Effect of Fuling Sini decoction on cardiac function in patients with septic cardiomyopathy
Objective To explore the effect of Fuling Sini decoction on cardiac function in patients with sepsis-induced cardiomyopathy(SIC).Methods Sixty SIC patients admitted to the department of intensive care unit(ICU)of Shenzhen Hospital(Longgang)of Beijing University of Traditional Chinese Medicine(TCM)from January 2021 to December 2022 were divided into a control group and a treatment group using a random number table method,with 30 patients in each group.Both groups received routine treatment,and the treatment group received Fuling Sini decoction(consisting of Poria cocos 30 g,Dry ginger 12 g,Ginseng 10 g,Prepared aconite 12 g,and Roasted licorice 15 g)based on routine treatment.Each dose was decocted into 200 mL,1 dose per day,divided into 3 times.Both groups of treatments lasted for 8 days.The use time of vasoactive drugs,ICU stay time and total hospital stay time,the 28-day mortality of two groups were recorded.TCM symptom score,sequential organ failure assessment(SOFA),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),procalcitonin(PCT),arterial oxygenation index(PaO2/FiO2),blood lactic acid(Lac),cardiac troponin Ⅰ(cTnⅠ),N-terminal pro-brain natriuretic peptide(NT-proBNP),heart type-fatty acid binding protein(H-FABP),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),mitral orifice early diastolic blood flow velocity(E),mitral orifice late diastolic blood flow velocity(A),and E/A ratio and tricuspid annular plane systolic excursion(TAPSE)were observed.Results The use time of vasoactive drugs,ICU stay time,and total hospital stay time in the treatment group were significantly shorter than those in the control group[use time of vasoactive drugs(days):4.47±2.16 vs.6.32±3.23,ICU stay time(days):9.18±3.32 vs.12.25±4.39,total hospital stay time(days):13.58±5.14 vs.17.13±6.65,all P<0.05].There was no statistically significant difference in the 28-day mortality between the treatment group and control group[20.00％(6/30)vs.43.33％(13/30),P>0.05].After treatment,the APACHE Ⅱ score and SOFA score in both groups decreased compared to before treatment,with a more significant decrease in the treatment group.The comparison between the two groups was most significant after 8 days of treatment(APACHE Ⅱ score:13.71±3.37 vs.16.21±3.82,SOFA score:3.24±0.85 vs.4.13±1.56,all P<0.05).After treatment,both groups showed a significant decrease in TCM syndrome scores compared to before treatment,with a more significant decrease in the treatment group(26.25±6.44 vs.29.43±6.83 on 3 days of treatment,21.42±4.22 vs.24.81±4.65 on 5 days of treatment,14.43±3.45 vs.17.58±4.56 on 8 days of treatment,all P<0.05).After treatment,PCT,Lac,and H-FABP in both groups decreased compared to before treatment,while PaO2/FiO2 increased,the treatment group showed more significant changes compared to the control group,especially after 8 days of treatment[PCT(μg/L):2.47±1.18 vs.3.54±1.51,Lac(mmol/L):1.86±0.41 vs.2.33±0.64,H-FABP(μg/L):4.67±1.22 vs.6.34±1.55,PaO2/FiO2(mmHg,1 mmHg≈0.133 kPa):297.63±53.92 vs.265.44±48.38,all P<0.05].After treatment,cTnI,NT-proBNP,LVESD,and LVEDD first increased and then decreased in both groups,while LVEF,E/A ratio and TAPSE first decreased and then increased,reaching a valley or peak at 8 days of treatment.Moreover,the above indicators showed statistical significance compared to the control group[cTnI(μg/L):0.15±0.06 vs.0.24±0.13,NT-proBNP(ng/L):825.43±164.73 vs.1234.40±243.37,LVESD(mm):48.36±4.46 vs.52.64±5.15,LVEDD(mm):38.39±3.22 vs.41.87±2.65,LVEF:0.55±0.08 vs.0.50±0.07,E/A ratio:1.23±0.12 vs.1.12±0.08,TAPSE(mm):22.45±2.23 vs.20.55±2.66,all P<0.05].Conclusion Fuling Sini Tang can improve the TCM syndrome of SIC patients,improve heart function,reduce myocardial injury,and shorten hospitalization time,making it a treatment worthy of clinical promotion.
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