[1]许世强,苏莉莉,丁亚楠,等.葶苈生脉五苓散联合沙库巴曲缬沙坦治疗射血分数降低心力衰竭疗效研究[J].陕西中医,2025,46(11):1504-1508.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.011]
　XU Shiqiang,SU Lili,DING Yanan,et al.Study on efficacy of Tingli Shengmai Wuling San combined with sacubitril/valsartan in treatment of heart failure with reduced ejection fraction[J].,2025,46(11):1504-1508.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.011]
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葶苈生脉五苓散联合沙库巴曲缬沙坦治疗射血分数降低心力衰竭疗效研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年11期
页码:
1504-1508
栏目:
临床研究
出版日期:
2025-11-05

文章信息/Info

Title:
Study on efficacy of Tingli Shengmai Wuling San combined with sacubitril/valsartan in treatment of heart failure with reduced ejection fraction
作者:
许世强; 苏莉莉; 丁亚楠; 高立威; 梅命珠
（石家庄市中医院，河北 石家庄 050051)
Author(s):
XU Shiqiang; SU Lili; DING Yanan; GAO Liwei; MEI Mingzhu
（Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050051,China）
关键词:
射血分数降低心力衰竭; 葶苈生脉五苓散; 沙库巴曲缬沙坦; 氨基末端脑钠肽前体; 可溶性生长刺激表达基因2蛋白; 基质金属蛋白酶组织抑制因子-1; 基质金属蛋白酶-9
Keywords:
Heart failure with reduced ejection fraction; Tingli Shengmai Wuling San; Sacubitril valsartan; N-terminal pro-brain natriuretic peptide; Soluble growth stimulation expressed gene 2; Tissue inhibitor of metal protease-1; Matrix metalloproteinase-9
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7369.2025.11.011
文献标志码:
A
摘要:
目的：探究葶苈生脉五苓散联合沙库巴曲缬沙坦治疗射血分数降低心力衰竭（HFrEF）患者的疗效及对心肌纤维化指标[血清氨基末端脑钠肽前体（NT-proBNP）、可溶性生长刺激表达基因2蛋白（sST2）、基质金属蛋白酶组织抑制因子（TIMP-1）、基质金属蛋白酶（MMP）-9]的影响。方法：选择HFrEF患者120例，随机数字表法分为葶苈生脉五苓散组、缬沙坦组，各60例。缬沙坦组采用沙库巴曲缬沙坦治疗，葶苈生脉五苓散组采用葶苈生脉五苓散联合沙库巴曲缬沙坦治疗。比较两组患者临床疗效、心功能指标、6分钟步行距离（6MWD）、中医证候积分、心肌纤维化指标及不良反应。结果：治疗后，葶苈生脉五苓散组的总有效率95.00%,高于缬沙坦组为83.33%（P＜0.05）。治疗后，两组左心室射血分数（LVEF）均升高，且葶苈生脉五苓散组高于缬沙坦组（均P＜0.05）。两组左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）均降低，且葶苈生脉五苓散组低于缬沙坦组（均P＜0.05）。治疗后，两组中医证候总积分均降低，且葶苈生脉五苓散组低于缬沙坦组，两组6MWD均增大，且葶苈生脉五苓散组大于缬沙坦组（均P＜0.05）。治疗后，两组NT-proBNP、sST2、TIMP-1、MMP-9水平均降低，且葶苈生脉五苓散组低于缬沙坦组（均P＜0.05）。治疗后，两组肿瘤坏死因子-α、IL-6水平均降低，且葶苈生脉五苓散组低于缬沙坦组（均P＜0.05）。结论：葶苈生脉五苓散联合沙库巴曲缬沙坦可减缓心室重构进程，改善HFrEF患者心功能，疗效较好。
Abstract:
Objective:To investigate therapeutic efficacy of Tingli Shengmai Wuling San combined with sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF) and its effects on myocardial fibrosis markers [serum N-terminal pro-brain natriuretic peptide (NT-proBNP),soluble growth stimulation expressed gene 2 protein (sST2),tissue inhibitor of matrix metalloproteinase (TIMP-1),and matrix metalloproteinase (MMP)-9].Methods:A total of 120 HFrEF patients were randomly divided into two groups (n=60 each) using a random number table.Tingli Shengmai Wuling San group treated with Tingli Shengmai Wuling San and sacubitril/valsartan,the valsartan group treated with sacubitril/valsartan alone.Clinical efficacy,cardiac function indicators,6-minute walking distance (6MWD),traditional Chinese medicine (TCM) syndrome scores,myocardial fibrosis markers,and adverse reactions were compared between the two groups.Results:After treatment,the total effective rate in the Tingli Shengmai Wuling San group was 95.00%,significantly higher than 83.33% in the valsartan group (P＜0.05).Left ventricular ejection fraction (LVEF) increased in both groups,with greater increase in the Tingli Shengmai Wuling San group (P＜0.05).Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) decreased in both groups,with greater reductions in the Tingli Shengmai Wuling San group (all P＜0.05).TCM syndrome total scores decreased in both groups,with a lower score in the Tingli Shengmai Wuling San group (P＜0.05).The 6MWD increased in both groups,with a greater improvement in the Tingli Shengmai Wuling San group (all P＜0.05).NT-proBNP,sST2,TIMP-1,and MMP-9 levels decreased in both groups,with lower levels in the Tingli Shengmai Wuling San group(all P＜0.05).Additionally,tumor necrosis factor-α and IL-6 levels decreased in both groups,with lower levels in the Tingli Shengmai Wuling San group (all P＜0.05).Conclusion:Tingli Shengmai Wuling San combined with sacubitril/valsartan can slow ventricular remodeling,improve cardiac function in HFrEF patients,and demonstrate superior therapeutic efficacy.

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备注/Memo

备注/Memo:
河北省中医药管理局科研计划项目（2022471）
更新日期/Last Update: 2025-11-04