目的 研究参附强心丸联合注射用重组人脑利钠肽治疗充血性心力衰竭的临床疗效。方法 选取2018年1月—2020年1月在天津市北辰区中医医院进行治疗的94例充血性心力衰竭患者，将所有患者随机分为对照组和治疗组，每组各47例。对照组患者给予注射用重组人脑利钠肽，首先1.5 μg/kg静脉冲击，然后以0.007 5 μg/（kg·min）连续静脉滴注；治疗组患者在对照组的基础上口服参附强心丸，1袋/次，3次/d。两组患者均接受治疗2周。观察两组的临床疗效，比较两组的Lee氏心衰评分、左心室功能、血清心肌酶、炎性因子水平及血清内皮素-1（ET-1）、一氧化氮（NO）和血管性血友病因子（vWF）水平。结果 治疗后，治疗组总有效率（93.62%）显著高于对照组（78.72%）（P<0.05）。治疗后，两组Lee氏心衰评分显著降低（P<0.05）；且治疗组Lee氏心衰评分降低较明显（P<0.05）。治疗后，两组左心室收缩末期容积（LVESV）明显降低，心输出量（CO）和左心室射血分数（LVEF）明显升高（P<0.05），且治疗组LVESV明显低于对照组，CO和LVEF明显高于对照组（P<0.05）。治疗后，两组血清心肌肌钙蛋白T（cTnT）、B型利钠肽（BNP）水平显著降低（P<0.05）；且治疗组血清cTnT、BNP水平降低较明显（P<0.05）。治疗后，两组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平显著降低（P<0.05）；且治疗组血清TNF-α、IL-6和IL-10水平降低较明显（P<0.05）。治疗后，两组血清ET-1、NO和vWF水平显著降低（P<0.05）；且治疗组血清ET-1、NO和vWF水平降低较明显（P<0.05）。结论 参附强心丸联合注射用重组人脑利钠肽治疗充血性心力衰竭具有较好的疗效，能够改善患者心功能指标和血清因子水平，安全性好。

Objective To study the efficacy of Shenfu Qiangxin Pills combined with Recombinant Human Brain Natriuretic Peptide for injection in treatment of congestive heart failure. Methods Patients (94 cases) with congestive heart failure in Beichen District Hospital of Traditional Chinese medicine from January 2018 to January 2020 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were given Recombinant Human Brain Natriuretic Peptide for injection, firstly intravenous infusion was carried out at 1.5 μg/kg, and then continuous intravenous infusion with 0.007 5 μg/(kg·min). Patients in the treatment group were po administered with Shenfu Qiangxin Pills on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and Lee's heart failure score, left ventricular function, serum myocardial enzyme, inflammatory factor levels, the serum levels of ET-1, NO, and vWF in two groups were compared. Results After treatment, the total effective rate of the treatment group (93.62%) was significantly higher than that of the control group (78.72%) (P<0.05). After treatment, Lee's heart failure score of the two groups was significantly decreased (P<0.05), and Lee's heart failure score of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, the LVESV in two groups was significantly decreased, but CO and the LVEF in two groups were significantly increased (P<0.05), and the LVESV in the treatment group was significantly lower than that in the control group, but CO and the LVEF were significantly higher than those in the control group (P<0.05). After treatment, the serum levels of cTnT and BNP in two groups were significantly decreased (P<0.05), and the serum levels of cTnT and BNP in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum levels of TNF-α, IL-6, and IL-10 in two groups were significantly decreased (P<0.05), and the serum levels of TNF-α, IL-6, and IL-10 in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the serum levels of ET-1, NO, and vWF in two groups were significantly decreased (P<0.05), and the serum levels of ET-1, NO, and vWF in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Shenfu Qiangxin Pill combined with Recombinant Human Brain Natriuretic Peptide for injection in the treatment of congestive heart failure has a good therapeutic effect, can improve the cardiac function index and serum factor level of patients, with good safety.

R972