目的 探討注射用益氣復(fù)脈（凍干）聯(lián)合比索洛爾治療充血性心力衰竭患者的臨床療效。方法 選取2020年1月—2020年8月在天津泰達(dá)醫(yī)院治療的106例充血性心力衰竭患者，隨機(jī)分為對(duì)照組（53例）和治療組（53例）。對(duì)照組患者口服富馬酸比索洛爾片，5 mg/次，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上靜脈滴注注射用益氣復(fù)脈（凍干），用0.9%氯化鈉注射液250 mL稀釋，8瓶/次，1次/d。兩組患者均治療2周。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)、6 min步行距離（6MWD）、炎癥因子水平、氧化應(yīng)激指標(biāo)水平、基質(zhì)金屬蛋白酶相關(guān)指標(biāo)的水平變化。結(jié)果 治療后，治療組總有效率94.34%，顯著高于對(duì)照組的86.79%（P<0.05）。治療后，兩組患者左心射血分?jǐn)?shù)（LVEF）、每搏輸出量（SV）、心輸出量（CO）、6MWT水平較治療前均有顯著提高，但氨基末端腦鈉肽前體（NT-proBNP）水平較治療前明顯下降（P<0.05）；治療后，治療組上述指標(biāo)改善的更明顯（P<0.05）。治療后，兩組患者腫瘤壞死因子-α（TNF-α）、超敏C-反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）水平較治療前均有顯著降低（P<0.05）；且治療后治療組患者血清炎癥因子水平降低更明顯（P<0.05）。治療后，兩組患者丙二醛（MDA）水平較治療前均顯著下降，但超氧化物歧化酶（SOD）水平較治療前均顯著升高（P<0.05）；且治療組氧化應(yīng)激指標(biāo)水平改善更明顯（P<0.05）。治療后，兩組患者基質(zhì)金屬蛋白酶2（MMP-2）、基質(zhì)金屬蛋白酶9（MMP-9）水平較治療前均顯著下降，但金屬蛋白酶組織抑制因子1（TIMP-1）較治療前均顯著升高（P<0.05）；且治療組患者上述指標(biāo)改善更明顯（P<0.05）。結(jié)論 注射用益氣復(fù)脈（凍干）聯(lián)合比索洛爾治療充血性心力衰竭具有較佳的臨床療效，可顯著改善充血性心力衰竭患者的心功能，抑制炎癥因子，減輕氧化應(yīng)激反應(yīng)，值得臨床廣泛應(yīng)用。

Objective To investigate the clinical effect of Yiqi Fumai Injection (freezed-dried) combined with bisoprolol in treatment of congestive heart failure. Methods A total of 106 patients with congestive heart failure who were treated in Tianjin TEDA Hospital from January 2020 to August 2020 were selected and randomly divided into control group (53 cases) and treatment group (53 cases). Patients in the control group were po administered with Bisoprolol Fumarate Tablets, 5 mg/time, once daily. Patients in the treatment group were iv administered with Yiqi Fumai Injection (freeze-dried) on the basis of the control group, 8 bottles/time, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of cardiac function indexes, 6-min walking distance (6MWD), inflammatory factors, oxidative stress indexes and matrix metalloproteinase-related indexes were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 94.34%, which was significantly higher than that of the control group (86.79%, P<0.05). After treatment, the left cardiac ejection fraction (LVEF), stroke output (SV), cardiac output (CO), and 6MWT levels in two groups were significantly increased compared with before treatment, but the amino-terminal brain natriuretic peptide precursor (NT-proBNP) levels were significantly decreased compared with before treatment (P<0.05). After treatment, the above indexes in the treatment group were improved more obviously (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the level of serum inflammatory factors in the treatment group were decreased more significantly (P<0.05). After treatment, malondialdehyde (MDA) level in two groups was significantly decreased, but superoxide dismutase (SOD) level was significantly increased (P<0.05). Serum oxidative stress indexes in treatment group were significantly improved (P<0.05). After treatment, the levels of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in two groups were significantly decreased compared with before treatment, but the tissue inhibitor 1 (TIMP-1) of metalloproteinase-1 was significantly increased (P<0.05). The above indexes in the treatment group were improved more significantly (P<0.05). Conclusion Yiqi Fumai Injection (freezed-dried) combined with bisoprolol has a good clinical effect in treatment of congestive heart failure, and can significantly improve the cardiac function of congestive heart failure, and can inhibit inflammatory factors, and also can reduce oxidative stress response, which is worthy of extensive clinical application.

R972