RESUMO
ObjectiveTo study the clinical efficacy of dapagliflozin combined with Shexiang Baoxinwan （SXBXW） in the treatment of acute heart failure with reduced ejection fraction （HFrEF） and syndrome of Qi deficiency and blood stasis. MethodA total of 176 patients hospitalized due to acute HFrEF （syndrome of Qi deficiency and blood stasis） were selected and randomized into control group， SXBXW group， dapagliflozin group， and SXBXW + dapagliflozin group （the latter three groups were called the intervention groups）. The New York Heart Association （NYHA） class， 6-minute walk test （6MWT） score， Kansas City Cardiomyopathy Questionnaire （KCCQ） score， traditional Chinese medicine （TCM） syndrome score， N-terminal pro-brain natriuretic peptide （NT-proBNP）， soluble suppression of tumorigenicity 2 （sST2）， interleukin-6 （IL-6）， and hypersensitive C-reactive protein （hs-CRP） of the patients were evaluated and measured at the time of admission， 1 week after treatment， and 2 weeks of treatment. Furthermore， the hospital stay， in-hospital mortality， and 30-day re-admission rate were recorded. Statistical analysis was performed to evaluate the efficacy of each group. ResultAfter 1 week of treatment， the SXBXW group exhibited superior NYHA class， KCCQ score， TCM syndrome score and curative effect， IL-6， and hs-CRP to the control group （P<0.05， P<0.01）. After 2 weeks of treatment， the SXBXW group showed superior TCM syndrome score， TCM curative effect， and hs-CRP （P<0.05， P<0.01） to the control group. The dapagliflozin group was superior to the control group in terms of TCM syndrome score， NT-proBNP， and sST2 （P<0.05， P<0.01） after 1 week of treatment and in terms of NYHA class， KCCQ score， NT-proBNP， sST2， and hospital stay （P<0.05， P<0.01） after 2 weeks of treatment. The SXBXW + dapagliflozin group exhibited better efficacy than the control group in terms of NYHA class， 6MWT score， KCCQ score， TCM syndrome score and curative effect， NT-proBNP， sST2， IL-6， and hs-CRP （P=0.014） after 1 week of treatment and in terms of NYHA class， KCCQ score， TCM syndrome score and curative effect， NT-proBNP， sST2， IL-6， hs-CRP， and hospital stay （P<0.01） after 2 weeks of treatment. ConclusionSXBXW and dapagliflozin have good therapeutic effect on acute HFrEF and syndrome of Qi deficiency and blood stasis， and their combination demonstrated better therapeutic effect， with good safety and tolerability.
RESUMO
Objective To investigate the effect of atovastatin combined with trimetazidine on cardiac function and inflammatory cytokines in patients with chronic heart failure(CHF). Methods Ninety-seven patients with CHF were randomly divided into three groups:control group treated with conventional therapy,atovastatin group treated with atovastatin based on conventional therapy, and combined treatment group treated with atovastatin and trimetazidine based on conventional therapy. The parameters of cardiac function, including left ventricular ejection fraction ( LVEF) and left ventficular end-diastolic diameter (LVEDD) ,and the plasma levels of CRP,brain natriuretic peptide(BNP) ,and TNF-α were detected in all patients of each group before and after treatment. Results The plasma levels of CRP,BNP and TNF-α in patients with cardiac function Ⅳ were significantly higher than in those with cardiac function ≤ Ⅲ (P<0. 05). There was significant difference in plasma levels of CRP, BNP,TNF-α,LVEF and LVEDD before and after treatment in all groups(P<0. 05 or P<0. 01). As compared with control group after treatment,the plasma levels of CRP,BNP and TNF-α after treatment in both atovastatin group and combined treatment group were decreased markedly(P<0. 05),so did LVEF, LVEDD and 6-min walk test(P<0. 05). There was no significant difference in changes of CRP,BNP and TNF-α plasma levels,LVEF and LVEDD between atovastatin group and combined group after treatment (P>0. 05),but 6-min walk test lengthened statistically in combined treatment group (P<0. 05). Conclusion Atovastatin based on conventional therapy may play a role in anti-inflammation by lowering the plasma levels of CRP, BNP and TNF-α in patients with CHF, thereby improving cardiac function. Atovastatin combined with tremetazidine could reduce the cardiac muscular oxygen consumption and raise the excise endurance in patients with CHF.