沙库巴曲缬沙坦联合丹参颗粒治疗急性心力衰竭临床评价

Clinical Evaluation of Sacubitril Valsartan Combined with Danshen Granules in the Treatment of Acute Heart Failure

目的探讨沙库巴曲缬沙坦联合丹参颗粒治疗急性心力衰竭(AHF)的临床疗效及对患者血清沉默信息调节蛋白3(SIRT3)表达水平的影响。方法选取医院2020年10月至2023年10月收治的AHF患者120例,根据治疗方案的不同分为对照组(54例)和观察组(66例)。两组患者均予常规对症支持治疗,并给予沙库巴曲缬沙坦钠片口服,观察组患者加服丹参颗粒。两组均连续治疗8周。结果观察组总有效率为90.91%,显著高于对照组的74.07%(P<0.05)。两组患者治疗后的中医证候积分、左室舒张末期内径、左室收缩末期内径及核转录因子κB mRNA表达水平均显著降低,心排血量(CO)、左室射血分数、心脏指数(CI)及SIRT3 mRNA表达水平均显著升高,且观察组均显著优于对照组(P<0.05)。观察组不良反应发生率为4.55%,显著低于对照组的16.67%(P<0.05)。结论沙库巴曲缬沙坦联合丹参颗粒可有效改善AHF患者的临床症状,提高CI和CO,减轻心室重塑,明显改善心脏功能,并且调节SIRT3/NF-κB相关通路。

Objective To investigate the clinical efficacy of sacubitril valsartan combined with Danshen Granules in the treatment of acute heart failure(AHF),and its effect on the expression level of serum silent information regulatory protein 3(SIRT3)in patients.Methods A total of 120 patients with AHF admitted to the hospital from October 2020 to October 2023 were selected and divided into the control group(54 cases)and the observation group(66 cases)based on different treatment regimens.The patients in the two groups received routine symptomatic supportive treatment and oral Sacubitril Valsartan Sodium Tablets,on this basis,the patients in the observation group received Danshen Granules.Both groups received continuous treatment for eight weeks.Results The total effective rate in the observation group was 90.91%,which was significantly higher than 74.07%in the control group(P<0.05).After treatment,the traditional Chinese medicine(TCM)syndrome score,left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),and nuclear transcription factor-κB(NF-κB)mRNA expression level significantly decreased in the two groups;the cardiac output(CO),left ventricular ejection fraction(LVEF),cardiac index(CI)and SIRT3 mRNA expression level significantly increased;and the above indexes in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 4.55%,which was significantly lower than 16.67%in the control group(P<0.05).Conclusion Sacubitril valsartan combined with Danshen Granules can effectively improve the clinical symptoms of AHF patients,increase the CI and CO,alleviate ventricular remodeling,significantly improve cardiac function,and regulate the SIRT3/NF-κB-related pathways.