目的 研究参附注射液联合布美他尼注射液治疗慢性充血性心力衰竭的临床疗效。方法 选取2018年1月—2022年10月无锡市中医医院收治的90例充血性心力衰竭患者，通过随机数字表法将所有患者分为对照组和治疗组，每组各45例。对照组静脉滴注布美他尼注射液，2 mg置于250 mL 0.9%氯化钠注射液中稀释，滴注时间30～60 min，1次/d。治疗组在对照组基础上静脉滴注参附注射液，40 mL置于250 mL 5%葡萄糖注射液中稀释，滴注时间30～60 min，1次/d。两组患者均连续治疗10 d。观察两组的临床疗效，比较两组患者呼吸机辅助通气时间、心功能指标和血清脑钠肽（BNP）、N末端B型利尿钠肽原（NT-proBNP）。结果 治疗后，治疗组的总有效率95.56%显著高于对照组的总有效率82.22%（P＜0.05）。治疗后，治疗组无创呼吸辅助通气时间明显短于对照组，差异有统计学意义（P＜0.05）。治疗后，两组左心室收缩末期内径（LVESD）、左心室收缩末期容积（LVESV）均较治疗前显著降低，左心室射血分数（LVEF）较治疗前明显升高（P＜0.05），且治疗组LVESD、LVESV低于对照组，LVEF高于对照组，两组比较差异有统计学意义（P＜0.05）。治疗后，两组血清BNP、NT-proBNP水平均较治疗前明显降低（P＜0.05），且治疗组血清BNP、NT-proBNP水平明显低于对照组，两组比较差异有统计学意义（P＜0.05）。结论 参附注射液联合布美他尼注射液治疗充血性心力衰竭的疗效确切，可改善患者心功能，降低血清BNP、NT-proBNP水平，安全性良好。

Objective To study the efficacy of Shenfu Injection combined with Bumetanide Injection in treatment of chronic congestive heart failure. Methods Patients (90 cases) with chronic congestive heart failure in Wuxi Hospital of Traditional Chinese Medicine from January 2018 to October 2022 were divided into control and treatment groups according to the random number table method, and each group had 45 cases. Patients in the control group were iv administered with Bumetanide Injection, 2 mg added into 0.9% sodium chloride injection 250 mL, dropping time 30-60 min, once daily. Patients in the treatment group were iv administered with Bumetanide Injection on the basis of the control group, 40 mL add into 250 mL 5% glucose injection, dropping time 30-60 min, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and the time for ventilator assisted ventilation time, cardiac function indicator, the levels of BNP and NT-proBNP in two groups were compared. Results After treatment, the total effective rate of 95.56% in the treatment group was significantly higher than 82.22% in the control group (P < 0.05). After treatment, ventilator assisted ventilation time in the treatment group was significantly shorter than that in the control group, with a statistically significant difference (P < 0.05). After treatment, LVESD and LVESV in two groups were significantly reduced compared to before treatment, but LVEF in two groups was significantly increased (P < 0.05). LVESD and LVESV in the treatment group were lower than those in the control group, but LVEF in the treatment group was higher than those in the control group, and the difference between two groups was statistically significant (P < 0.05). After treatment, the serum levels of BNP and NT-proBNP in two groups were significantly lower than before treatment (P < 0.05), and the serum levels of BNP and NT-proBNP in the treatment group were significantly lower than those in the control group, and the difference between two groups was statistically significant (P < 0.05). Conclusion Shenfu Injection combined with Bumetanide Injection is effective in treatment of chronic congestive heart failure, which can improve cardiac function, reduce the serum levels of BNP and NT-proBNP, with good safety.

睿E（睿意）急诊医学研究专项基金（R201931）