高雅楠 张娟

摘要 目的：观察养心氏片治疗糖尿病合并慢性心力衰竭（CHF）的临床疗效。方法：选取2019年6月至2020年6月山东中医药大学附属医院收治的糖尿病合并慢性心力衰竭患者78例作为研究对象，采用随机数字表法分为对照组和观察组，每组39例，2组均采用常规治疗方式，观察组在常规治疗的基础上加用养心氏片治疗。观察治疗前后的患者空腹血糖（FBG）、餐后2 h血糖（2 h PBG）、糖化血红蛋白（HbA1c）以及左室射血分數（LVEF）、6 min步行试验、N末端B型脑钠肽前体（NT-pro BNP）、中医临床症状、心功能分级（NYHA）的变化。结果：治疗1个疗程后，在FBG、2 h PBG、HbA1c方面，观察组治疗前后比较及观察组与对照组治疗后的比较，差异均有统计学意义（P<0.05）;在LVEF、6 min步行试验及NT-pro BNP方面，观察组治疗前后比较及观察组与对照组治疗后的比较，差异均有统计学意义（P<0.05）;在中医临床症状及心功能分级改善方面，观察组明显优于对照组，差异有统计学意义（P<0.05）。结论：养心氏片联合西药治疗糖尿病合并慢性心力衰竭比单纯西药治疗效果更好。

关键词 养心氏片;2型糖尿病;慢性心力衰竭;血糖;心功能

Clinical Observation of Yangxinshi Tablet in the Treatment of Type 2 Diabetes Mellitus Complicated with Chronic Heart Failure

GAO Yanan1，ZHANG Juan2

（1 The First Clinical Medical College of Shandong University of Traditional Chinese Medicine，Jinan 250014，China; 2 Affiliated Hospital of Shandong University of Traditional Chinese Medicine，Jinan 250014，China）

Abstract Objective：To observe the clinical efficacy of Yangxinshi Tablets in the treatment of diabetes mellitus complicated with chronic heart failure（CHF）.Methods：A total of 78 patients with diabetes mellitus complicated with chronic heart failure who were admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from June 2019 to June 2020 were selected as the research objects and were randomly divided into a Yangxinshi group（observation group）and a control group，with 39 cases in each group.Both groups were treated with conventional treatment while the observation group was treated with Yangxinshi Tablets on the basis of conventional treatment.Fasting blood glucose（FBG），2-hour postprandial blood glucose（2 h PBG），glycosylated hemoglobin（HbA1c），left ventricular ejection fraction（LVEF），6 min walk test，N-terminal pro brain natriuretic peptide precursor（NT-Pro BNP），clinical symptoms of traditional Chinese medicine and cardiac function classification（NYHA）were observed before and after treatment.Results：After a course of treatment，FBG，2 h PBG and HbA1c in the observation group before and after treatment and the comparison between the observation group and the control group after treatment were statistically significant（P<0.05）; LVEF，6 min walking test and NT-Pro BNP of the observation group before and after treatment and the comparison between 2 groups after treatment were also statistically significant（P<0.05）; in the improvement of TCM clinical symptoms and cardiac function classification，the observation group was significantly better than the control group with a statistically significant difference（P<0.05）.Conclusion：The effect of Yangxinshi Tablets combined with Western medicine in the treatment of diabetes complicated with chronic heart failure is better than that of Western medicine alone.

Keywords Yangxinshi Tablet; Type 2 diabetes; Chronic heart failure; Blood glucose; Heart function

中图分类号：R255.4;R256.2文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.06.020

近年来，糖尿病（Diabetes Mellitus，DM）的患病率逐年上升，目前已被列为全球性的公共卫生问题。根据国际糖尿病联盟（IDF）调研结果显示，截至2017年，全球约有4.25亿DM患者，而中国DM患者占全球1/4以上[1]。DM的短期危害性不易被察觉，随病程延长，若血糖管理不佳，并发症亦随之出现，且危害性极大。DM是慢性心力衰竭的高危因素之一，可导致继发性心肌损害，DM合并慢性心力衰竭是严重的并发症之一，治疗上用药多、花费高且死亡率极高，临床治疗颇为棘手。目前西医治疗慢性心力衰竭的药物主要包括利尿剂、RAAS抑制剂、β受体阻滞剂、正性肌力药、伊伐布雷定等，可以缓解患者的部分症状，但随病情进展，疗效并不理想。因此，如何挽救患者的生命，提高患者生命质量，降低死亡率成为亟待解决的难题。……