Meta analysis of the efficacy of western medicine combined with Qiliqiangxin capsule versus western medicine alone in the treatment of chronic heart failure

Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin capsule combined treatment has more advantages, providing reference for clinical decision-making in the treatment of chronic heart failure. Methods: Randomized controlled trials (RCTs) of conventional Western medicine treatment and Western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed, Embase, Webofscience, CNKI, WanFang, VIP, and CBM. The bias risk assessment was conducted using the RCT tool recommended by Cochrane, and then the meta-analysis was performed using RevMan5.4 and Stata17 software. Compare the efficacy evaluation of cardiac function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), cardiac stroke output (SV), 6-minute walking test (6MWT), and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group (hereinafter referred to as the treatment group) and the conventional western medicine group (hereinafter referred to as the control group). Results: A total of 20 RCTs meeting the criteria were included, including 2953 patients, including 1508 in the treatment group and 1445 in the control group. The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation, LVEF, LVEDD, SV, 6MWT, and NT-proBNP improvement than the control group. Its central functional efficacy evaluation (OR=2.09,95% CI: 1.71-2.55, P<0.001), LVEF (WMD=7.05,95% CI: 5.30-8.79, P<0.00001), LVEDD (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), SV (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), 6MWT (SMD=0.70,95% CI: 0.54-0.87, P<0.00001), NT-proBNP (SMD=-1.95,95% CI: -2.5 2 to 1.38 (P<0.0001), with statistically significant differences. Conclusion: Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure, improve LVEF, LVEDD, SV, and NT-proBNP index, and improve exercise tolerance. It is worth using for reference in the treatment.

Meta-analysis of curative effect of Sacubitril valsartan combined with Qiliqiangxin capsule in the treatment of patients with chronic cardiac failure

Objective:To systematically review the effect of Sacubitril valsartan combined with Qiliqiangxincapsule on clinical effect,serological index,cardiac function,quality of live,and adverse reactions in patients with heart failure.Methods:Search the databases of CNKI,VIP,WanFang,CBM,DuXiu,ChiCTR,Web of science,The Cochrane Library,PubMed and Embase to collect the randomized controlled trial(RCT)of Sacubitril valsartan combined with Qiliqiangxin capsule in the treatment of patients with heart failure,The search time limit is from the establishment of the database to May 2021.After the literatures were screened,evaluated and extracted by two researchers independently,Meta analysis was carried out with Stata 16.1 software.Results:A total of 18 RCTs,were included,including 1613 patients.The results of the Meta-analysis showed that there was statistical significance in improving the effective rate(OR=2.60,95%CI[2.09,3.24],P<0.00001),N-terminal pro-brain natriuretic peptide(MD=-468.36,95%CI[-606.80,-329.92],P<0.00001),left ventricular ejection fraction(MD=5.41,95%CI[4.93,5.89],P<0.00001),left ventricular end-diastolic diameter(MD=-3.27,95%CI[-3.65,-2.90],P<0.00001),left ventricular end-systolic diameter(MD=-3.60,95%CI[-4.99,-2.21],P<0.00001),6-minute walking distance(MD=61.42,95%CI[50.04,72.80],P<0.00001),Minnesota living with heart failure questionnaire(MD=-11.39,95%CI[-14.50,-8.28],P<0.00001),and traditional Chinese medicine syndrome score scale(MD=-3.62,95%CI[-6.45,-0.80],P=0.01),but there was no significant difference in cardiac output(MD=0.26,95%CI[-0.02,0.54],P=0.07)and adverse reactions.Conclusion:The current evidence shows that Sacubitril Valsartan combined with Qiliqiangxin capsule can better improve cardiac function,TCM symptoms and quality of life in patients with heart failure than simple Sacubitril Valsartan.However,there was no significantdifference in improving cardiac output between the two groups.However,higher quality RCTs are needed to verify.

Study on gene regulation mechanism of Qiliqiangxin capsule on myocardial fibrosis in myocardial infarction rats

Objective:To investigate the effect and possible mechanism of Qiliqiangxin capsule on myocardial fibrosis in rats with myocardial infarction(MI).Methods:The rat model of myocardial infarction was established by ligation of anterior descending branch of left coronary artery.The rats were randomly divided into model group,Qiliqiangxin capsule group,captopril group after operation.Rats that without ligation were set as parallel control group,namely,the sham group.Cardiac pathology was observed by hematoxylin eosin(HE)staining after 4 weeks of treatment.Masson staining was used to observe myocardial fibrosis and calculate collagen volume fraction(CVF).The miR-133a and expression levels of transforming growth factor β1(TGF-β1),Smad 2,Smad 3,type Ⅰ collagen(col-Ⅰ),type Ⅲ collagen(col-Ⅲ)mRNA were examined by Real-time PCR.Results:Compared with the sham group,myocardial cells in model group were disordered,CVF was significantly increased(P<0.01),the expression levels of col-Ⅰ,col-ⅢmRNA were increased(P<0.01);besides,the expression level of miR-133a was significantly decreased(P<0.01),the expression levels of TGF-β1,Smad 2 and Smad 3 mRNA were increased(P<0.05,P<0.01).Compared with the model group,the arrangement of myocardial cells in Qiliqiangxin capsule group and captopril group were orderly and CVF was significantly decreased(P<0.05);the expression level of miR-133a was increased(P<0.05,P<0.01);the expression levels of TGF-β1,Smad 2 and Smad 3 mRNA were significantly decreased(P<0.01).Conclusion:Qiliqiangxin capsule can improve myocardial infarction rat myocardial tissue fibrosis,its mechanism may be in related with the regulation on miR-133a/TGF-β1/Smads signal pathway at the genetic level.

Mechanism of Qiliqiangxin capsule on the regulation of IP3Rs/GRP75/VDAC1 gene in myocardial infarction rat heart

Objective:To investigate the regulatory effect of Qiliqiangxin Capsule on mitochondrial Ca^(2+)related genes in rats with myocardial infarction(MI).Methods:The rat model of MI was established by ligation of the left anterior descending coronary artery.After operation,the rats were randomly assigned to the model group,the Qiliqiangxin group and the captopril group;a sham-operated group was also available as a control.After four weeks of treatment,the extent of infarction in rats was observed by gross cardiac structure and the morphological changes of myocardial histopathology were observed by HE staining.Detection of mitochondrial Ca^(2+)transport-related genes such as inositol-1,4,5-trisphosphate receptor 2(IP3R2),glucose regulated protein 75(GRP75),voltage-dependent anion channel 1(VDAC1),and mitofusion 2(Mfn2)and mitochondrial apoptosis-related genes such as B-cell lymphoma-2(Bcl-2)and Bcl-2 related X protein(Bax)mRNA expression changes was measured by RT-PCR in the infarct margins of the heart;Western blot was used to detect changes in Bcl-2,Bax protein expression in myocardial tissue.The rate of apoptosis in cardiac myocardial tissue was detected by TUNEL staining.Results:Compared with the sham group,the anterior left ventricular wall of the model group showed a large area of infarction,and the structure of myocardial tissue was disordered.The mRNA expression level of mitochondrial Ca^(2+)transport-related genes such as IP3R2,GRP75,VDAC1,and Mfn2 were significantly increased(P<0.05,P<0.01);The mRNA and protein expression of Bcl-2,a molecule related to mitochondrial apoptosis,were significantly decreased(P<0.01),while the mRNA and protein expression of Bax were significantly increased(P<0.01);and apoptosis rate was significantly increased(P<0.01).Compared with the model group,the infarct size of cardiac gross specimens in the Qiliqiangxin group and the captopril group was reduced and myocardial fibers were relatively well ordered;The mRNA expression of mitochondrial Ca^(2+)transport-related genes such as IP3R2,GRP75,VDAC1,and Mfn2 were significantly reduced(P<0.01);the mRNA and protein expression of Bcl-2,a molecule related to mitochondrial apoptosis,were increased(P<0.05,P<0.01),and the mRNA and protein expression of Bax were significantly decreased(P<0.05,P<0.01).and apoptosis rate was significantly decreased(P<0.01).Conclusion:Qiliqiangxin Capsule can improve the morphological structure of the heart of rats with MI,and its mechanism is related to regulation of the gene expression of mitochondrial Ca^(2+)transport complex IP3R2/GRP75/VDAC1,thereby inhibiting apoptosis.

达格列净联合芪苈强心胶囊治疗射血分数中间值心力衰竭的临床疗效观察

目的回顾性研究分析钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂达格列净联合芪苈强心胶囊治疗射血分数中间值(40%~49%)心力衰竭(HFmrEF)患者的临床效果及安全性。方法选择2022年8月至2023年9月期间于河南中医药大学第一附属医院心内科接受治疗的患者进行筛选,将西医诊断为射血分数中间值心力衰竭、中医诊断为心衰病(阳气亏虚血瘀证)的70例患者作为研究对象。按治疗方法不同分组,在常规治疗基础上采用达格列净治疗者作为对照组;采用达格列净联合芪苈强心胶囊者作为研究组,两组各35例,用药时间≥4周。比较两组患者治疗前后NYHA功能分级、6 min步行试验(6MWT)、明尼苏达心力衰竭生活质量问卷(MLHFQ)评分、心率、超声心动图心功能相关指标[左室舒张末期内径(LVEDd)、左室射血分数(LVEF)]、N末端脑钠肽前体(NT-proBNP)、30 d内再入院率等指标变化,进行统计学分析。结果与对照组比较,治疗后研究组患者NYHA分级明显减低(P<0.05),MLHFQ评分明显减低(P<0.01),6MWT较前明显升高(P<0.01),研究组的治疗总有效率较对照组明显升高(P<0.01),研究组治疗后NT-proBNP水平降低幅度更为明显(P<0.01),LVIDd减少程度明显低于对照组(P<0.01),LVEF升高幅度明显高于对照组(P<0.01);两组治疗前后比较,平均基础心率均有不同程度减慢(P<0.05),与对照组相比,研究组治疗后平均心率指标改善程度更为明显(P<0.01);随访用药期间两组具有较好的安全性与耐受性,30 d再入院率及就诊比较,差异无统计学意义。结论达格列净片联合芪苈强心胶囊能够明显改善HFmrEF患者(阳气亏虚血瘀证)的症状和心功能,对于HFmrEF患者治疗方案选择,可供临床参考。

西药联合芪苈强心胶囊与单纯西药治疗慢性心力衰竭疗效比较的Meta分析

目的:对常规西药联合芪苈强心胶囊与单用西药治疗慢性心力衰竭的临床疗效进行比较,证明芪苈强心胶囊联合西药治疗更具优势,为慢性心衰的临床治疗策略提供参考依据。方法:检索PubMed、Embase、Web of science、中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献(CBM)等数据库中常规西药治疗以及西药联合芪苈强心胶囊治疗慢性心衰的随机对照实验(RCTs),采用Cochrance推荐的RCT的工具进行偏倚风险评估后,用Rev Man 5.4及Stata 17软件进行Meta分析。比较常规西药联合芪苈强心胶囊组(以下简称治疗组)与常规西药组(以下简称对照组)的心功能疗效评价、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心脏每搏输出量(SV)、6 min步行试验(6MWT)距离及N末端脑钠肽前体(NT-proBNP)指数。结果:纳入符合标准的RCTs共20篇,包括2953例患者,其中治疗组1508例,对照组1445例。Meta分析结果显示,治疗组的心功能疗效评价、LVEF、LVEDD、SV、6MWT及NT-proBNP改善情况均显著优于对照组。其中心功能疗效评价(OR=2.09,95%CI:1.71~2.55,P<0.001)、LVEF(WMD=7.05,95%CI:5.30~8.79,P<0.00001)、LVEDD(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、SV(WMD=6.73,95%CI:3.18~10.29,P=0.0002)、6MWT(SMD=0.70,95%CI:0.54~0.87,P<0.00001)、NT-proBNP(SMD=-1.95,95%CI:-2.52~-1.38,P<0.0001),差异均有统计学意义。结论:常规西药联合芪苈强心胶囊能显著提高心力衰竭的临床疗效,改善LVEF、LVEDD、SV及NT-proBNP指数,提高运动耐量,在治疗中值得借鉴。

芪苈强心胶囊对缺血性心力衰竭患者心室重构、心肌纤维化及血管再生的影响

目的:探讨芪苈强心胶囊联合常规西医治疗对缺血性心力衰竭(IHF)的疗效。方法:将102例IHF患者按照治疗方式不同分为对照组与观察组,每组各51例。对照组予以常规西医治疗;观察组在除常规西医治疗外,加服芪苈强心胶囊(4粒/次,3次/d)。治疗6个月后,比较两组患者治疗前后左心室射血分数(LVEF)、左室重构指数(LVRI)、左室舒张末期内径(LVEDD)、左室收缩内径(LVESD)、左室质量指数(LVMI)、血清N末端B型脑钠肽(NT-proBNP)、中医证候积分、6 min步行试验(6MWT)、心肌纤维化相关细胞因子[转化生长因子β1(TGF-β1)、III型前胶原(PCIII)、透明质酸(HA)]、血管再生相关指标[血管内皮生长因子(VEGF)、C1q肿瘤坏死因子相关蛋白3(CTRP3)、缺氧诱导因子1α(HIF-1α)]的差异,并进行安全性评价。结果:治疗后,观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组LVEF、LVRI均增高(P<0.05),且观察组高于对照组(P<0.05);LVEDD、LVESD、LVMI、NT-proBNP均降低(P<0.05),且观察组低于对照组(P<0.05);观察组中医证候积分及MLHFQ评分均显著低于对照组(P<0.05),6MWT显著高于对照组(P<0.05);观察组血清TGF-β1、PCIII、HA水平低于对照组(P<0.05),VEGF、CTRP3、HIF-1α水平高于对照组(P<0.05)。结论:芪苈强心胶囊联合西医常规治疗IHF疗效显著,能够有效改善患者心室重构、心功能及临床症状,减轻心肌纤维化、促进血管再生可能是其作用机制。

芪苈强心胶囊联合尼可地尔治疗心力衰竭的疗效及对血清NT-ProBNP和炎性因子的影响

目的:探讨芪苈强心胶囊联合尼可地尔治疗慢性心力衰竭(CHF)的效果。方法:选取CHF患者116例为研究对象,随机分为对照组与观察组各58例,对照组予以尼可地尔治疗,观察组予以芪苈强心胶囊联合尼可地尔治疗,两组均治疗3个月。评价两组治疗效果,对两组心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、6 min步行试验(6 MWT)和血清行N-末端脑利尿钠肽前体(NT-proBNP)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平进行统计分析。结果:治疗后,观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组LVEF和6 MWT水平高于对照组,差异有统计学意义(P<0.05),LVEDD低于对照组,差异有统计学意义(P<0.05);观察组NT-proBNP、hs-CRP、IL-6水平显著低于对照组,差异有统计学意义(P<0.05)。结论:芪苈强心胶囊联合尼可地尔治疗CHF疗效较好,能够减轻患者炎性反应,改善其心功能,提高运动耐量。

芪苈强心胶囊联合常规西药治疗老年退行性心脏瓣膜病合并心力衰竭的临床效果分析

目的:分析芪苈强心胶囊联合常规西药治疗老年退行性心脏瓣膜病合并心力衰竭的临床效果。方法:选取2020年1月-2022年12月兰州大学第一医院收治的老年退行性心脏瓣膜病合并心力衰竭患者64例作为研究对象,采用随机数字表法分为对照组和观察组,各32例。对照组给予常规西药治疗,观察组在对照组基础上联合芪苈强心胶囊治疗。比较两组治疗效果。结果:观察组治疗有效率高于对照组,差异有统计学意义(P=0.023)。治疗后,两组左室舒张末期容积、左室收缩末期容积小于治疗前,且观察组小于对照组,两组左室射血分数、每搏输出量大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。治疗后,两组6 min步行距离大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:芪苈强心胶囊联合常规西药治疗老年退行性心脏瓣膜病合并心力衰竭的临床效果显著,可改善患者心功能,提高运动耐力,且不会增加不良反应。

芪苈强心胶囊辅助沙库巴曲缬沙坦钠治疗射血分数降低型慢性心力衰竭患者的临床疗效

目的:研究芪苈强心胶囊辅助沙库巴曲缬沙坦钠治疗射血分数降低型慢性心力衰竭(Heart failure with reduced ejection fraction,HFrEF)患者的临床疗效。方法:选取我院2020年12月至2022年12月收治的HFrEF患者78例,随机分为西药组、中药辅助组,各39例。西药组采用沙库巴曲缬沙坦钠治疗,中药辅助组采用芪苈强心胶囊辅助沙库巴曲缬沙坦钠治疗。治疗3 m后,比较两组临床疗效,四维心脏彩超仪检测心率、左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室后壁厚度(Left ventricular posterior wall thickness,LVWP)、每搏输出量(Stroke volume,SV),24 h动态心电分析系统检测正常窦性心搏间期标准差(Standard deviation of NN intervals,SDNN)、相邻RR间期差值均方根(Root mean square of successive R-R interval differences,RMSSD),酶联免疫吸附法检测血清半乳糖凝集素3(Galectin-3,Gal-3)、心肌肌钙蛋白(Cardiac Troponin T,cTnT)、生长刺激表达基因2蛋白(Soluble growth stimulation expressed gene 2,sST2)、B型利钠肽(Brain natriuretic peptide,BNP)水平;治疗后随访6 m,比较两组主要不良心血管事件(Major adverse cardiovascular events,MACE)发生情况。结果:治疗后,中药辅助组临床总有效率高于西药组(P<0.05);与治疗前相比,两组治疗后心率、LVWP均降低,LVEF、SV均升高,其中中药辅助组改善更为显著(P<0.05);与治疗前相比,两组治疗后RMSSD、SDNN均升高,血清Gal-3、cTnT、sST2、BNP水平均降低,其中中药辅助组改善更为显著(P<0.05);治疗后随访6 m,中药辅助组MACE发生率略低于西药组,但组间比较,差异无统计学意义(P>0.05)。结论:芪苈强心胶囊辅助合沙库巴曲缬沙坦钠治疗HFrEF疗效显著,可改善心率变异性,增强心功能,减轻心肌损伤,改善心室重构,降低MACE发生的风险。

芪苈强心胶囊联合重组人脑利钠肽治疗心肌梗死合并心力衰竭的效果观察

目的:探讨苈强心胶囊联合重组人脑利钠肽(rhBNP)治疗心肌梗死(MI)合并心力衰竭(HF)的效果。方法:选取2020年5月—2022年5月嘉峪关市中医医院收治的MI合并HF患者100例作为研究对象,根据随机数字表法分为研究组与对照组,各50例。对照组采用rhBNP治疗,研究组采用芪苈强心胶囊与rhBNP联合治疗。比较两组治疗效果。结果:研究组治疗总有效率高于对照组,差异有统计学意义(P=0.007)。治疗前,两组B型钠尿肽(BNP)、心肌肌钙蛋白(cTnT)水平比较,差异无统计学意义(P>0.05);治疗后,两组BNP、cTnT水平低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组不良反应总发生率低于对照组,差异有统计学意义(P=0.017)。结论:苈强心胶囊联合rhBNP治疗MI合并HF的效果显著,可改善患者心肌受损情况,降低不良反应发生率。

芪苈强心胶囊联合沙库巴曲缬沙坦钠对老年慢性心力衰竭患者血清Gal-3、Copeptin水平及TLR4/NF-κB信号通路的影响

目的:探讨芪苈强心胶囊辅助治疗老年CHF对患者Gal-3、Copeptin水平及TLR4/NF-κB信号通路的影响。方法:采用随机数表法将2021年3月至2023年3月平顶山市第一人民医院112例老年CHF患者分为采用沙库巴曲缬沙坦钠(诺欣妥)治疗的常规组(n=56例)和采用芪苈强心胶囊辅助治疗的联合组(n=56例)。观察两组疗效、心功能、血清半乳糖凝集素-3(Gal-3)、Copeptin水平、Toll样受体(TLR4)、核因子-κ(NF-κB)水平及不良反应。结果:治疗3个月后,联合组的临床治疗总有效率、心输出量(CO)、左心室射血分数(LVEF)高于常规组(P<0.05);联合组TLR4、NF-κB、Gal-3、Copeptin水平低于常规组(P<0.05);两组患者用药期间不良反应发生率对比,差异无统计学意义(P>0.05)。结论:芪苈强心胶囊联合沙库巴曲缬沙坦钠可调节TLR4、NF-κB水平,促进老年CHF患者心功能恢复,并抑制心肌重构,进而有效提高临床治疗疗效,且不增加患者不良反应发生风险。

芪苈强心胶囊联合米力农对心肌梗死患者动脉血流、心功能和血管内皮功能的影响

目的:探讨芪苈强心胶囊联合米力农治疗对心肌梗死患者动脉血流、心功能及血管内皮功能的影响。方法:将149例心肌梗死患者按照治疗方案不同分为对照组(n=74)与观察组(n=75)。对照组采用米力农治疗;观察组在对照组的基础上加用芪苈强心胶囊治疗。两组均治疗1周后评估疗效,检测两组患者治疗前后动脉血流[舒张早期最大充盈速度(E)、舒张晚期最大充盈速度(A)及E/A比值]、心功能[心功能分级、左室射血分数(LVEF)、每搏量(SV)、体循环血管阻力(SVR)及B型利钠肽前体(NT-proBNP)]及血管内皮功能指标[一氧化氮(NO)、内皮素1(ET-1)、血管紧张素Ⅱ(AngⅡ)]的变化,统计患者不良反应发生情况。结果:观察组患者治疗总有效率均高于对照组(P<0.05);治疗后,观察组患者E峰、E/A比值均高于对照组(P<0.05);A峰低于对照组(P<0.05);LVEF、SV高于对照组(P<0.05);SVR、NT-proBNP低于对照组(P<0.05);NO高于对照组(P<0.05);ET-1、AngⅡ低于对照组(P<0.05),两组患者不良反应总发生率无统计学差异(P>0.05)。结论:芪苈强心胶囊联合米力农治疗心肌梗死疗效肯定,安全性较高,其机制可能与芪苈强心胶囊、米力农联合应用可综合两者优势,通过改善动脉血流、血管内皮功能,从而改善心脏收缩、舒张功能,促进心室充盈有关。

芪苈强心胶囊辅助替米沙坦方案对扩张型心肌病患者心室重塑及炎症因子表达的影响

目的探究芪苈强心胶囊辅助替米沙坦方案对扩张型心肌病患者心室重塑及炎症因子表达的影响。方法选取2021年1—12月成武中医医院心内科收治的100例扩张型心肌病患者作为研究对象,按照抽签法分为对照组与研究组,每组50例。对照组采用替米沙坦治疗,研究组采用芪苈强心胶囊辅助替米沙坦方案治疗。比较两组临床疗效、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、右心室收缩末期内径(LVESD)]、心室重塑指标[基质金属蛋白酶-9(MMP-9)、Ⅰ型前胶原氨基末端肽(PⅠNP)、Ⅲ型前胶原氨基末端肽(PⅢNP)]、炎症因子[肿瘤坏死因子-α(TNF-α)、N末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)]水平、血管内皮功能[一氧化氮(NO)、内皮素-1(ET-1)、可溶性血管内皮黏附因子-1(SICAM-1)]水平。结果研究组治疗总有效率为98.00%,高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组LVEF均高于治疗前,LVEDD、LVESD均短于治疗前,且研究组LVEF高于对照组,LVEDD、LVESD均短于对照组,差异有统计学意义(P<0.05);治疗后,两组MMP-9、PⅠNP、PⅢNP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组TNF-α、NT-proBNP、hs-CRP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组NO水平均高于治疗前,ET-1、SICAM-1水平均低于治疗前,且研究组NO水平高于对照组,ET-1、SICAM-1水平均低于对照组,差异有统计学意义(P<0.05)。结论芪苈强心胶囊辅助替米沙坦方案治疗扩张型心肌病效果显著,可改善患者心室重塑,降低炎症因子水平,提高心功能,值得临床推广应用。

芪苈强心胶囊对急性左心衰竭患者血管内皮功能及心功能指标的影响

目的:探讨芪苈强心胶囊对急性左心衰竭患者血管内皮功能及心功能指标的影响。方法:按随机数字表法将2021年1月—2023年12月在萍乡赣西医院接受治疗的80例急性左心衰竭患者分为两组,每组40例。对照组采用重组人脑利钠肽治疗,观察组在对照组基础上加用芪苈强心胶囊治疗。对比两组中医证候疗效、血管内皮功能、心功能指标和不良反应发生情况。结果:观察组治疗总有效率高于对照组(P<0.05);观察组治疗后内皮素-1(ET-1)低于对照组,一氧化氮(NO)、充血肱动脉内径增加度(FMD)水平均高于对照组(P<0.05);观察组治疗后左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)均低于对照组,左心室射血分数(LVEF)高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:芪苈强心胶囊在急性左心衰竭患者治疗中效果显著,能够改善患者血管内皮功能,可有效促进患者心功能水平恢复,利于缓解患者中医证候,且副作用较少,安全性较高。

参附注射液联合芪苈强心胶囊治疗冠心病合并心力衰竭患者的效果分析

目的分析参附注射液联合芪苈强心胶囊治疗冠状动脉粥样硬化性心脏病(简称冠心病)合并心力衰竭患者的效果。方法选取新沂市中医医院于2021年1月—2023年8月收治的78例冠心病合并心力衰竭患者为研究对象,以随机数表法分为对照组和观察组,每组39例。对照组使用常规治疗,观察组使用常规治疗+参附注射液联合芪苈强心胶囊治疗。比较两组治疗效果、心功能及心肌酶水平。结果观察组总有效率(94.87%)高于对照组(79.49%),差异有统计学意义(χ^(2)=4.129,P<0.05)。观察组左心室射血分数、每搏输出量、心输出量、心脏排血指数均高于对照组,差异有统计学意义(P均<0.05)。观察组肌酸激酶、乳酸脱氢酶、肌酸激酶同工酶水平均较对照组低,差异有统计学意义(P均<0.05)。结论参附注射液联合芪苈强心胶囊治疗冠心病合并心力衰竭患者效果佳,可提高疗效,改善心功能,降低心肌酶表达。

芪苈强心胶囊治疗慢性心力衰竭随机双盲、多中心临床研究

目的观察芪苈强心胶囊治疗慢性心力衰竭的疗效和安全性。方法采用平行随机、阳性药对照、双盲双模拟、多中心临床试验设计方法,488例冠心病、高血压病心力衰竭患者随机分为芪苈强心胶囊治疗组(326例)和心宝丸对照组(162例),疗程4周,观察心功能分级、Lee氏心力衰竭计分、心脏收缩和舒张功能、中医证候和生活质量等疗效指标及安全性指标。结果(1)心功能疗效:治疗组和对照组显效率分别为48.8%和41.4%,总有效率分别为78.5%和71.6%,2组比较差异无显著意义(P>0.05);(2)Lee氏心力衰竭计分疗效:治疗组和对照组显效率分别为42.3%和32.1%,总有效率分别为82.5%和72.8%,2组比较差异有显著意义(P<0.05,P<0.01);(3)中医证候疗效:治疗组和对照组显效率分别为46.6%和32.1%,总有效率分别为90.2%和82.1%,2组比较差异有显著意义(P<0.05,P<0.01);(4)心脏收缩和舒张功能:治疗组明显提高患者左室射血分数(LVEF)和E/A比值,改善心脏收缩和舒张功能;(5)生活质量:治疗组改善患者生活质量优于对照组(P<0.01)。(6)安全性观察:治疗组未见不良反应。结论芪苈强心胶囊治疗慢性心力衰竭具有明显疗效和良好的安全性。

芪苈强心调节急性心肌梗死大鼠心肌TNF-α和IL-10表达

目的:探讨中药芪苈强心对急性心肌梗死(Acute myocardial infarction,AMI)大鼠心功能和炎症细胞因子TNF-α、IL-10表达的效用。方法:结扎大鼠左前降支,建立AMI模型。存活者随机分为梗死组(MI组)和芪苈强心治疗组(MI-Q组),另设假手术组(S组)。MI-Q组术后次日给予芪苈强心生药按4g/(kg·d)溶于生理盐水1.5ml治疗,MI组和S组仅以等量生理盐水同时间点灌胃,分别于术后第1、4周采用超声心动图和血流动力学检测心功能,实时定量PCR和免疫组织化学染色检测心肌组织中TNF-α和IL-10表达。结果:MI组大鼠左室功能明显减低,心肌细胞分泌的炎症因子TNF-α/IL-10比值明显升高。给予芪苈强心治疗后,心肌梗死大鼠心功能明显改善,心肌细胞表达TNF-α显著减少,IL-10表达显著增加。结论:减少心肌细胞促炎因子和增加抗炎因子的免疫调节作用可能是中药芪苈强心改善AMI大鼠心功能的免疫药理机制之一。

芪苈强心胶囊辅治对慢性心力衰竭患者血清细胞因子的影响

目的观察芪苈强心胶囊辅治对慢性心力衰竭(CHF)患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、高敏C-反应蛋白(hs-CRP)及肝肾功能、心肌酶水平的影响,探讨其对CHF的治疗作用。方法 CHF患者85例随机分为2组,常规治疗组35例,芪苈强心组50例。常规治疗组应用利尿剂、ACEI、ARB等药物治疗芪苈强心组在常规治疗组的基础上加服芪苈强心胶囊,2组均于治疗4周后检测血清TNF-α、IL-6、hs-CRF水平及肝功能、肾功能、心肌酶变化。结果治疗前2组血清TNF-α、IL-6、hs-CRP水平比较差异无统计学意义(P>0.05);2组治疗4周后均较治疗前有显著下降(P<0.05或P<0.01),且芪苈强心组较常规治疗组下降更显著(P<0.05)。2组治疗前后肝功能、肾功能及心肌酶水平比较差异均无统计学意义(P>0.05)。结论在常规治疗的基础上,加服芪苈强心胶囊治疗可进一步降低CHF患者体内血清TNF-α、IL-6、hs-CRP水平,且对肝功能、肾功能及心肌酶无显著影响。

芪苈强心胶囊对慢性心力衰竭大鼠心脏功能及血浆血管加压素的影响

目的探讨芪苈强心胶囊对慢性心力衰竭(CHF)大鼠心脏功能及血浆血管加压素(AVP)的影响。方法 SD大鼠结扎冠脉前降支,建立CHF大鼠模型,将大鼠随机分为慢性心力衰竭组(C组),芪苈强心高、中、低剂量治疗组(Q1、Q2、Q3组)和呋塞米治疗组(F组),另设假手术组(S组)。药物灌胃6周后检测大鼠超声心动图和血流动力学指标,放射免疫法测定血浆AVP浓度。结果与S组比较,C组大鼠心脏功能显著减退,血浆AVP浓度显著升高(P<0.01)。经过芪苈强心胶囊治疗后,Q1、Q2、Q3组大鼠心脏功能、血流动力学指标均有显著改善,血浆AVP浓度显著降低(P<0.05);F组大鼠心脏功能及血流动力学指标均无显著改善,而血浆AVP浓度显著升高(P<0.05)。结论芪苈强心胶囊可以改善CHF大鼠的心脏功能,降低血浆AVP浓度。