Efficacy of Shenfu Decoction and Fuling Sini Decoction Against Chronic Heart Fail-ure with Heart Yang Deficiency and Its Impact on TGF-β1 and Smad 3
Objective To investigate the efficacy of Shenfu Decoction combined with Fuling Sini Decoction in the treatment of patients with chronic heart failure characterized by heart yang deficiency,and to explore its effect on the ex-pressions of transforming growth factor-beta 1(TGF-β1)and Smad family member 3(Smad3).Methods Ninety chron-ic heart failure patients with heart yang deficiency admitted to Beijing Huairou Hospital of Traditional Chinese Medicine from January 2020 to January 2023 were enrolled and randomly assigned into a control group and a study group,with 45 in each group.The control group was treated with conventional Western medicine,while the study group was given Shenfu De-coction and Fuling Sini Decoction on the basis of the control group.Each patient underwent four treatment courses,with each course lasting four weeks.Cardiac function parameters(left ventricular end-diastolic diameter[LVEDD],left ven-tricular end-systolic diameter[LVESD],left ventricular ejection fraction[LVEF],stroke volume[SV]),heart failure bio-markers(heart-type fatty acid-binding protein[H-FABP],B-type natriuretic peptide[BNP]),myocardial fibrosis markers(type Ⅰ procollagen amino-terminal propeptide[PICP],type Ⅲ procollagen amino-terminal propeptide[P ⅢNP],cardiac troponin Ⅰ[cTnⅠ]),and the expressions of TGF-[31 and Smad3 were measured and compared between the two groups before and after treatment.Additionally,exercise tolerance,heart failure scores,Minnesota Living with Heart Failure Questionnaire scores,and traditional Chinese medicine(TCM)syndrome scores were evaluated,and the clinical effi-cacy as well as the incidence of major adverse cardiac events(MACE)was recorded.Results The study group exhibited a higher overall effective rate of 95.56％(43/45)compared with the control group at 80.00％(36/45)(P＜0.05).After treatment,both groups had marked improvements in cardiac function parameters(LVEDD,LVESD,LVEF,SV),heart fail-ure biomarkers(H-FABP,cTnⅠ,BNP),myocardial fibrosis markers(PICP,P Ⅲ NP),as well as reduced expressions of TGF-β1 and Smad3(all P＜0.05),and the study group was superior to the control group in all metrics(P＜0.05).Ex-ercise tolerance improved and heart failure and Minnesota scores decreased after treatment in both groups(P＜0.05),with the study group showing better results than the control group(P＜0.05).TCM syndrome scores also decreased after treat-ment(P＜0.05),with the study group scoring lower than the control group(P＜0.05).The incidence of MACE during the treatment was 4.44％(2/45)in the study group,lower than 17.78％(8/45)in the control group(P＜0.05).Conclu-sion Shenfu Decoction combined with Fuling Sini Decoction significantly improves clinical symptoms and signs in chronic heart failure patients with heart yang deficiency,down-regulates the expressions of TGF-β1 and Smad3,inhibits myocar-dial fibrosis,and promotes the recovery of cardiac function,demonstrating an ideal therapeutic effect.
Chronic heart failureHeart yang deficiencyShenfu DecoctionFuling Sini DecoctionTransforming growth factor-beta 1Smad family member 3
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