目的 研究參附注射液聯(lián)合布美他尼注射液治療慢性充血性心力衰竭的臨床療效。方法 選取2018年1月—2022年10月無錫市中醫(yī)醫(yī)院收治的90例充血性心力衰竭患者，通過隨機數(shù)字表法將所有患者分為對照組和治療組，每組各45例。對照組靜脈滴注布美他尼注射液，2 mg置于250 mL 0.9%氯化鈉注射液中稀釋，滴注時間30～60 min，1次/d。治療組在對照組基礎(chǔ)上靜脈滴注參附注射液，40 mL置于250 mL 5%葡萄糖注射液中稀釋，滴注時間30～60 min，1次/d。兩組患者均連續(xù)治療10 d。觀察兩組的臨床療效，比較兩組患者呼吸機輔助通氣時間、心功能指標和血清腦鈉肽（BNP）、N末端B型利尿鈉肽原（NT-proBNP）。結(jié)果 治療后，治療組的總有效率95.56%顯著高于對照組的總有效率82.22%（P＜0.05）。治療后，治療組無創(chuàng)呼吸輔助通氣時間明顯短于對照組，差異有統(tǒng)計學意義（P＜0.05）。治療后，兩組左心室收縮末期內(nèi)徑（LVESD）、左心室收縮末期容積（LVESV）均較治療前顯著降低，左心室射血分數(shù)（LVEF）較治療前明顯升高（P＜0.05），且治療組LVESD、LVESV低于對照組，LVEF高于對照組，兩組比較差異有統(tǒng)計學意義（P＜0.05）。治療后，兩組血清BNP、NT-proBNP水平均較治療前明顯降低（P＜0.05），且治療組血清BNP、NT-proBNP水平明顯低于對照組，兩組比較差異有統(tǒng)計學意義（P＜0.05）。結(jié)論 參附注射液聯(lián)合布美他尼注射液治療充血性心力衰竭的療效確切，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）急診醫(yī)學研究專項基金（R201931）