附萸汤辅助比索洛尔治疗射血分数保留型心力衰竭的效果

Effect of Fuyu Decoction with Bisoprolol in the Treatment of Ejection Fraction Preserved Heart Failure

目的探讨附萸汤辅助比索洛尔在射血分数保留型心力衰竭(HFpEF)中应用。方法将2021年6月至2023年3月开封市中医院收治的100例HFpEF患者随机分为两组,各50例。两组均接受基础治疗,对照组接受比索洛尔治疗,观察组接受比索洛尔联合附萸汤治疗,连续治疗1个月。统计两组中医疗效、中医证候积分、6 min步行距离(6 MWD)、不良反应、主要不良心血管事件(MACE)发生率。测定外周血单个核细胞TLR4/NF-κB信号通路相关mRNA、蛋白。检测心功能指标[左室射血分数(LVEF)、左心室每搏输出量(SV)、左心房压力(LAP)]。结果观察组治疗总有效率高于对照组(P<0.05);治疗1个月后观察组外周血单个核细胞TLR4、NF-κB mRNA、蛋白表达低于对照组(P<0.05);治疗1个月后观察组LVEF、6 MWD、SV高于对照组,LAP、中医证候积分低于对照组(P<0.05);两组不良反应、MACE发生率差异无统计学意义(P>0.05)。结论附萸汤辅助比索洛尔治疗HFpEF效果确切,机制可能与调节TLR4/NF-κB信号通路有关。

Objective To investigate the effect of Fuyu decoction in the treatment of ejection fraction preserved heart failure(HFpEF)and its influence on cardiac function and prognosis.Methods A total of 100 patients with HFpEF admitted to Kaifeng Traditional Chinese Medicine Hospital from June 2021 to March 2023 were randomly divided into two groups,with 50 cases in each group.Both groups received basic treatment,the control group received bisoprolol,and the observation group received bisoprolol combined with Fuyu decoction for 1 month.The incidence of traditional Chinese medical science efficacy,traditional Chinese medical science syndrome score,6-minute walking distance(6 MWD),adverse reactions,and major adverse cardiovascular events(MACE)in the two groups were analyzed.TLR4/NF-κB signaling pathway related mRNA and protein in peripheral blood mononuclear cells were determined.The cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular stroke volume(SV)and left atrial pressure(LAP)]were measured.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After one month of treatment,the expression of TLR4,NF-κB mRNA,and protein in peripheral blood mononuclear cells in the observation group was lower than that in the control group(P<0.05).After 1 month of treatment,LVEF,6 MWD and SV in the observation group were higher than those in the control group,LAP and traditional Chinese medical science syndrome score were lower than those in the control group(P<0.05).There was no statistically difference in the incidence of adverse reactions and MACE between the two groups(P>0.05).Conclusion Fuyu decoction is effective in the treatment of HFpEF with bisoprolol,and the mechanism may be related to the regulation of TLR4/NF-κB signaling pathway.