目的 探讨注射用益气复脉（冻干）联合比索洛尔治疗充血性心力衰竭患者的临床疗效。方法 选取2020年1月—2020年8月在天津泰达医院治疗的106例充血性心力衰竭患者，随机分为对照组（53例）和治疗组（53例）。对照组患者口服富马酸比索洛尔片，5 mg/次，1次/d。治疗组患者在对照组的基础上静脉滴注注射用益气复脉（冻干），用0.9%氯化钠注射液250 mL稀释，8瓶/次，1次/d。两组患者均治疗2周。观察两组的临床疗效，比较两组患者治疗前后心功能指标、6 min步行距离（6MWD）、炎症因子水平、氧化应激指标水平、基质金属蛋白酶相关指标的水平变化。结果 治疗后，治疗组总有效率94.34%，显著高于对照组的86.79%（P<0.05）。治疗后，两组患者左心射血分数（LVEF）、每搏输出量（SV）、心输出量（CO）、6MWT水平较治疗前均有显著提高，但氨基末端脑钠肽前体（NT-proBNP）水平较治疗前明显下降（P<0.05）；治疗后，治疗组上述指标改善的更明显（P<0.05）。治疗后，两组患者肿瘤坏死因子-α（TNF-α）、超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）水平较治疗前均有显著降低（P<0.05）；且治疗后治疗组患者血清炎症因子水平降低更明显（P<0.05）。治疗后，两组患者丙二醛（MDA）水平较治疗前均显著下降，但超氧化物歧化酶（SOD）水平较治疗前均显著升高（P<0.05）；且治疗组氧化应激指标水平改善更明显（P<0.05）。治疗后，两组患者基质金属蛋白酶2（MMP-2）、基质金属蛋白酶9（MMP-9）水平较治疗前均显著下降，但金属蛋白酶组织抑制因子1（TIMP-1）较治疗前均显著升高（P<0.05）；且治疗组患者上述指标改善更明显（P<0.05）。结论 注射用益气复脉（冻干）联合比索洛尔治疗充血性心力衰竭具有较佳的临床疗效，可显著改善充血性心力衰竭患者的心功能，抑制炎症因子，减轻氧化应激反应，值得临床广泛应用。

Objective To investigate the clinical effect of Yiqi Fumai Injection (freezed-dried) combined with bisoprolol in treatment of congestive heart failure. Methods A total of 106 patients with congestive heart failure who were treated in Tianjin TEDA Hospital from January 2020 to August 2020 were selected and randomly divided into control group (53 cases) and treatment group (53 cases). Patients in the control group were po administered with Bisoprolol Fumarate Tablets, 5 mg/time, once daily. Patients in the treatment group were iv administered with Yiqi Fumai Injection (freeze-dried) on the basis of the control group, 8 bottles/time, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of cardiac function indexes, 6-min walking distance (6MWD), inflammatory factors, oxidative stress indexes and matrix metalloproteinase-related indexes were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 94.34%, which was significantly higher than that of the control group (86.79%, P<0.05). After treatment, the left cardiac ejection fraction (LVEF), stroke output (SV), cardiac output (CO), and 6MWT levels in two groups were significantly increased compared with before treatment, but the amino-terminal brain natriuretic peptide precursor (NT-proBNP) levels were significantly decreased compared with before treatment (P<0.05). After treatment, the above indexes in the treatment group were improved more obviously (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the level of serum inflammatory factors in the treatment group were decreased more significantly (P<0.05). After treatment, malondialdehyde (MDA) level in two groups was significantly decreased, but superoxide dismutase (SOD) level was significantly increased (P<0.05). Serum oxidative stress indexes in treatment group were significantly improved (P<0.05). After treatment, the levels of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in two groups were significantly decreased compared with before treatment, but the tissue inhibitor 1 (TIMP-1) of metalloproteinase-1 was significantly increased (P<0.05). The above indexes in the treatment group were improved more significantly (P<0.05). Conclusion Yiqi Fumai Injection (freezed-dried) combined with bisoprolol has a good clinical effect in treatment of congestive heart failure, and can significantly improve the cardiac function of congestive heart failure, and can inhibit inflammatory factors, and also can reduce oxidative stress response, which is worthy of extensive clinical application.

R972