目的 研究參附強心丸聯(lián)合注射用重組人腦利鈉肽治療充血性心力衰竭的臨床療效。方法 選取2018年1月—2020年1月在天津市北辰區(qū)中醫(yī)醫(yī)院進行治療的94例充血性心力衰竭患者，將所有患者隨機分為對照組和治療組，每組各47例。對照組患者給予注射用重組人腦利鈉肽，首先1.5 μg/kg靜脈沖擊，然后以0.007 5 μg/（kg·min）連續(xù)靜脈滴注；治療組患者在對照組的基礎(chǔ)上口服參附強心丸，1袋/次，3次/d。兩組患者均接受治療2周。觀察兩組的臨床療效，比較兩組的Lee氏心衰評分、左心室功能、血清心肌酶、炎性因子水平及血清內(nèi)皮素-1（ET-1）、一氧化氮（NO）和血管性血友病因子（vWF）水平。結(jié)果 治療后，治療組總有效率（93.62%）顯著高于對照組（78.72%）（P<0.05）。治療后，兩組Lee氏心衰評分顯著降低（P<0.05）；且治療組Lee氏心衰評分降低較明顯（P<0.05）。治療后，兩組左心室收縮末期容積（LVESV）明顯降低，心輸出量（CO）和左心室射血分?jǐn)?shù)（LVEF）明顯升高（P<0.05），且治療組LVESV明顯低于對照組，CO和LVEF明顯高于對照組（P<0.05）。治療后，兩組血清心肌肌鈣蛋白T（cTnT）、B型利鈉肽（BNP）水平顯著降低（P<0.05）；且治療組血清cTnT、BNP水平降低較明顯（P<0.05）。治療后，兩組血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）和白細(xì)胞介素-10（IL-10）水平顯著降低（P<0.05）；且治療組血清TNF-α、IL-6和IL-10水平降低較明顯（P<0.05）。治療后，兩組血清ET-1、NO和vWF水平顯著降低（P<0.05）；且治療組血清ET-1、NO和vWF水平降低較明顯（P<0.05）。結(jié)論 參附強心丸聯(lián)合注射用重組人腦利鈉肽治療充血性心力衰竭具有較好的療效，能夠改善患者心功能指標(biāo)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