RESUMEN
ObjectiveTo observe the effect of Jiawei Shenqi Yixin prescription on cardiovascular risk factors in the patients with heart failure with preserved ejection fraction and insulin resistance. MethodFrom January 2021 to January 2022， a total of 82 patients with heart failure with preserved ejection fraction were enrolled in the ward of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine. The patients were randomly assigned into two groups （ 41 cases） and received the same basic treatment. The observation group was additionally treated with Jiawei Shenqi Yixin prescription for 8 weeks. The clinical efficacy， traditional Chinese medicine （TCM） efficacy， cardiac function indexes ［NT-probrain natriuretic peptide （NT-proBNP） and 6-min walking test （6MWT）］， echocardiographic parameters ［left atrial volume index （LAVI）， left ventricular mass index （LVMI）， peak early diastolic to peak late diastolic mitral flow velocity （E/A） ratio］， insulin resistance-related indexes ［fasting insulin （FINS）， fasting plasma glucose （FPG）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， homeostatic model assessment of insulin resistance （HOMA-IR）， triglyceride-glucose index （TYG）， and triglyceride to high-density lipoprotein cholesterol （TG/HDL-C） ratio］， inflammatory cytokines ［tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， adiponectin （ADP）， and C-reactive protein （CRP）］， vascular endothelial function indicators ［nitric oxide （NO）， endothelial nitric oxide synthase （eNOS）， inducible nitric oxide synthase （iNOS）， and endothelin-1 （ET-1）］， and the safety of treatment were determined. In addition， Pearson correlation analysis was performed to analyze the correlations of insulin resistance， inflammatory cytokines， and vascular endothelial factors with the mitigation of heart failure. ResultIn terms of clinical efficacy， the therapy of the observation group was significantly effective in 26 patients， effective in 12 patients， ineffective in 3 patients， with the total effective rate of 92.68%， the therapy of the control group was significantly effective in 14 patients， effective in 12 patients， and ineffective in 15 patients， with the total effective rate of 63.41%. The clinical total effective rate of the observation group was higher than that of the control group （χ2=11.6， P<0.05）. In terms of TCM efficacy， the therapy of the observation group was significantly effective in 26 patients， effective in 11 patients， and ineffective in 4 patients， with the total effective rate of 90.24%； the therapy of the control group was significantly effective in 9 patients， effective in 13 patients， and ineffective in 19 patients， with the total effective rate of 53.66%. The TCM total effective rate of the observation group was higher than that of the control group （χ2=8.19， P<0.05）. Compared with those before treatment， the levels of NT-proBNP， LAVI， LVMI， FPG， FINS， HOMA-IR， TYG， TG/HDL-C， TNF-α， IL-6， CRP， ET-1， and iNOS in two groups declined after treatment （P<0.05）， while the levels of 6MWT， E/A， ADP， NO， and eNOS elevated （P<0.05）. After treatment， the observation group had lower levels of NT-proBNP， LAVI， LVMI， FPG， FINS， HOMA-IR， TYG， TG/HDL-C， TNF-α， CRP， and ET-1 （P<0.05） and higher levels of 6MWT， E/A， ADP， and NO than the control group （P<0.05）. In addition， the increase in 6MWT after treatment was positively correlated with the increase in NO and the decrease in ET-1. The decrease in LVMI after treatment was positively correlated with the increase in NO and the decrease in FINS. The increase in left ventricular ejection fraction after treatment was positively correlated with the decreases in TNF-α and TYG （P<0.05）. Adverse reactions were observed in neither group. ConclusionJiawei Shenqi Yixin prescription can significantly mitigate the symptoms， reduce inflammation， and improve vascular endothelial function in the patients with heart failure with preserved ejection fraction and insulin resistance， being safe without causing adverse reactions.
RESUMEN
Objective To study the protective effects ofcatalpol on cardiomyocytes in type 2 diabetic rats.Methods Based on the method of random number table,8-wee k-old SD rats were randomly divided into normal group (10 rats) and experimental group (90 rats).The rats in the experimental group that were fed with high-fat and high-sugar diet for 8 weeks were injected intraperitoneally with STZ (15 mg/kg),with fasting blood glucose≥16.7mmol/L as a model for type 2 diabetes.Then based on fasting blood glucose and body weight,the rats meeting the criteria of type 2 diabete mellitus were randomy divided into five group,namely,the model group,the control group,the low or medium and high doses of the catalpol group,and there were 12 rats in each group.The normal group and the model group were filled with distilled water (5 ml/kg·d,the control group were treated with metformin (90 mg/kg·d),and Low,medium and high dose group were intragastric administration of Catalpol(2.5,5,10 mg/kg·d).Then,the level of glucose,myocardial oxidative stress related protein,cardiac strcture and function change were measured after 12 weeks of intervention in rats.Results Compared with the model group,the level of fasting blood glucose in catalpol low,medium and high dose groups was significantly lower (P＜0.05).The levels of SOD (197.43 ± 8.85 U/ml,186.54 ± 5.89 U/ml,175.62 ± 7.67 U/ml vs.157.75 ±11.29 U/ml) in myocardial tissue of those groups significantly increased (P＜0.05),the levels of MDA (7.26 ±0.72 nmol/mg,8.58 ± 0.93 nmol/mg,10.62 ± 0.59 nmol/mg vs.14.80 ± 0.71 nmol/mg) in myocardial tissue of those groups significantly decreased (P＜0.05),the E/A value (1.25 ± 0.18,1.09 ± 0.14,0.97 ± 0.11 vs.0.51 ±0.11) in those groups significantly increased (P＜0.05),the E/E'values (12.33 ± 0.73,13.26 ± 1.07,14.73 ± 1.23 vs.20.54 ± 1.64) and the IVRT (21.90 ± 2.60 ms,22.05 ± 2.84 ms,24.42 ± 2.22 ms vs.27.40 ± 2.81 ms) in those groups significantly decreased (P＜0.05).Conclusions The catalpol can reduce oxidative stress,improve cardiac function and protect cardiomyocytes.