目的 觀察注射用益氣復(fù)脈（凍干）治療老年冠心病合并慢性心力衰竭（CHF）伴低血壓患者的臨床療效及安全性。方法 回顧性收集2018年2月—2022年2月在貴州醫(yī)科大學(xué)附屬醫(yī)院中醫(yī)科住院的老年冠心病合并CHF伴低血壓患者90例為研究對(duì)象，根據(jù)治療方案不同分為對(duì)照組和試驗(yàn)組，每組各45例。對(duì)照組患者僅行抗心衰治療，試驗(yàn)組在對(duì)照組基礎(chǔ)上給予注射用益氣復(fù)脈（凍干）5.2 g用5%葡萄糖注射液或0.9%氯化鈉注射液250 mL溶解，靜脈滴注，每天1次，連續(xù)使用14 d。治療后觀察兩組的臨床療效，比較兩組患者治療前后心功能指標(biāo)［左室射血分?jǐn)?shù)（LVEF）、氨基端前心鈉肽（NT-proBNP）、6 min步行試驗(yàn)距離（6MWD）］和血壓水平。觀察治療期間兩組不良反應(yīng)發(fā)生情況。結(jié)果 治療后，試驗(yàn)組總有效率為95.56%，顯著高于對(duì)照組的84.44%（P＜0.05）。治療前兩組患者LVEF、NT-proBNP、6MWD比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療后兩組患者LVEF和6MWD均較本組治療前顯著增加（P＜0.05），NT-proBNP均較本組治療前顯著降低（P＜0.05），且試驗(yàn)組LVEF和6MWD顯著高于對(duì)照組（P＜0.05），NT-proBNP顯著低于對(duì)照組（P＜0.05）。治療前兩組患者平均收縮壓和舒張壓比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療后，兩組患者平均收縮壓和舒張壓均較本組治療前顯著升高（P＜0.05），且試驗(yàn)組治療后平均收縮壓和舒張壓均顯著高于對(duì)照組（P＜0.05）。治療期間對(duì)照組不良反應(yīng)發(fā)生率為11.11%，試驗(yàn)組不良反應(yīng)發(fā)生率為6.67%，兩組比較，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。結(jié)論 注射用益氣復(fù)脈（凍干）治療老年冠心病合并CHF伴低血壓患者臨床療效肯定，改善患者心功能，并升壓平穩(wěn)，具有較高安全性。

Objective To observe the clinical efficacy and safety of Yiqi Fumai Lyophilized Injection in the treatment of coronary heart disease with chronic heart failure (CHF) and hypotension. Methods A total of 90 elderly patients with coronary heart disease with chronic heart failure (CHF) and hypotension hospitalized in the Department of Traditional Chinese Medicine of the Affiliated Hospital of Guizhou Medical University from February 2018 to February 2022 were retrospectively collected as the research objects. According to different treatment schemes, they were divided into the control group and the experimental group, with 45 cases in each group. Patients in the control group only received anti heart failure treatment (including sufficient rest, oxygen inhalation, correction of arrhythmia, control of blood pressure, and maintenance of electrolytes, application β-receptor blockers, angiotensin II receptor antagonists, angiotensin converting enzyme inhibitors, etc). On the basis of the control group, the patients in experimental group were given 5.2 g of Yiqi Fumai Lyophilized Injection, dissolved in 250 mL of 5% Glucose Injection or 0.9% Sodium Chloride Injection, intravenous drip once a day, for 14 consecutive days. After 14 days of treatment the clinical efficacy of the two groups was observed, and the heart function indexes [(left ventricular ejection fraction (LVEF), N-terminal fragment of brain natriuretic peptide (NT-proBNP), and 6-minute walk test distance (6MWD)] and blood pressure were compared between the two groups before and after treatment. The occurrence of adverse reactions in both groups during the treatment period were observed. Results After 14 days of treatment, the total effective rate of the experimental group was 95.56%, significantly higher than 84.44% in the control group (P＜0.05). There was no statistically significant difference in LVEF, NT-proBNP, and 6MWD between the two groups of patients before treatment (P＞0.05). After treatment, LVEF and 6MWD in both groups of patients significantly increased compared to before treatment in same group (P＜0.05), while NT-proBNP significantly decreased compared to before treatment in same group (P＜0.05). LVEF and 6MWD in the experimental group were significantly higher than those in the control group (P＜0.05), while NT-proBNP was significantly lower than those in the control group (P＜0.05). There was no statistically significant difference in average systolic and diastolic blood pressure between the two groups of patients before treatment (P＞0.05). After After 14 days of treatment, the average systolic and diastolic blood pressure of both groups of patients significantly increased compared to before treatment in same group (P＜0.05), and the average systolic and diastolic blood pressure of the experimental group after treatment was significantly higher than that of the control group (P＜0.05). During the treatment period, the incidence of adverse reactions in the control group was 11.11%, while the incidence of adverse reactions in the experimental group was 6.67%. The difference between the two groups was statistically significant (P＜0.05). Conclusion The clinical efficacy of Yiqi Fumai Lyophilized Injection in the treatment of elderly patients with coronary heart disease complicated with CHF and hypotension is positive, and it can improve the patients' cardiac function, stabilize the pressure rise, and has high safety.

R972