESR in the treatment group were lower than those in the control group, but EDI was significantly higher than that in the control group, and there were differences between two groups (P<0.05). After treatment, CRP and BNP in the two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, CRP and BNP in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05).Conclusion Tongxinluo Capsules combined with sodium ferulate has significant effect in treatment of acute exacerbation of elderly chronic pulmonary heart disease, and can effectively improve the blood gas status, and also can correct the high blood coagulation state, and improve the cardiopulmonary function, which has a certain clinical application value.