目的 探討大株紅景天注射液聯(lián)合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2015年10月-2017年8月在陜西中醫(yī)藥大學(xué)附屬醫(yī)院接受治療的充血性心力衰竭患者148例，隨機(jī)分成對照組（74例）和治療組（74例）。對照組靜脈滴注注射用重組人腦利鈉肽，首次靜脈沖擊1.5μg/kg，然后保持滴速7.5 μg/（kg·min）。治療組在對照組的基礎(chǔ)上靜脈滴注大株紅景天注射液，10 mL加入生理鹽水250 mL，1次/d。兩組患者均連續(xù)治療2周。觀察兩組的臨床療效，比較治療前后兩組患者超聲心動圖指標(biāo)、血清內(nèi)皮素-1（ET-1）、N-末端腦鈉肽前體（NT-proBNP）和腫瘤壞死因子-α（TNF-α）水平以及6 min步行距離（6MWT）。結(jié)果 治療后，對照組的臨床總有效率為79.73%，顯著低于治療組的93.24%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組收縮末期內(nèi)徑（LVESD）和左室舒張末期內(nèi)徑（LVEDD）均顯著降低，心指數(shù)（CI）和左心室射血分?jǐn)?shù)（LVEF）均顯著升高，同組比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組患者超聲心動圖指標(biāo)改善情況明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者血清ET-1、NT-proBNP、TNF-α水平明顯降低，6MWT明顯增加，同組比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組患者血清標(biāo)志物水平和6MWT明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 大株紅景天注射液聯(lián)合重組人腦利鈉肽可顯著緩解充血性心力衰竭患者心衰癥狀，改善心功能，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of Sofren Injection combined with recombinant human brain natriuretic peptide in treatment of congestive heart failure. Methods Patients (148 cases) with congestive heart failure in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from October 2015 to August 2017 were randomly divided into control (74 cases) and treatment (74 cases) groups. Patients in the control group were iv administered with Recombinant Human Brain Natriuretic Peptide for injection, the first dose of intravenous pulse was 1.5 μg/kg, then at the rate of 7.5 μg/(kg·min). Patients in the treatment group were iv administered with Sofren Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, echocardiographic indexes, ET-1, NT-proBNP, TNF-α and 6MWT in two groups before and after treatment were compared. Results After treatment, clinical efficacy in the control group was 79.73%, which were significantly lower than 93.24% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the LVESD and LVEDD in two groups were significantly decreased, but the CI and LVEF was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of echocardiographic indexes in the treatment group was significantly better than that in the control group, with significant difference between two groups (P<0.05). After treatment, the ET-1, NT-proBNP, and TNF-α levels in two groups were significantly decreased, 6MWT was significantly increased, there were differences in the same group (P<0.05). And these serum markers levels and 6MWT in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Sofren Injection combined with recombinant human brain natriuretic peptide can significantly relieve heart failure symptoms and improve the cardiac function in treatment of congestive heart failure, which has a certain clinical application value.