【摘要】 目的：探索参附注射液联合达格列净治疗难治性心力衰竭患者的临床疗效及安全性。方法：选取2021年1月至2022年3月在九江市第一人民医院难治性心力衰竭患者62例，按随机数字表法将62例患者随机分为对照组和观察组各31例。两组患者均严格按照指南进行综合评估、干预危险因素和纠正诱发因素。对照组给予达格列净及其他基础的抗心力衰竭药物治疗。观察组在此基础上加用参附注射液治疗。观察两组患者临床疗效、心脏彩超指标[左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室舒张末容积(LVEDV)、每搏输出量(SV)]，NT-proBNP和炎性因子(hs-CRP、IL-6)水平。结果：经过1个疗程的治疗后，观察组的总有效率大于对照组(90.32% vs 67.74%，P<0.05)；观察组患者LVEDD、LVEDV、NT-proBNP下降幅度大于对照组(P<0.05)，LVEF、SV升高幅度大于对照组 (P<0.05)，hs-CRP、IL-6下降幅度大于对照组(P<0.05)。结论：在规范化心力衰竭治疗的基础上，采用参附注射液联合达格列净治疗难治性心力衰竭，其心功能改善明显、临床疗效显著，且安全性较好，为难治性心力衰竭的药物治疗提供了新思路，值得临床推广应用。更多还原

【Abstract】 Objective:To explore the clinical efficacy and safety of Shenfu injection combined with dapagliflozin in the treatment of patients with refractory heart failure.Methods:62 patients with refractory heart failure who were hospitalized in the Jiujiang First People’s Hospital from January 2021 to March 2022 were selected as the research objects,and the 62 patients were randomly divided into the control group and the observation group according to the random number table method,31 patients in each group.Both groups of patients were strictly in accordance with the guidelines for comprehensive assessment,intervention of risk factors and correction of predisposing factors.The control group was treated with dapagliflozin and other basic anti-heart failure drugs,and the observation group was treated with shenfu injection on this basis.The clinical efficacy,cardiac color doppler ultrasound indexes left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),left ventricular end-diastolic volume (LVEDV),stroke volume (SV),N-terminal B The levels of NT-proBNP and inflammatory factors (hs-CRP,IL-6) in 2 groups were observed.Results:After one course of treatment,the total effective rate of the observation group was higher than that of the control group (90.32% vs 67.74%,P<0.05);the decrease of LVEDD,LVEDV,NT-proBNP of the observation group was greater than that of the control group (P<0.05),LVEF,SV increased more than the control group (P<0.05),hs-CRP,IL-6 decreased more than the control group (P<0.05).Conclusion:On the basis of standardized treatment of heart failure,shenfu injection combined with dapagliflozin in the treatment of refractory heart failure has obvious improvement in cardiac function,significant clinical efficacy,and good safety,which is the drug treatment for refractory heart failure.It provides new ideas and is worthy of clinical application.更多还原