目的 通过N末端脑钠肽前体（NT-proBNP）和可溶性生长刺激表达基因2蛋白（ST2）以及中医证候评分等相关指标的研究，探讨加味葶苈大枣泻肺汤对慢性心力衰竭患者临床疗效。方法 纳入92例心衰患者，随机分为治疗组和对照组，每组各46例，对照组予以西医治疗，治疗组在对照组西医治疗的基础上口服加味葶苈大枣泻肺汤治疗，共治疗8周，分别检测两组患者试验前后的NT-proBNP、ST2以及中医证候评分水平，观察NYHA心功能改善情况。结果 治疗后，治疗组患者的心功能改善效果总有效率为95.6%，对照组总有效率为82.6%。通过组间比较发现，试验前两组NT-proBNP、ST2、中医证候评分无差异（P > 0.05）。试验后治疗组NT-proBNP均低于对照组，且有统计学差异（P = 0.041）；试验后治疗组ST2均低于对照组，且有统计学差异（P = 0.046）；试验后治疗组中医证候评分均低于对照组，且有统计学差异（P < 0.001）。通过组内比较发现，与治疗前相比，治疗后治疗组NT-proBNP、ST2、中医证候评分明显降低，且有统计学差异（P < 0.001），与治疗前相比，治疗后对照组NT-proBNP、中医证候评分下降，且有统计学差异（P < 0.001），而对照组ST2治疗前后无统计学差异（P = 0.282）。结论 加味葶苈大枣泻肺汤结合西医常规治疗慢性心衰患者，降低患者的NT-proBNP、ST2、中医证候评分，可显著改善临床疗效，值得在临床中推广应用。

Objective Through plasma amino- terminal pro- brain natriuretic peptide (NT- proBNP), soluble growth stimulation expressed gene 2 (ST2) and TCM syndrome score and other related indicators of the study, to explore the clinical efficacy of Jiawei Tingli Dazao Decoction in patients with chronic heart failure. Methods In 92 cases of chronic heart failure, participants were randomly divided into a treatment group and a control group, with 46 cases in each group. The control group was given western medicine treatment, and the treatment group was added oral administration of Jiawei Tingli Dazao Decoction, for 8 weeks’treatment. The NT-proBNP, ST2 and TCM syndrome score levels, and NYHA heart function of the 2 groups before and after treatment were observed. Results After treatment, the total effective rate of cardiac function improvement was 95.6% in the treatment group and 82.6% in the control group. Comparison between groups: before the experiment, there was no statistically significant difference in the scores of NT-proBNP, ST2 and TCM syndromes between the 2 groups (P > 0.05). After the experiment, NT-proBNP in the treatment group was lower than that in the control group, and the difference was statistically significant (P = 0.041). After the experiment, ST2 of the treatment group was lower than that of the control group, and the difference was statistically significant (P = 0.046). After experiment, TCM syndrome scores of the treatment group were all lower than those of the control group, and the difference was statistically significant (P < 0.001). Comparison within the group: compared with before the treatment, NTproBNP, ST2, TCM syndrome score of the treatment group were decreased, and the difference was statistically significant (P < 0.05); Compared with before treatment, the score of NT-proBNP and TCM syndrome in the control group decreased, and the difference was statistically significant (P < 0.001), while the difference before and after ST2 treatment in the control group was not statistically significant (P = 0.282). Conclusion Jiawei Tingli Dazao Decoction combined with western medicine conventional therapy in the treatment of chronic heart failure patients, reduce the patient's NTproBNP, ST2, TCM syndrome score level, can significantly improve the clinical efficacy, which is worthy of promotion in clinical application.

上海市科学技术委员会科研计划资助项目重点项目（16401972100）：加味葶苈大枣泻肺汤对慢性心力衰竭临床疗效的研究，负责人：李玉明。