CHINESE JOURNAL OF MEDICINAL GUIDE >
Effects of Qishenjiang Decoction on Serum Levels of VEGF， ADMA and sST2 in Patients with Chronic Heart Failure
Received date: 2025-12-25
Revised date: 2026-02-15
Accepted date: 2026-04-20
Online published: 2026-06-29
Objective： To investigate the effects of qishenjiang decoction on vascular endothelial growth factor （VEGF）， asymmetric dimethylarginine （ADMA）， soluble suppression of tumorigenicity 2 （sST2）， and N-terminal pro-B-type natriuretic peptide （NT-proBNP）， and key biomarkers in patients with chronic heart failure， and to explore the potential mechanisms，thereby providing evidence for optimizing comprehensive treatment strategies for chronic heart failure.Methods： A total of 92 patients with chronic heart failure who visited our hospital and met the inclusion criteria were enrolled and randomly assigned to the control group and the observation group，with 46 patients in each group.Both groups received standardized conventional therapy. In addition，the observation group was treated with qishenjiang decoction for 12 weeks. Serum NT-proBNP， ADMA， VEGF， and sST2 levels， as well as echocardiographic parameters and cardiac function indicators of the patients were measured before treatment and after 12 weeks of treatment. Changes in these indicators were compared between the two groups， with emphasis on improvements in angiogenic capacity，endothelial function， and inflammatory remodeling status.Results： After treatment， the serum NT-proBNP levels of patients decreased in both groups compared with baseline （P<0.001）， and the post-treatment NT-proBNP level in the observation group was lower than that in the control group （t=2.530， P=0.014）. After treatment， serum ADMA levels of patients in the observation group were lower than those in the control group （t=2.319， P=0.024）. Serum VEGF levels of patients increased in both groups after treatment compared with baseline （P<0.001）， and the post-treatment VEGF level in the observation group was higher than that in the control group （t=2.052， P=0.044）. Serum sST2 levels of patients decreased in both groups after treatment compared with baseline （P<0.001）， and the post-treatment sST2 level in the observation group was lower than that in the control group （t=2.270， P=0.026）. After treatment， patients in the observation group showed significant improvements in left ventricular ejection fraction （LVEF）， left ventricular end-systolic diameter （LVESD）， and fractional shortening （FS） compared with baseline （P<0.05）.Conclusion： Qishenjiang decoction may improve angiogenesis impairment in patients with chronic heart failure through multi-target synergistic regulation of the VEGF-mediated angiogenic pathway， the ADMA-related endothelial function axis， and the sST2-associated inflammatory signaling network.
FU Xueting, WU Xiaodong, ZHAO Mingfen
.
Effects of Qishenjiang Decoction on Serum Levels
of VEGF， ADMA and sST2 in Patients with Chronic Heart
Failure
［1］ 蔡建平，田焕，杨巧芳.慢性心力衰竭患者症状群特征及其影响因素分析［J］.中华现代护理杂志，2021，27（25）：3410-3415.
［2］ Murphy SP， Ibrahim NE， Januzzi JL， et al.Heart failure with reduced ejection fraction： a review［J］.JAMA， 2020，324（5）：488-504.
［3］ 中华中医药学会.中医内科常见病诊疗指南·心衰病［M］.北京：中国中医药出版社，2021.
［4］ McDonagh TA， Metra M， Adamo M， et al. 2023 Focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure［J］.Eur Heart J， 2023，44（37）：3627-3639.
［5］ Januzzi JL， van Kimmenade R， Lainchbury J， et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure： an international pooled analysis of 1256 patients［J］.Eur Heart J， 2006，27（3）：330-337.
［6］ Yancy CW， Jessup M， Bozkurt B， et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure［J］.J Am Coll Cardiol， 2017，70（6）：776-803.
［7］ Ponikowski P， Voors AA， Anker SD， et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure［J］.Rev Esp Cardiol （Engl Ed）， 2016，69（12）：1167.
［8］ Bayes-Genis A， Zhang Y， Ky B， et al. ST2 and patient prognosis in chronic heart failure［J］.Am J Cardiol， 2015，115（7 Suppl）：64B-69B.
［9］ Sibal L， Agarwal SC， Home PD， et al. The role of asymmetric dimethylarginine（ADMA） in endothelial dysfunction and cardiovascular disease［J］.Curr Cardiol Rev， 2010，6（2）：82-90.
［10］ Taimeh Z， Loughran J， Birks EJ， et al. Vascular endothelial growth factor in heart failure［J］.Nat Rev Cardiol， 2013，10（9）：519-530.
［11］ Semenza GL. Hypoxia-inducible factor 1 and cardiovascular disease［J］.Annu Rev Physiol， 2014，76：39-56.
［12］ Taqueti VR， Solomon SD， Shah AM， et al.Coronary microvascular dysfunction and future risk of heart failure with preserved ejection fraction［J］.Eur Heart J， 2018，39（10）：840-849.
［13］ 中华医学会心血管病学分会，中国医师协会心血管内科医师分会，中国医师协会心力衰竭专业委员会，等.中国心力衰竭诊断和治疗指南2024［J］.中华心血管病杂志，2024，52（3）：235-275.
［14］ 张伯礼，吴勉华.中医内科学［M］.第4版.北京：中国中医药出版社，2017.
［15］ 任丽丽.中医辨证论治个体化疗效评价指标构建及应用［D］.济南：山东中医药大学，2023.
［16］ Jahmunah V， Oh SL， Wei JKE， et al. Computer-aided diagnosis of congestive heart failure using ECG signals-A review［J］.Phys Med， 2019，62：95-104
［17］ Setouhi A， Maghraby K， Taha N， et al. sST2 levels and 3D speckle tracking as predictors of CAD severity inchronic coronary syndrome［J］.Egypt Heart J， 2024，76（1）：1-8.
［18］ Ye Huangshu， Wu Qianwen， Zhang Ning， et al. The prognostic value of sST2 in connective tissue disease patients with pulmonary hypertension［J］.Rheumatology （Oxford）， 2022，61（10）：3989-3996.
［19］ Jin Yinsheng， Wei Shuang， Yao Lingling. Diagnostic performance of miR-214， BNP， NT-proBNP and soluble sST2 in acute heart failure［J］.Int J Clin Pract， 2021，75（10）：e14643.
［20］ Zhu Zhongsheng， Li Jinyu， Zhang Xiaorong. Astragaloside IV protects against oxidized low-density lipoprotein（ox-LDL）-induced endothelial cell injury by reducing oxidative stress and inflammation［J］.Med Sci Monit， 2019，25：2132-2140.
［21］ Sun Bin， Rui Ruping， Pan Haiying， et al. Effect of combined use of astragaloside IV（AsIV） and atorvastatin （AV） on expression of PPAR-γ and inflammation-associated cytokines in atherosclerosis rats［J］.Med Sci Monit， 2018，24：6229-6236.
［22］ 刘茜，王新婷，程培培，等.Ⅱ型心肾综合征大鼠模型制备方法的改良［J］.中国实验动物学报，2023，31（11）：1381-1388.
［23］ 史睿.心脏超声在慢性心衰患者中的诊断效果分析［J］.中西医结合心血管病电子杂志，2022，10（17）：125-127.
/
| 〈 |
|
〉 |