关键词:

射血分数保留, 心力衰竭, 沙库巴曲缬沙坦, 参附救心汤, 炎症, 心室重构, 运动耐力

Abstract:

Objective　To observe the clinical effect of Shenfu Jiuxin Decoction combined with sacubitril/valsartan in the treatment of heart failure with preserved ejection fraction. Methods　A total of 80 patients with heart failure with ejection fraction preservation were selected from the Second Affiliated Hospital of Shanxi University of Traditional Chinese Medicine from June 2020 to June 2023, and were divided into two groups according to the random number table method. In the control group, there were 17 males and 23 females, aged 51-83 (62.53±4.17) years, New York Heart Association (NYHA) classification: 21 cases of grade II and 19 cases of grade III. In the study group, there were 16 males and 24 females, aged 50-84 (63.14±4.65) years, NYHA classification: 22 cases of grade II and 18 cases of grade III. The control group was treated with sacubitril/valsartan tablets (the initial dose was 50 mg each time, and increased to 100 mg each time after 2 weeks, twice a day) based on the basic treatment, and the study group was treated with Shenfu Jiuxin Decoction (taking 100 ml each time, twice a day) based on the control group for 2 months. The clinical efficacies of the two groups were compared. Before and after treatment, cold limbs, facial edema, palpations, asthma/inability to sleep, foaming sputum, oliguria and abdominal distension, blue lips, accompanied by ascites, pleural fluid, face gray, irritability, and sweating were evaluated. Before and after treatment, the patients' 6-min walking distance, Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, left ventricular ejection fraction, left ventricular mass index, and E peak deceleration time were evaluated. The levels of tumor necrosis factor α (TNF-α), interleukin 33 (IL-33), soluble stromal lysin 2 (sST2), and N-terminal B-type natriuretic peptide (NT-proBNP) were detected. t test and χ² test were used. Results　The total effective rate of the study group was 97.50% (39/40), which was higher than that of the control group [80.00% (32/40)] (P<0.05). After treatment, the scores of cold limbs, facial edema, palpations, asthma/inability to sleep, foaming sputum, oliguria and abdominal distension, blue lips, accompanied by ascites, pleural fluid, face gray, irritability, and sweating in the study group were lower than those in the control group (all P<0.05); the 6-min walking distance of the study group was longer than that of the control group (P<0.05); the MLHFQ score of the study group was lower than that of the control group (P<0.05); the left ventricular ejection fraction of the study group was higher than that of the control group (P<0.05); the left ventricular mass index and E peak deceleration time of the study group were lower than those of the control group (both P<0.05); the levels of TNF-α, IL-33, sST2, and NT-proBNP in the study group were lower than those in the control group (all P<0.05). Conclusion　Shenfu Jiuxin Decoction combined with sacubitril/valsartan can inhibit the inflammation, reduce the sST2 and NT-proBNP levels, improve the ventricular remodeling, cardiac function, exercise endurance, clinical efficacy, and quality of life in patients with heart failure with preserved ejection fraction.

Key words:

Ejection fraction preservation, Heart failure, Sacubitril/valsartan, Shenfu Jiuxin Decoction, Inflammation, Ventricular remodeling, Exercise endurance