目的 探讨注射用益气复脉（冻干，YQFM）联合酒石酸美托洛尔对2型糖尿病（T2DM）合并心力衰竭（HF）患者的疗效。方法 回顾性选取山西省中医院2021年6月—2023年6月收治的200例T2DM合并HF患者作为研究对象，根据治疗方案不同分为对照组和试验组，对照组采用二甲双胍常规降糖和酒石酸美托洛尔抗HF治疗，试验组在对照组的基础上加用YQFM。对比治疗前后两组患者的血糖水平、心功能指标、心肌标志物N末端B型脑钠肽前体（NT-proBNP）、6 min步行试验距离（6MWD），观察两组不良反应情况。结果 治疗前，两组患者的各项基线资料比较无统计学意义。治疗后试验组总有效率（91.0%）明显高于对照组（79.0%）（P＜0.05）；治疗前，两组患者的血糖水平、心功能指标、心肌标志物水平、运动耐力等指标比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者的空腹血糖（FPG）、餐后2 h血糖（2 h PG）水平和糖化血红蛋白（HbA1c）水平均明显低于本组治疗前（P＜0.05），左室射血分数（LVEF）水平均高于本组治疗前，左室舒张末期内径（LVEDd）和左室收缩末期内径（LVEDs）水平均明显低于本组治疗前（P＜0.05），血清NT-proBNP水平均低于本组治疗前（P＜0.05），6MWD水平明显高于本组治疗前（P＜0.05）。治疗后，试验组与对照组比较，上述各项血糖指标、心功能指标、运动耐力等的改善效果均更显著（P＜0.05）。治疗期间两组患者出现的不良反应有胸闷、心慌、皮疹和胃肠道轻微不适等，均未出现明显不适和过敏情况，两组不良反应总发生率比较，差异不显著（P＞0.05）。结论 YQFM联合酒石酸美托洛尔治疗T2DM合并HF患者能发挥协同治疗作用，可显著改善患者心功能、提高运动耐量，且安全性好。

Objective To explore the efficacy of Yiqi Fumai Lyophilized Injection (YQFM) combined with metoprolol tartrate in patients with type 2 diabetes mellitus (T2DM) combined with heart failure (HF). Methods A total of 200 patients with T2DM combined with HF admitted to Shanxi Hospital of Traditional Chinese Medicine from June 2021 to June 2023 were retrospectively selected as the study subjects, and were divided into a control group and an experimental group according to the different treatment protocols. Patients in the control group were treated with metformin for conventional glucose lowering and metoprolol tartrate for anti-HF treatment, and patients in the experimental group were treated with YQFM on the basis of the control group. Blood glucose level, cardiac function indexes, myocardial markers N-terminal B-type brain natriuretic peptide precursor (NT-proBNP), 6 min walking test distance (6MWD) were detected in the two groups before and after the treatment, and the adverse reactions were observed in the two groups. Results Before treatment, there was no statistical significance in the comparison of various baseline data between the two groups. After treatment, the total effective rate of the experimental group (91.0%) was significantly higher than that of the control group (79.0%) (P < 0.05). Before treatment, there was no statistically significant difference in the comparison of blood glucose levels, cardiac function indexes, myocardial marker levels, exercise endurance, etc. between the two groups of patients (P > 0.05). After treatment, the fasting glucose (FPG), 2 h postprandial glucose (2 h PG) and glycosylated hemoglobin (HbA1c) levels of the two groups were significantly lower than those before the treatment in same group (P < 0.05), the levels of left ventricular ejection fraction (LVEF) were higher than those before the treatment in same group, the levels of left ventricular end-diastolic internal diameter (LVEDd) and left ventricular end-systolic internal diameters (LVEDs) were significantly lower than those before the treatment in same group (P < 0.05), serum NT-proBNP levels were lower than before treatment in same group (P < 0.05), and 6MWD levels were significantly higher than before treatment in same group (P < 0.05). After treatment, the experimental group compared with the control group, the improvement effect of all the above blood glucose indexes, cardiac function indexes, exercise endurance, etc. was more significant (P < 0.05). During the treatment period, the adverse reactions of the two groups of patients included chest tightness, panic, skin rash and slight discomfort in the gastrointestinal tract, and so on, and no obvious discomfort or allergy occurred, and the difference between the total incidence of adverse reactions in the two groups was insignificant when compared with the control group (P > 0.05). Conclusion YQFM combined with metoprolol tartrate in the treatment of T2DM combined with HF patients can play a synergistic therapeutic effect, which can significantly improve the patients' cardiac function, improve exercise tolerance, and have good safety.

R972