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目的 探讨厄贝沙坦联合参松养心胶囊治疗慢性心力衰竭(CHF)合并窦性心动过缓的临床效果.方法 选取2016年12月至2018年3月山西大医院心血管内科收治的CHF合并窦性心动过缓患者89例,采用随机数表法随机分为联合治疗组(n=45)和厄贝沙坦组(n=44),厄贝沙坦组给予厄贝沙坦片治疗,联合治疗组在厄贝沙坦组基础给予参松养心胶囊.比较分析两组患者治疗前后心功能、心率相关指标等情况.结果 治疗后联合治疗组的有效率(91.1% )显著高于厄贝沙坦组(81.8% ),差异有统计学意义(P<0.05).治疗前两组患者的平均心率和心率变异性指标比较,差异均无统计学意义(P>0.05);治疗后联合治疗组各项指标的改善程度显著高于厄贝沙坦组,差异有统计学意义(P<0.05).治疗前两组患者心功能相关参数比较,差异无统计学意义(P>0.05),治疗后联合治疗组左心室功能参数改善程度均显著高于厄贝沙坦组,差异有统计学意义(P<0.05).治疗前两组患者N末端脑钠肽(NT-proBNP)和心型脂肪酸结合蛋白(H-FABP )表达水平比较,差异无统计学意义(P>0.05),治疗后联合治疗组的各项水平显著高于厄贝沙坦组,差异有统计学意义(P<0.05).结论 参松养心胶囊联合厄贝沙坦可以改善CHF并窦性心动过缓患者的心功能,保护心肌细胞,提高心率,保证治疗效果.

Objective To investigate the clinical effect of irbesartan combined with Shensong Yan-gxin capsule on chronic heart failure(CHF) complicated with sinus bradycardia. Methods A retrospective study was performed on 89 cases of patients with CHF complicated with sinus bradycardia who were admit-ted from December 2016 to March 2018.Patients were randomly divided into the combined treatment group (n=45) and irbesartan group(n=44).Patients in the irbesartan group were given irbesartan tables,the others in the combined treatment group were given Shensong Yangxin capsule on the basis of treatment in irbesartan group.The heart function and heart rate indexes of the two groups before and after treatment were compared and analyzed. Results After treatment, the effective rate of the combined treatment group (91.1%) was significantly higher than that of the irbesartan group(81.8%),(P<0.05).Before treat-ment,the mean heart rate and heart rate variability indexes of the two groups were compared,and the differ-ences were not statistically significant(P>0.05).After treatment,the improvement degree of each index in the combined treatment group was significantly higher than that in the irbesartan group(P<0.05).Before treatment,the mean heart rate and heart rate variability indexes of the two groups were compared,and the differences were not statistically significant(P>0.05).After treatment,the improvement degree of each in-dex in the combined treatment group was significantly higher than that in the irbesartan group,(P<0.05). Before treatment,there was no statistically significant difference in cardiac function parameters between the two groups(P>0.05). After treatment,the improvement degree of left ventricular function parameters in the combined treatment group was significantly higher than that in the irbesartan group, ( P <0.05). Be-fore treatment,the two groups of patients with n-terminal brain natriuretic peptide( NT-proBNP) and heart type fatty acid binding protein( H-FABP) expression levels were compared,the difference was not statisti-cally significant(P>0.05);after treatment,the combined treatment group was significantly higher than the level of irbesartan group(P<0.05). Conclusion The combination of Shensong Yangxin capsule and irbe-sartan can improve the cardiac function of patients with CHF complicated with sinus bradycardia,protect the cardiac myocytes,improve heart rate,and ensure the therapeutic effect.