Wang Shao-Mei, Ye Li-Fang, Wang Li-Hong
Cardiovascular Medicine Department, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Bengbu Medical College, Bengbu, China.
Front Pharmacol. 2020 Apr 17;11:459. doi: 10.3389/fphar.2020.00459. eCollection 2020.
In recent years, the application of Shenmai (SM) injection, a traditional Chinese medicine (TCM), to treat heart failure (HF) has been gradually accepted in China. However, whether SM improves energy metabolism in patients with HF has not been determined due to the lack of high-quality studies. We aimed to investigate the influence of SM on energy metabolism in patients with HF.
This single-blind, controlled study randomly assigned 120 eligible patients equally into three groups receiving SM, trimetazidine (TMZ), or control in addition to standard medical treatment for HF for 7 days. The primary endpoints were changes in free fatty acids (FFAs), glucose, lactic acid (LA), pyroracemic acid (pyruvate, PA) and branched chain amino acids (BCAAs) in serum. The secondary outcomes included the New York Heart Association (NYHA) functional classification, TCM syndrome score (TCM-s), left ventricular injection fraction (LVEF), left ventricular internal diastolic diameter (LVIDd), left ventricular internal dimension systole (LVIDs), and B-type natriuretic peptide (BNP).
After treatment for 1 week, the NYHA functional classification, TCM-s, and BNP level gradually decreased in the patients in all three groups, but these metrics were significantly increased in the patients in the SM group compared with those in the patients in the TMZ and control groups (P < 0.05). Moreover, energy metabolism was improved in the NYHA III-IV patients in the SM group compared with those in the patients in the TMZ and control groups as evidenced by changes in the serum levels of FFA, LA, PA, and BCAA.
Integrative treatment with SM in addition to standard medical treatment for HF was associated with improved cardiac function compared to standard medical treatment alone. The benefit of SM in HF may be related to an improvement in energy metabolism, which seems to be more remarkable than that following treatment with TMZ.
近年来，中药参麦注射液应用于治疗心力衰竭在中国已逐渐被接受。然而，由于缺乏高质量研究，参麦是否能改善心力衰竭患者的能量代谢尚未确定。我们旨在研究参麦对心力衰竭患者能量代谢的影响。
这项单盲对照研究将120例符合条件的患者随机平均分为三组，除接受心力衰竭标准药物治疗外，分别接受参麦、曲美他嗪或对照治疗，为期7天。主要终点是血清中游离脂肪酸（FFA）、葡萄糖、乳酸（LA）、丙酮酸（PA）和支链氨基酸（BCAA）的变化。次要结局包括纽约心脏协会（NYHA）心功能分级、中医证候评分（TCM-s）、左心室射血分数（LVEF）、左心室内径舒张末期（LVIDd）、左心室内径收缩末期（LVIDs）和B型利钠肽（BNP）。
治疗1周后，三组患者的NYHA心功能分级、TCM-s和BNP水平均逐渐下降，但参麦组患者的这些指标与曲美他嗪组和对照组相比显著升高（P<0.05）。此外，参麦组NYHA III-IV级患者的能量代谢较曲美他嗪组和对照组有所改善，血清FFA、LA、PA和BCAA水平的变化证明了这一点。
与单纯标准药物治疗相比，参麦联合标准药物治疗心力衰竭可改善心功能。参麦在心力衰竭中的益处可能与能量代谢改善有关，这似乎比曲美他嗪治疗后的改善更显著。
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