参附益心颗粒联合诺欣妥治疗慢性心力衰竭的疗效及对血清sST2、MMP-9水平的影响

    Therapeutic effect of Shenfu Yixin Granule combined with Nuoxintuo for chronic heart failure and its impacts on serum sST2 and MMP-9 levels

    • 摘要:
      目的 探究参附益心颗粒联合诺欣妥治疗慢性心力衰竭的疗效及对血清可溶性生长刺激表达基因2蛋白(sST2)、基质金属蛋白酶-9(MMP-9)水平的影响。
      方法  随机地将2021年2月~2023年2月在本院进行治疗的慢性心力衰竭患者200例,分为对照组(n=100)和研究组(n=100)。两组患者前期均进行一些基础治疗,然后对照组采用诺欣妥进行治疗,研究组在对照组基础上联合参附益心颗粒进行治疗,两组治疗时长均为6个月。治疗结束后,比较两组间的临床疗效,并检测两组患者心肌功能指标左室收缩末期容量(LVESV)、左室舒张末期容量(LVEDV)、左室射血分数(LVEF)水平,心脏型脂肪酸结合蛋白(h-FABP)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平,检测血清可溶性生长刺激表达基因2蛋白(sST2)、基质金属蛋白酶-9(MMP-9)水平,血管内皮功能指标内皮素(ET)、血清降钙素基因相关肽(CGRP)、一氧化氮(NO)水平以及治疗后的不良反应率。
      结果  研究组的治疗效果明显优于对照组(P<0.01)。治疗前,两组患者的心肌功能指标LVEDV、LVESV、h-FABP、Lp-PLA2、血清sST2、MMP-9、血管内皮功能指标ET都维持在一个较高的水平,且两组间没有显著差异;经过治疗后,两组患者的这些指标均降低,且研究组比对照组降低的幅度更大(均P<0.01)。两组患者治疗后的LVEF、CGRP、NO水平较治疗前显著升高,且研究组升高更显著(均P<0.01)。对照组的不良反应率显著高于研究组(P<0.01)。
      结论  联合参附益心颗粒与诺欣妥对治疗慢性心力衰竭患者有较好的疗效,能有效增强患者心肌功能、血管内皮功能,减轻心脏负担。

       

      Abstract:
      AIM To investigate the therapeutic effect of Shenfu Yixin Granule combined with Nuoxintuo in the treatment of chronic heart failure and its impacts on serum soluble growth stimulating gene 2 protein (sST2) and matrix metalloproteinase-9 (MMP-9) levels.
      METHODS From February 2021 to February 2023, 200 patients with chronic heart failure admitted to our hospital were randomly divided into a reference group and a research group, with 100 patients in each group. Both groups received some basic treatment in the early stage. Then, the reference group received treatment with Nuoxintuo, while the research group received treatment with Shenfu Yixin Granules on the basis of the treatment in the reference group. The treatment course were six months for both groups. After treatment, the clinical efficacy was compared between the two groups and the myocardial function indicators including left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) levels, and heart fatty acid binding protein (h-FABP), lipoprotein related phospholipase A2 (Lp-PLA2) levels, serum soluble growth stimulating gene 2 protein (sST2), matrix metalloproteinase-9 (MMP-9) levels, serum vascular endothelial function indicators including endothelin (ET), calcitonin gene related peptide (CGRP) and nitric oxide (NO) levels, as well as the post-treatment incidence of adverse reactions were measured and compared between the two groups.
      RESULTS The therapeutic effect in the research group was much better than that in the reference group (P<0.01). Before treatment, LVEDV, LVESV, h-FABP, Lp-PLA2, serum sST2, MMP-9 and endothelial function indicator ET were all maintained at a high level in both groups and there was no great difference between the two groups. After treatment, these indicators decreased in both groups, but the research group showed a greater decrease than the reference group (P<0.01). There was no great difference in LVEF, CGRP and NO levels between the two groups before treatment, but after treatment, the levels of LVEF, CGRP and NO increased in both groups and the research group showed a greater increase (P<0.01). Moreover, the adverse reaction rate in the reference group was much higher than that in the research group (P<0.01).
      CONCLUSION The combination of Shenfu Yixin Granule and Nuoxintuo achieves a good therapeutic effect in patients with chronic heart failure, which effectively enhances the myocardial function and vascular endothelial function and reduce the heart burden in these patients.

       

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