王大正　刘翠　刘静　李开璇　谢燕　周莉

摘要 目的：探析慢性心功能不全采取麝香保心丸聯合沙库巴曲缬沙坦钠进行治疗的临床效果。方法：选取2019年2月至2020年5月滁州市第一人民医院收治的慢性心功能不全患者60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30例。对照组给予沙库巴曲缬沙坦钠治疗，观察组给与麝香保心丸联合沙库巴曲缬沙坦钠治疗，比较2组患者用药前后左室舒张末期容积（EDV）、左室短轴缩短率（FS）、左室射血分数（LVEF）、醛固酮（ALD）、血管紧张素Ⅱ（Ang Ⅱ）、B型利钠肽（BNP）等指标的变化，同时比较2组患者的不良反应发生率及治疗有效率。结果：观察组患者在用药过后的LVEF、EDV、FS、血压、心率等心功能指标改善幅度明显较大（P<0.05）;观察组ALD、Ang Ⅱ、BNP指标明显低于对照组（P<0.05）;观察组不良反应发生率和对照组差异无统计学意义（P>0.05）;观察组治疗有效率明显高于对照组（P<0.05）。结论：麝香保心丸联合沙库巴曲缬沙坦钠用于慢性心功能不全患者的治疗中具有疗效好、安全性高等优势，还可改善醛固酮、血管紧张素Ⅱ水平，对改善患者的预后有着积极的作用。

关键词 慢性心功能不全;沙库巴曲缬沙坦钠;醛固酮;麝香保心丸;血管紧张素Ⅱ;不良反应;安全性;治疗效果

Abstract Objective：To explore the clinical effects of Shexiang Baoxin Pills combined with sacubatril and valsartan sodium in the treatment of chronic cardiac insufficiency.Methods：A total of 60 patients with chronic cardiac insufficiency treated to Chuzhou First People′s Hospital from February 2019 to May 2020 were selected and were divided into a control group and an observation group according to the method of random number grouping，with 30 cases in each group.The control group was treated with sacubatril and valsartan sodium，and the observation group was treated with Shexiang Baoxin Pills combined with sacubatril and valsartan sodium.The changes of left ventricular end diastolic volume（EDV），left ventricular short axis shortening rate（FS），left ventricular ejection fraction（LVEF），aldosterone level（ALD），angiotensin Ⅱ（Ang Ⅱ），B-type natriuretic peptide（BNP） and other indexes were compared before and after treatment.At the same time，the incidence of adverse reactions and the total treatment effective rate of treatment were compared between the 2 groups.Results：After medication，LVEF，EDV，FS，blood pressure，heart rate and other cardiac function indexes in the observation group improved significantly（P<0.05）; the indexes of ALD，Ang Ⅱ and BNP in the observation group were significantly lower than those in the control group（P<0.05）; there was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group（P>0.05）; the total effective rate of the observation group was significantly higher than the control group（P<0.05）.Conclusion：Shexiang Baoxin Pills combined with sacubatril and valsartan sodium in the treatment of patients with chronic cardiac insufficiency has the advantages of good curative effect and high safety.It can also improve the levels of aldosterone and angiotensin Ⅱ，and plays a positive role in improving the prognosis of patients.

Keywords Chronic cardiac insufficiency; Sacubitril and valsartan sodium; Aldosterone; Shexiang Baoxin Pills; Angiotensin Ⅱ; Adverse reactions; Safety; Therapeutic effects

中图分类号：R289.5;R541文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.18.017

慢性心功能不全（Chronic Cardiac Insufficiency，CCI）作为复杂的临床综合征，主要是以心脏功能变化及心脏结构变化为主，具有心室功能不全、神经内分泌激活、外周血流分布异常等特征，属于各类型心血管疾病进展的终末阶段[1]。CCI患者还会发生呼吸困难、下肢水肿、乏力、倦怠等症状，在检查时还会发现胸腔积液、肺部啰音、心室增大等症状，对患者的生存期限以及生命质量产生严重的影响[2]。近年来，CCI患病率呈逐年升高的趋势，应该及时寻求一种有效的措施进行治疗，从而提升患者整体治疗效果。……