Effect of Jiaomu Gualou Decoction combined with bisoprolol on myocardial microcirculation and oxidation/antioxidant balance in patients with heart failure / 国际中医中药杂志

ABSTRACT

Objective:To investigate the effect of Jiaomu Gualou Decoction combined with bisoprolol on myocardial microcirculation and oxidative/antioxidant balance in patients with heart failure.Methods:A total of 128 patients with heart failure who met the inclusion criteria from March 2020 to February 2021 in Dagang Hospital of Traditional Chinese Medicine, Binhai New Area, Tianjin were divided into 2 groups by random number table method, with 64 in each group. On the basis of conventional treatment, the control group was given oral bisoprolol, and the study group was given Jiaomu Gualou Decoction and oral bisoprolol. Both groups were treated continuously for 4 weeks. TCM syndrome scores were performed before and after treatment. The left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD) were detected by ultrasonic diagnostic equipment, and the frequency, duration and total myocardial ischemia load of the 24-hour ECG were recorded. Lipid peroxide (LPO) was detected by fluorescence method, SOD, MDA and GSH-Px were detected by colorimetric method. The adverse events were recorded and clinical response was evaluated.Results:The response rate was 93.75% (60/64) in the study group and 79.69% (51/64) in the control group, and the difference between the two groups was statistically significant ( χ2=5.49, P=0.019). After treatment, the scores of shortness of breath, phlegm, sternocostal fullness, and fatigue in the study group were significantly lower than those in the control group ( t values were 8.48, 8.15, 8.86, and 6.88, respectively, all Ps<0.001). After treatment, the LVEF of the study group [(53.26±5.18)% vs. (48.65±5.27)%, t=4.99] was significantly higher than that of the control group, and the LVESD [(42.59±3.26) mm vs. (46.98±3.55) mm, t=7.29], LVEDD [(52.79±4.15) mm vs. (57.48±4.60) mm, t=6.06] significantly lower than the control group ( P<0.01). After treatment, frequency of ST segment fall [(2.51±0.42) times/24 h vs. (3.79±0.55) times/24 h, t=14.80], duration [(15.26±3.45) min/24 h vs. (22.65±3.71) min/24 h, t=11.67] and total myocardial ischemia load [(25.79±5.13) mm/min vs. (38.02±5.44) mm/min, t=13.09] were significantly lower than those in the control group ( P<0.01). After treatment, the levels of serum GSH-Px and SOD in the study group were significantly higher than those in the control group ( t values were 10.97, 14.37, respectively, all Ps<0.001), while the levels of LPO and MDA were significantly lower than those in the control group ( t values were 7.50, 11.04, respectively, all Ps<0.001). During the treatment period, the incidence of adverse events was 4.69% (3/64) in the study group and 7.81% (5/64) in the control group, with no significant difference between the two groups ( χ2=0.13, P=0.715). Conclusion:The Jiaomu Gualou Decoction combined with bisoprolol can improve the cardiac function and myocardial microcirculation in patients with heart failure, promote the body's oxidation/antioxidant balance, relieve the clinical symptoms of patients, and improve the response effect safely.