目的 观察温阳化饮方（熟附子、桂枝、党参、白术、茯苓、葶苈子等）联合西药常规治疗，对阳虚水泛 型老年慢性心力衰竭（Chronic heart failure，CHF）患者的临床疗效。方法 选取2021 年12 月～2022 年12 月在 汕头市澄海区人民医院接受治疗的120 例阳虚水泛型老年CHF 患者作为研究对象，随机分为对照组和观察组， 每组60 例。对照组给予西医常规治疗，观察组在对照组的治疗基础上增加温阳化饮方口服治疗，疗程为4 周。 观察2 组患者治疗前后的指标：（1）中医证候评分；（2）血清N 末端B 型利钠肽原（NT-proBNP）、超敏C 反应 蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）水平；（3）左室射血分数（LVEF）、左室舒张末 期内径（LVEDD）；（4）6 min 步行距离。比较2 组患者的临床疗效及安全性。结果 治疗后，（1）2 组患者的中 医证候评分均较治疗前明显降低（P＜0.05），且观察组明显低于对照组（P＜0.05）。（2）2 组患者的血清hs-CRP、 TNF-α、IL-6、NT-proBNP 水平均较治疗前明显降低（P＜0.05），且观察组明显低于对照组（P＜0.05）。（3）2 组 患者的LVEF 水平均较治疗前明显升高（P＜0.05），LVEDD 水平均较治疗前明显降低（P＜0.05），且观察组的 LVEF 水平明显高于对照组（P＜0.05），LVEDD 水平明显低于对照组（P＜0.05）。（4）2 组患者的6 min 步行距离 均较治疗前明显增加（P＜0.05），且观察组的增加幅度明显大于对照组（P＜0.05）。（5）观察组的总有效率 （96.67%）明显高于对照组（86.67%）（P＜0.05）；观察组的不良反应总发生率（1.67%）明显低于对照组（11.67%） （P＜0.05）。结论 温阳化饮方联合西药常规治疗能够有效降低阳虚水泛型老年CHF 患者的中医证候评分，改 善临床症状及心功能，减轻机体炎症反应，临床疗效优于单纯西药治疗，且安全性较好。

Abstract: Objective To observe the clinical efficacy of Wenyang Huayin Prescription （cooked Aconiti Lateralis Radix Praeparata， Cinnamomi Ramulus， Codonopsis Radix， Atractylodis Macrocephalae Rhizoma， Poria， Descurainiae Semen Lepidii Semen，etc.） combined with conventional western medicine in the treatment of elderly patients with chronic heart failure （CHF）. Methods A total of 120 elderly CHF patients with fluid retention due to yang deficiency syndrome who were treated in People’s Hospital of Chenghai District from December 2021 to December 2022 were selected as the research objects. They were randomly divided into control group and observation group，with 60 cases in each group. The control group was given conventional western medicine treatment，and the observation group was treated with Wenyang Huayin Prescription on the basis of the treatment of the control group. The course of treatment was four weeks. The indexes of the two groups were observed before and after treatment:（1） TCM syndrome scores；（2） serum levels of N-terminal pro-B-type natriuretic peptide （NT-proBNP）， highsensitivity C-reactive protein （hs-CRP），tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）；（3） left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVEDD）；（4） 6-minute walking distance. The clinical efficacy and safety of the two groups were compared. Results After treatment，（1） the scores of TCM syndromes in the two groups were significantly lower than those before treatment （P＜0.05），and the scores in the observation group were significantly lower than those in the control group （P＜0.05） . （2） The levels of serum hs-CRP， TNF- α， IL-6 and NT-proBNP in the two groups were significantly lower than those before treatment（P＜0.05），and the levels in the observation group were significantly lower than those in the control group （P＜0.05） . （3） The levels of LVEF in the two groups were significantly higher than those before treatment （P＜ 0.05）， and the levels of LVEDD were significantly lower than those before treatment （P＜0.05） . The level of LVEF in the observation group was significantly higher than that in the control group （P＜0.05），and the level of LVEDD was significantly lower than that in the control group （P＜0.05）.（4） The 6-minute walking distance in the two groups was significantly increased when compared with that before treatment （P＜0.05），and the increase in the observation group was significantly greater than that in the control group （P＜0.05）. （5） The total effective rate of the observation group （96.67%） was significantly higher than that of the control group （86.67%）（P＜0.05）；the total incidence of adverse reactions in the observation group （1.67%） was significantly lower than that in the control group （11.67%）（P＜0.05）. Conclusion Wenyang Huayin Prescription combined with conventional western medicine treatment can effectively reduce the TCM syndrome score of elderly CHF patients with fluid retention due to yang deficiency syndrome， improve clinical symptoms and cardiac function， and reduce the body′s inflammatory response. The clinical efficacy is superior to that of western medicine alone，and the safety is relatively high.

R285.6；R259

国家自然科学基金项目（81473743）；汕头市科技计划项目（20052185263871）；广东省教育厅重点领域专项计划项目（2019KZDZX1041）。