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目的:评价独参汤合真武汤治疗慢性充血性心力衰竭(chronic congestive heart failure, CCHF)阳虚血瘀证的临床疗效。方法:将符合入选标准的2017年3月-2019年12月上海中医药大学附属上海市中西医结合医院患者120例，采用随机数字表法分为2组，每组60例。对照组采用西医常规疗法治疗，研究组在对照组基础上联合服用独参汤合真武汤治疗，2组均治疗1个月。分别于治疗前后进行中医证候评分，采用ELISA法检测血清TNF-α、IL-17、CRP水平，采用心脏彩色多普勒超声心动图检测左室射血分数(left ventricular ejection fraction, LVEF)、左室舒张末期内径(left ventricular end diastolic diameter, LVEDD)、左室收缩末期内径(left ventricular end systolic diameter, LVESD)，记录治疗期间的不良反应，评价临床疗效。结果:研究组总有效率为91.7%(55/60)、对照组为71.7%(43/60)，2组比较差异有统计学意义(n χ2=8.015，n P=0.005)。研究组治疗后心悸、喘急、畏寒肢冷、舌黯淡、四肢浮肿评分均低于对照组(n t值分别为13.953、13.915、30.945、32.339、20.403，n P值均<0.001)。治疗后，研究组LVEF[(56.28±4.34)%比(42.47±4.56)%，n t=16.993]高于对照组(n P<0.01)；LVEDD[(44.32±6.23)mm比(53.81±5.19)mm，n t=9.066]、LVESD[(31.28±4.62)mm比(37.51±4.73)mm，n t=7.299]低于对照组(n P<0.01)。研究组治疗后血清TNF-α、IL-17、CRP水平均低于对照组(n t值分别为12.644、15.975、14.379，n P值均<0.001)。对照组不良反应发生率为6.7%(4/60)、研究组为8.3%(5/60)，2组比较差异无统计学意义(n χ2=0.120，n P=0.729)。n 结论:独参汤合真武汤可有效改善CCHF阳虚血瘀证患者的心功能及临床症状，降低炎性细胞因子水平，提高临床疗效，且安全性较好。“,”Objective:To observe the clinical efficacy of n Dushen Decoction and n Zhenwu Decoction in the treatment of chronic congestive heart failure (CCHF) of Yang deficiency and blood stasis type.n Methods:From March 2017 to December 2019, 120 patients with CCHF of Yang-deficiency and blood stasis type admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were selected, and they were divided into study group and control group according to the randomized number table method, with 60 in each group. The control group was given western medicine of conventional treatment, and the study group was combined with n Dushen Decoction and n Zhenwu Decoction on the basis of the control group. Both groups were treated for 1 month. Before and after treatment, TCM syndrome scores were performed, serum TNF-α, IL-17 and CRP were detected by ELISA, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were detected by color doppler echocardiography the adverse reactions during the treatment were recorded and the clinical efficacy was evaluated.n Results:The total effective rate was 91.7% (55/60) in the study group and 71.7% (43/60) in the control group, with significant difference between the two groups (n χ2=8.015, n P=0.005). After treatment, the scores of palpitation, dyspnea, chilly limbs, dull tongue and edema in the study group were significantly lower than those in the control group (n t=13.953, 13.915, 30.945, 32.339, 20.403, n P<0.001). After treatment, LVEF [(56.28 ± 4.34)%n vs. (42.47 ± 4.56)%, n t=16.993] in the study group was significantly higher than that of the control group (n P<0.01); LVEDD [(44.32 ± 6.23) mmn vs. (53.81 ± 5.19) mm, n t=9.066] and LVESD [(31.28 ± 4.62) mm n vs. (37.51 ± 4.73) mm, n t=7.299] in the study group were significantly lower than those in the control group (n P<0.01). After treatment, the serum levels of TNF-α, IL-17 and CRP in the study group were significantly lower than those in the control group (n t=12.644, 15.975 and 14.379, n P<0.001). The incidence of adverse reactions was 6.7% (4/60) in the control group and 8.3% (5/60) in the study group, and there was no significant difference between the two groups (n χ2=0.120, n P=0.729).n Conclusion:Dushen Decoction and n Zhenwu Decoction in the treatment of CCHF can improve the clinical symptoms, improve the cardiac function, reduce inflammatory factors, improve the treatment efficiency with good safety.n