夏长青　王芳　张娜　王磊　高健

摘要 目的：探討芪苈强心胶囊治疗老年冠心病心力衰竭的临床效果。方法：选取2018年6月至2021年5月石家庄市中医院东院区收治的冠心病心力衰竭老年患者94例作为研究对象。按照随机数字表法分为对照组和观察组，每组47例。对照组在常规治疗基础上给予安慰剂。观察组在常规治疗基础上给予芪苈强心胶囊。比较2组的疗效、中医症状评分、左心室射血分数（LVEF）、左心室舒张期末内径（LVEDD）、左心室收缩期末内径（LVESD）、心率（HR）、每搏输出量（SV）、心脏指数（CI）、N端脑钠肽前体（NT-proBNP）、脂联素（APN）、一氧化氮（NO）、6 min步行试验（6MWT）、不良反应发生率。结果：观察组治疗效果优于对照组（P<0.05）。2组治疗后的中医症状评分、LVEDD、LVESD、HR、NT-proBNP、APN降低，LVEF、CO、CI、NO、6MWT增高。观察组的中医症状评分、LVEDD、LVESD、HR、NT-proBNP、APN低于对照组，LVEF、CO、CI、NO、6MWT高于对照组，差异均有统计学意义（均P<0.05）。2组的不良反应发生率比较，差异无统计学意义（P>0.05）。结论：在冠心病心力衰竭的老年患者治疗过程中，给予芪苈强心胶囊，可提升疗效，改善心功能和临床症状，用药的安全性良好。

关键词 芪苈强心胶囊;冠心病;心力衰竭;心脑血管疾病;冠状动脉;利尿剂;左心室射血分数;安慰剂

Abstract Objective：To explore the clinical effects of Qili Qiangxin Capsules in elderly patients with coronary heart disease and heart failure.Methods：A total of 94 elderly patients with coronary heart disease and heart failure admitted to the East Branch of Shijiazhuang Traditional Chinese Medicine Hospital from June 2018 to May 2021 were selected as the research objects.According to random number table method，they were divided into a control group（n=47） and an observation group（n=47）.The control group was given placebo on the basis of conventional treatment.The observation group was given Qili Qiangxin Capsules on the basis of conventional treatment.The curative effect，TCM symptom score，left ventricular ejection fraction（LVEF），left ventricular end diastolic diameter（LVEDD），left ventricular end systolic diameter（LVESD），heart rate（HR），stroke volume（SV），Heart index（CI），N-terminal brain natriuretic peptide（NT-proBNP），adiponectin（APN），nitric oxide（NO），6-minute walk test（6-MWT），incidence of adverse reactions were compared.Results：The treatment effect of the observation group was better than that of the control group（P<0.05）.After treatment，the TCM syndrome scores，LVEDD，LVESD，HR，NT-proBNP，APN decreased，and LVEF，CO，CI，NO，6-MWT increased.The TCM syndrome score，LVEDD，LVESD，HR，NT-proBNP and APN of the observation group were lower than those of the control group，while LVEF，CO，CI，NO，6-MWT were higher than those of the control group，the differences were statistically significant（all P<0.05）.There was no statistically significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：In the treatment of elderly patients with coronary heart disease and heart failure，Qili Qiangxin Capsules can improve the efficacy，improve heart function and clinical symptoms，and the medication is safe.

Keywords Qili Qiangxin Capsules; Coronary heart disease; Heart failure; Cardio-cerebrovascular disease; Coronary artery; Diuretics; Left ventricular ejection fraction; Placebo

中图分类号：R256.2文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.18.016

世界卫生组织所公布的数据表明，心脑血管疾病是近些年来威胁全球人群健康的首要因素，其致死率以及致残率在全部疾病中名列第一位[1]。心力衰竭是各种心血管疾病患者最终发生的病理改变，其患病率也在逐渐增加，对心力衰竭患者的救治目前仍然是各级医院心脏内科的主要工作之一[2]。冠心病导致的心力衰竭是较为常见的类型，冠心病的全称为冠状动脉粥样动脉硬化性心脏病，发病之后患者可因冠状动脉的缺氧缺血等导致心肌细胞损伤，心肌收缩力下降，心排出量不足，人体的器官以及组织血液灌注缺乏，肺循环以及体循环淤血等[3]。……