目的 观察参附强心丸联合盐酸贝那普利治疗老年高血压合并心力衰竭的临床疗效和安全性。方法 将64例老年高血压合并心力衰竭患者随机分为治疗组和对照组，每组各32例。对照组在常规治疗基础上口服盐酸贝那普利片10 mg/次，1次/d；治疗组在对照组基础上口服参附强心丸6 g/次，2次/d。两组患者均服药持续性治疗8周。治疗结束后，观察两组患者的中医症候疗效、心力衰竭疗效、心功能指标。结果 治疗后，治疗组和对照组在中医症候疗效方面的总有效率分别为90.63%、71.88%，差异有统计学意义（P<0.05）；两组在心力衰竭疗效方面总有效率分别为87.5%、71.9%，治疗组疗效优于对照组，差异有统计学意义（P<0.05）；治疗组左室射血分数（LVEF）均较治疗前增加，左室舒张末内径（LVEDD）较治疗前缩小，血浆脑钠素（BNP）与治疗前比较有明显下降，治疗组疗效明显优于对照组，差异有统计学意义（P<0.05）。结论 参附强心丸联合盐酸贝那普利是治疗老年高血压合并心力衰竭患者的有效方法，值得临床推广。

Objective To observe the efficacy and safety of Shenfu Qiangxin Pills combined with benazepril hydrochloride in treatment of senile hypertension with heart failure. Methods Patients (64 cases) with senile hypertension with heart failure were randomly divided into treatment group and control group. Each had 32 cases. On the basis of conventional treatment, the patients in the control group were given Benazepril Hydrochloride Tablets 10 mg/time, once daily; The patients in the treatment group were given Shenfu Qiangxin Pills 6 g/time, twice daily on the basis of the control group. The patients in the two groups were taken continuous treatment for 8 weeks. After the treatment, traditional Chinese medicine syndrome efficacy, heart failure efficacy, and cardiac function indexes were observed. Results After the treatment, the total effective rates for the patients in both the treatment and control groups were 90.63% and 71.88% in traditional Chinese medicine syndrome efficacy with significant difference (P < 0.05). The total effective rates for the patients in both groups were 87.5% and 71.9% in heart failure efficacy, and the treatment group was better than the control group with significant difference (P < 0.05). Compared with the control group, left ventricular ejection fraction (LVEF) increased; Left ventricular end diastolic diameter (LVDD) lessened; Brain natriuretic peptide (BNP) decreased and the treatment group was better than the control group with significant difference (P < 0.05). Conclusion Shenfu Qiangxin Pills combined with benazepril hydrochloride is effective in the treatment of senile hypertension with heart failure, which is worthy of clinical application.

天津市卫生局中医、中西医结合科研自筹基金课题（200020）