目的 探讨通心络胶囊联合磷酸肌酸钠治疗慢性心力衰竭的临床效果。方法 选取2017年1月—2018年9月天津中医药大学第一附属医院收治的慢性心力衰竭患者142例，随机分成对照组（71例）和治疗组（71例）。对照组静脉滴注注射用磷酸肌酸钠，1.0 g加入5%葡萄糖液250 mL，持续30～45 min，2次/d。治疗组在对照组基础上口服通心络胶囊，3粒/次，3次/d。两组患者连续治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者超声心动图指标、明尼苏达心衰生活质量量表（MLHFQ）评分及心肌肌钙蛋白I（cTnI）、B型利钠肽（BNP）和血小板α颗粒膜蛋白-140（GMP-140）水平。结果 治疗后，对照组临床有效率为83.1%，显著低于治疗组的94.4%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者左室射血分数（LVEF）值显著升高（P<0.05），左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、左室舒张末期容量（LVEDV）和左室收缩末期容量（LVESV）及左室心肌质量指数（LVMI）值显著降低（P<0.05），且治疗组这些超声心动图指标明显好于对照组（P<0.05）。治疗后，两组身体领域、情绪领域、其他领域评分和总分均显著降低（P<0.05），且治疗组MLHFQ各评分项目明显低于对照组（P<0.05）。治疗后，两组血清cTnI水平及血浆BNP、GMP-140水平均显著下降（P<0.05），且治疗组cTnI、BNP、GMP-140水平明显低于对照组（P<0.05）。结论 通心络胶囊联合磷酸肌酸钠治疗慢性心力衰竭可明显改善患者心功能，抑制左心室重构，正性调节心肌微循环，减轻心肌损伤。

Objective To investigate the clinical effect of Tongxinluo Capsules combined with creatine phosphate sodium in treatment of chronic heart failure. Methods Patients (142 cases) with chronic heart failure in First Teaching Hospital of Tianjin University of TCM from January 2017 to September 2018 were randomly divided into control (71 cases) and treatment (71 cases) groups. Patients in the control group were iv administered with Creatine Phosphate Sodium for injection, 1 g added into 5% glucose injection 250 mL for 30-45 min, twice daily. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the echocardiographic indexes, MLH FQ scores, cTnI, BNP and GMP-140 levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 83.1%, which was significantly lower than 94.4% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the LVEF value in two groups was significantly increased (P<0.05), LVESD, LVEDD LVEDV, LVESV, and LVMI value was significantly decreased (P<0.05), and these echocardiographic indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the scores in physical, emotional and other fields, and total scores in two groups were significantly decreased (P<0.05), and the MLH FQ scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum cTnI levels and concentration of BNP and GMP-140 in plasma in two groups were significantly decreased (P<0.05), and the cTnI BNP and GMP-140 levels in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Tongxinluo Capsules combined with creatine phosphate sodium in treatment of chronic heart failure, can significantly improve patients' heart function, inhibit left ventricular remodeling, positively regulate myocardial microcirculation, alleviate myocardial injury.