目的 探討注射用益氣復(fù)脈（凍干，YQFM）聯(lián)合酒石酸美托洛爾對2型糖尿?。═2DM）合并心力衰竭（HF）患者的療效。方法 回顧性選取山西省中醫(yī)院2021年6月—2023年6月收治的200例T2DM合并HF患者作為研究對象，根據(jù)治療方案不同分為對照組和試驗組，對照組采用二甲雙胍常規(guī)降糖和酒石酸美托洛爾抗HF治療，試驗組在對照組的基礎(chǔ)上加用YQFM。對比治療前后兩組患者的血糖水平、心功能指標(biāo)、心肌標(biāo)志物N末端B型腦鈉肽前體（NT-proBNP）、6 min步行試驗距離（6MWD），觀察兩組不良反應(yīng)情況。結(jié)果 治療前，兩組患者的各項基線資料比較無統(tǒng)計學(xué)意義。治療后試驗組總有效率（91.0%）明顯高于對照組（79.0%）（P＜0.05）；治療前，兩組患者的血糖水平、心功能指標(biāo)、心肌標(biāo)志物水平、運動耐力等指標(biāo)比較，差異均無統(tǒng)計學(xué)意義（P＞0.05）。治療后，兩組患者的空腹血糖（FPG）、餐后2 h血糖（2 h PG）水平和糖化血紅蛋白（HbA1c）水平均明顯低于本組治療前（P＜0.05），左室射血分?jǐn)?shù)（LVEF）水平均高于本組治療前，左室舒張末期內(nèi)徑（LVEDd）和左室收縮末期內(nèi)徑（LVEDs）水平均明顯低于本組治療前（P＜0.05），血清NT-proBNP水平均低于本組治療前（P＜0.05），6MWD水平明顯高于本組治療前（P＜0.05）。治療后，試驗組與對照組比較，上述各項血糖指標(biāo)、心功能指標(biāo)、運動耐力等的改善效果均更顯著（P＜0.05）。治療期間兩組患者出現(xiàn)的不良反應(yīng)有胸悶、心慌、皮疹和胃腸道輕微不適等，均未出現(xiàn)明顯不適和過敏情況，兩組不良反應(yīng)總發(fā)生率比較，差異不顯著（P＞0.05）。結(jié)論 YQFM聯(lián)合酒石酸美托洛爾治療T2DM合并HF患者能發(fā)揮協(xié)同治療作用，可顯著改善患者心功能、提高運動耐量，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