Efficacy of Ershen Zhenwu Decoction Combined with Metoprolol in Treating Pa-tients with Heart Failure with Preserved Ejection Fraction of Left Ventricular and Its Effects on Cardiac Function and Neuroendocrine Factors
Objective To investigate the efficacy of Ershen Zhenwu decoction combined with metoprolol in trea-ting patients with heart failure with preserved ejection fraction(HFpEF)of left ventricular and its effects on cardiac function and neuroendocrine factors.Methods Ninety-two HFpEF patients treated at the Cardiovascular Medicine Department of Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine from June 2021 to June 2023 were se-lected and divided into a control group and a study group according to the simple random number table method,with 46 pa-tients in each group.Both groups received conventional treatment;the control group was given oral metoprolol in addition to conventional intervention,while the study group received Ershen Zhenwu decoction combined with the control group's regi-men.Both groups were treated for four weeks.Clinical efficacy,the incidence of adverse reactions,traditional Chinese medi-cine(TCM)syndrome scores,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic di-ameter(LVESD),left ventricular end-diastolic diameter(LVEDD),isovolumic relaxation time(IVRT)],neuroendocrine factor[aldosterone(ALD),angiotensin Ⅱ(AngⅡ),norepinephrine(NE)],and levels of neutrophil gelatinase-associated lipocalin(NGAL)and growth differentiation factor-15(GDF-15)were observed and compared before and after treatment.Results After treatment,the total effective rate in the study group was 93.48％(43/46),significantly higher than the control group's 78.26％(36/46),with a statistically significant difference(P＜0.05).TCM syndrome scores for chest pain,palpitations,shortness of breath,edema,cyanosis of lips and nails,dark complexion,and aversion to cold limbs de-creased significantly in both groups compared to before treatment,with a statistically significant difference(P＜0.05);the study group showing significantly lower scores than the control group,with a statistically significant difference(P＜0.05).LVEF levels increased,while LVESD,LVEDD,and IVRT levels decreased significantly in both groups compared to before treatment,with a statistically significant difference(P＜0.05);the study group showed significantly higher LVEF and lower LVESD,LVEDD,and IVRT levels than the control group,with a statistically significant difference(P＜0.05).Serum levels of ALD,Ang Ⅱ,and NE decreased significantly in both groups compared to before treatment,with a statistically significant difference(P＜0.05);the study group showed significantly lower levels than the control group,with a statistically signifi-cant difference(P＜0.05).Serum levels of NGAL and GDF-15 also decreased significantly in both groups compared to before treatment,with a statistically significant difference(P＜0.05);the study group showed significantly lower levels than the control group,with a statistically significant difference(P＜0.05).The incidence of adverse reactions in the study group was 4.35％(2/46)compared to 8.70％(4/46)in the control group,with no significant difference(P＞0.05).Con-clusion The combination of Ershen Zhenwu decoction and metoprolol in treating HFpEF can alleviate clinical symptoms,regulate ALD,Ang Ⅱ,NE,NGAL,and GDF-15 levels,improve cardiac function,enhance the overall therapeutic effect,and demonstrate good safety and tolerance.
Ershen Zhenwu DecoctionMetoprololHeart Failure with Preserved Ejection Fraction of Left Ventric-ularCardiac FunctionNeuroendocrine Factors
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