目的 探讨芪苈强心胶囊治疗慢性充血性心力衰竭（cCHF）的临床疗效及安全性，并分析其对中医证候积分、心功能、心室重塑的影响。方法 选取2024年3月～2025年3月于本院就诊的106例cCHF患者分为对照组、研究组，各53例。对照组采取常规西药治疗，研究组采取芪苈强心胶囊联合常规西药治疗，连续治疗4周。比较两组临床疗效及治疗前后中医证候积分、心功能、心室重塑、炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、淀粉样蛋白A（SAA）]、血管内皮功能[血管紧张素Ⅱ（AngⅡ）、内皮素-1（ET-1）、一氧化氮（NO）、血管内皮生长因子（VEGF）]。观察两组不良反应。结果 研究组总有效率高于对照组（P＜0.05）；治疗后，研究组中医证候积分较对照组明显降低（P＜0.05）；治疗后，研究组CO、LVFS、LVEF、较对照组明显升高，LVEDD、IVST、LVPWT、LVMI较对照组明显降低（P＜0.05）；治疗后，研究组血清TNF-α、IL-6、SAA水平较对照组明显降低（P＜0.05）；治疗后，研究组AngⅡ、ET-1水平较对照组明显降低，NO、VEGF水平较对照组明显升高（P＜0.05）；两组治疗后均无新发症状及明显不良反应。结论 芪苈强心胶囊联合常规西药治疗cCHF患者的疗效显著，可增强心功能，延缓心室重塑，并可减轻炎症反应，改善血管内皮功能。

目的 分析基于微信平台步行运动训练对慢性充血性心力衰竭(CHF)患者心脏康复水平的影响。方法 本次研究对象来源于梅州市中医医院一内科2020年11月—2021年12月住院的90例CHF患者,根据随机数字表法分组(每组n=45),对比组给予常规药物治疗,观察组在对比组基础上给予基于微信平台步行运动训练治疗,对比两组临床疗效、心脏功能指标、血清NT-proBNP、D-D、6分钟步行距离、日常生活能力评分、明尼苏达心力衰竭生活质量调查表(MLHFQ)评分。结果 观察组临床总有效率(95.56%)高于对比组(66.67%),观察组治疗后左心室舒张末期内径、左心室收缩末期内径均低于对比组,观察组治疗后左室射血分数高于对比组,观察组治疗后血清NT-proBNP、D-D均低于对比组,观察组治疗后6分钟步行距离、日常生活能力评分均高于对比组,观察组治疗后MLHFQ评分低于对比组,P＜0.05(差异均具有统计学意义)。结论 基于微信平台步行运动训练可有效改善CHF患者心功能,抑制NT-proBNP、D-D高表达,提高日常生活能力、生存质量。

Objective To analyze the effect of walking training through Wechat on cardiac rehabilitation of chronic congestive heart failure (CHF) patients. Methods A total of 90 patients with CHF hospitalized in the First Internal Medicine Department of Meizhou Traditional Chinese Medicine Hospital from November 2020 to December 2021 were enrolled in this study. They were divided into two groups according to the random number table method (45 patients in each group).The control group was given routine drug treatment,and the observation group was given walking training through Wechat on the basis of control group. The clinical efficacy,cardiac function indexes,serum NT-proBNP,D-D levels,6-minute walking distance,ability of daily life (ADL) score and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared between two groups. Results The total clinical effective rate of the observation group (95.56%) was higher than that of the control group (66.67%),the LVEDd and LVESd of the observation group were lower than those of the control group after treatment,the LVEF of the observation group was higher than that of the control group after treatment,the serum NT-proBNP and D-D levels of the observation group were lower than those of the control group after treatment,the 6-minute walking distance and ADL score of the observation group were higher than those of the control group after treatment,and the MLHFQ score of the observation group was lower than that of the control group after treatment,P<0.05 (the difference was statistically significant).Conclusions Walking training by Wechat could effectively improve the cardiac function of CHF patients,inhibit the high expression of NT proBNP and D-D,and improve the ability of daily living and quality of life.