目的：观察益气泻肺利水法对老年心力衰竭合并肺部感染患者心肺耐力、心室重构、纤维蛋白溶解等指标的影响。方法：选择老年心力衰竭合并肺部感染患者102例，采用随机数字表法分为对照组和观察组各51例。研究过程中，对照组脱落2例，最终纳入49例，观察组脱落2例、病情加重剔除1例，最终纳入48例。对照组患者采用西医对症治疗，观察组患者在此基础上采用益气泻肺利水法治疗，两组均连续治疗7 d。观察两组患者治疗前后的中医证候评分、心肺耐力指标（无氧阈摄氧量、峰值摄氧量）、六分钟步行试验（6MWT）距离、心室重构指标（左心室射血分数、左心室质量指数、心肌能量消耗、E峰减速时间）、炎症指标[肿瘤坏死因子-α(TNF-α)、巨噬细胞炎性蛋白-1α(MIP-1α)]、心肌损伤指标[心型脂肪酸结合蛋白（H-FABP）、纤溶酶原激活剂抑制物-1(PAI-1)]及不良反应情况，并评价两组的临床疗效。结果：治疗后，两组中医证候评分、左心室质量指数、心肌能量消耗、E峰减速时间及MIP-1α、TNF-α、H-FABP、PAI-1水平均较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）；两组无氧阈摄氧量、峰值摄氧量、6MWT距离、左心室射血分数均较治疗前升高（P<0.05），且观察组高于对照组（P<0.05）。治疗后，观察组总有效率97.91%，对照组总有效率81.63%，两组临床疗效比较，差异有统计学意义（Z=2.412,P=0.009）。结论：益气泻肺利水法对老年心力衰竭合并肺部感染患者具有减少炎症反应、降低心肌细胞损伤程度、改善心室重构及纤维蛋白溶解指标水平、提升心肺耐力和心功能的作用。

Objective:To observe the influence of the method of benefiting qi,purging the lung,and promoting diuresis on the cardiopulmonary endurance,ventricular remodeling,and fibrinolytic indexes of elderly patients with heart failure complicated by pulmonary infection. Methods:A total of 102 elderly patients with heart failure complicated by pulmonary infection were selected and divided into the control group and the observation group,each consisting of 51cases,using the random number table method. During the study process,2 cases dropped out in the control group,leaving a final total of 49 cases. In the observation group,2 cases dropped out and 1 case was excluded due to an aggravated condition,resulting in a final total of 48 cases. The patients in the control group were treated with basic symptomatic treatment of Western medicine,while the patients in the observation group were treated with the method of benefiting qi,purging the lung,and promoting diuresis on this basis. Both groups were treated continuously for 7 days. The traditional Chinese medicine(TCM) syndrome scores,cardiopulmonary endurance indicators(anaerobic threshold oxygen uptake,peak oxygen uptake),six-minute walk test(6MWT) distance,ventricular remodeling indicators(left ventricular ejection fraction,left ventricular mass index,myocardial energy consumption,E peak deceleration time),inflammatory indicators [tumor necrosis factor-α(TNF-α),macrophage inflammatory protein-1α(MIP-1α)],myocardial injury indicators [heart-type fatty acid binding protein(H-FABP),plasminogen activator inhibitor-1(PAI-1)],and adverse reactions of the two groups of patients before and after treatment were observed,and the clinical efficacy of the two groups was evaluated. Results:After treatment,the scores of TCM syndrome,left ventricular mass index,myocardial energy consumption,E peak deceleration time,and the levels of MIP-1α,TNF-α,H-FABP,and PAI-1 in both groups were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05). The anaerobic threshold oxygen uptake,peak oxygen uptake,6MWT distance,and left ventricular ejection fraction in both groups were higher than those before treatment(P<0.05),and those in the observation group were higher than those in the control group(P<0.05). After the treatment,the total effective rate of the observation group was 97.91%,and that of the control group was 81.63%. The comparison of clinical efficacy between the two groups was statistically significant(Z=2.412,P=0.009). Conclusions:The method of benefiting qi,purging the lung,and promoting diuresis has the effects of reducing inflammatory responses,lowering the degree of myocardial cell injury,improving ventricular remodeling and fibrinolytic index levels,and enhancing cardiopulmonary endurance and cardiac function in elderly patients with heart failure complicated by pulmonary infection.