目的 探討丹紅注射液聯(lián)合卡維地洛片治療心力衰竭的臨床療效。方法 選取2014年7月-2016年8月在陜西中醫(yī)藥大學(xué)附屬醫(yī)院進(jìn)行治療的心力衰竭患者150例，隨機(jī)分為對(duì)照組（75例）和治療組（75例）。對(duì)照組患者口服卡維地洛片，初始劑量5 mg/次，2次/d，服用5 d后以5 mg/d遞增，總量不超過(guò)50 mg/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注丹紅注射液，20 mL加入5%葡萄糖溶液250 mL，1次/d。兩組患者均連續(xù)治療4周。觀察兩組的臨床療效，比較治療前后兩組患者心功能指標(biāo)、血清細(xì)胞因子水平和血清氧化應(yīng)激指標(biāo)。結(jié)果 治療后，對(duì)照組臨床總有效率為82.67%，顯著低于治療組的97.33%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者左心室舒張末期內(nèi)徑（LVEDD）、左心室收縮末期容積（LVESV）和左心室收縮末期內(nèi)徑（LVESD）顯著降低，左室射血分?jǐn)?shù)（LVEF）明顯升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者心功能指標(biāo)比對(duì)照組改善更顯著（P<0.05）。治療后，兩組患者血清N末端前腦利鈉肽（NT-proBNP）、生長(zhǎng)分化因子-15（GDF-15）、β內(nèi)啡肽（β-EP）、細(xì)胞黏附分子-1（ICAM-1）水平均顯著降低，血管內(nèi)皮生長(zhǎng)因子（VEGF）和心肌營(yíng)養(yǎng)素1（CT-1）水平均升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述指標(biāo)改善后水平明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者血清超氧化物歧化酶（SOD）和總抗氧化能力（TAC）水平均明顯升高，丙二醛（MDA）和脂質(zhì)過(guò)氧化物（LPO）水平明顯降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者血清氧化應(yīng)激指標(biāo)顯著優(yōu)于對(duì)照組（P<0.05）。結(jié)論 丹紅注射液聯(lián)合卡維地洛片治療心力衰竭可有效改善心功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Danhong Injection combined with carvedilol in treatment of heart failure. Methods Patients (150 cases) with heart failure in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from July 2014 to August 2016 were randomly divided into control (75 cases) and treatment (75 cases) groups. Patients in the control group were po administered with Carvedilol Tablets, the initial dose was 5 mg/time, twice daily, then increased by 5 mg/d after 5 d, and the maximum dose was not more than 50 mg/d. Patients in the treatment group were iv administered with Danhong Injection on the basis of the control group, 20 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, cardiac function indexes, serum cytokines levels and serum oxidative stress indexes in two groups before and after treatment were compared. Results After treatment, clinical efficacy in the control group was 82.67%, which were significantly lower than 97.33% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the LVEDD, LVESV and LVESD in two groups was significantly decreased, but the LVEF was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement of cardiac function indexes in the treatment group was more significant than that in the control group (P<0.05). After treatment, the NT-proBNP, GDF-15, β-EP, and ICAM-1 levels in two groups were significantly decreased, but VEGF and CT-1 levels were significantly increased, and there were differences in the same group (P<0.05). And these indicators levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the SOD and TAC levels in two groups were significantly increased, but MDA and LPO levels were significantly decreased, and there were differences in the same group (P<0.05). And the serum oxidative stress indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Danhong Injection combined with carvedilol can effectively improve the cardiac function in treatment of heart failure, which has a certain clinical application value.