2025 年第 3 期 第 20 卷

熊胆救心丸联合沙库巴曲缬沙坦治疗射血分数降低型慢性心力衰竭的临床研究

Clinical study of Xiongdan Jiuxin pills combined with sacubitril/valsartan in the treatment of chronic heart failure with reduced ejection fraction

作者：向轩1孟文2陈俊锦1陈芳红2李海英2何学明2

英文作者：Xiang Xuan1 Meng Wen2 Chen Junjin1 Chen Fanghong2 Li Haiying2 He Xueming2

单位：1徐州医科大学附属连云港市立东方医院心血管内科，连云港222042；2徐州医科大学附属连云港市立东方医院转化医学中心实验室，连云港222042

英文单位：1Department of Cardiovascular Medicine Lianyungang Municipal Oriental Hospital Affiliated to Xuzhou Medical University Lianyungang 222042 China; 2Translational Medicine Central Laboratory Lianyungang Municipal Oriental Hospital Affiliated to Xuzhou Medical University Lianyungang 222042 China

关键词：慢性心力衰竭；熊胆救心丸；沙库巴曲缬沙坦

英文关键词：Chronicheartfailure;XiongdanJiuxinpills;Sacubitril/valsartan

• 摘要：

• 目的 探究熊胆救心丸联合沙库巴曲缬沙坦治疗射血分数降低型慢性心力衰竭的临床效果。方法 选取2020年10月到2023年10月徐州医科大学附属连云港市立东方医院收治入院的120例射血分数降低型慢性心力衰竭患者。根据随机数字表法分为对照组和观察组，每组60例。所有患者均给予常规治疗，对照组另给予沙库巴曲缬沙坦，观察组在对照组基础上给予熊胆救心丸。比较2组6 min步行试验距离、最大运动时间、心功能指标、血清指标、不良反应发生情况。结果 治疗后，2组6 min步行试验距离和最大运动时间均长于治疗前，且观察组均长于对照组，差异均有统计学意义（均P＜0.001）。治疗后，2组左心室射血分数、每搏输出量、心排出量、一氧化氮、一氧化氮合酶水平均高于治疗前，且观察组均高于对照组，2组左心室舒张末期内径、内皮素1、层粘连蛋白、透明质酸、Ⅲ型前胶原氨基端肽水平均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P＜0.05）。治疗期间，观察组与对照组不良反应发生率比较差异无统计学意义［10.0%（6/60）比6.7%（4/60）］（χ2=0.436，P=0.509）。结论 熊胆救心丸联合沙库巴曲缬沙坦对射血分数降低型慢性心力衰竭的疗效显著，可改善患者的运动耐量、心功能及血管内皮功能，减缓心肌纤维化，且安全性较好。

• Objective  To investigate the clinical effect of Xiongdan Jiuxin pills combined with sacubitril/valsartan in the treatment of chronic heart failure with reduced ejection fraction. Methods A total of 120 patients with chronic heart failure with reduced ejection fraction admitted to Lianyungang Municipal Oriental Hospital Affiliated to Xuzhou Medical University from October 2020 to October 2023 were selected. According to the random number table method, they were divided into the control group and the observation group, with 60 cases in each group. All patients were given conventional treatment, the control group was given sacubitril/valsartan, and the observation group was given Xiongdan Jiuxin pills on the basis of the control group. The 6 min walk test distance, maximum exercise time, cardiac function indexes, serum indexes, and adverse reactions were compared between the two groups. Results After treatment, the 6 min walk test distance and maximum exercise time of the two groups were longer than those before treatment, and those of the observation group were longer than those of the control group (all P＜0.001). After treatment, left ventricular ejection fraction, stroke volume, cardiac output, nitric oxide and nitric oxide synthase in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group; the levels of left ventricular end-diastolic diameter, endothelin-1, laminin, hyaluronic acid and N-terminal procollagen type Ⅲ in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P＜0.05). During the treatment, there was no significant difference in the incidence of adverse reactions between the observation group and the control group ［10.0%(6/60) vs 6.7%(4/60)］(χ2=0.436, P=0.509). Conclusion Xiongdan Jiuxin pills combined with sacubitril/valsartan has a significant effect on chronic heart failure with reduced ejection fraction, which can improve the exercise tolerance, cardiac function and vascular endothelial function of patients, slow down myocardial fibrosis, and has good safety.