| Objective:To objectively evaluate the clinical efficacy of Bushen Huoxue Lishui Prescription in treating chronic heart failure with blood stasis and water retention syndrome,and to observe its effect on serum levels of sST2,GAL-3,ADH and RDW,so as to explore more objective methods and basis of TCM in clinical diagnosis and treatment of chronic heart failure.Methods:60 inpatients and outpatients of Jiangsu Traditional Chinese Medicine Hospital who met the diagnostic criteria of chronic heart failure were divided into treatment group and control group according to random number table.Both groups were treated with standardized western medicine according to the Chinese Heart Failure Diagnosis and Treatment Guidelines in 2014.On the basis of this,the treatment group was treated with Bushen Huoxue Lishui Recipe,and the course of treatment was 6 weeks±5 days.The TCM syndromes and symptoms score,Lee’s Heart Failure Score System:,quality of life score,6-minute walking distance change,serum levels of sST2,GAL-3,ADH,RDW,BNP,NYHA cardiac function classification,and safety index were observed before and after treatment,and the data were analyzed and concluded.Result:(1)There were no differences in general data,blood biology index,cardiac function classification,Lee’s heart failure score,TCM syndrome score,Minnesota Heart Failure Quality of Life Questionnaire score,6-minute walking distance and safety index between the two groups before treatment(P>0.05).(2)TCM syndrome and symptom integral:After treatment,the efficacy of TCM symptom integral was 90%in the treatment group and 56.6%in the control group.The efficacy of the treatment group was obvious higher than that of the control group(P<0.05).(3)NYHA Cardiac Function Grading:After treatment,the effective rate of the treatment group was 86.7%,and that of the control group was 70%.The effective rate of the treatment group was obvious higher than that of the control group(P<0.05).(4)Heart Failure Efficacy score(Lee’s Heart Failure Score):After treatment,the efficacy of Lee’s Heart Failure Score between the two groups was compared.The effective rate of the treatment group was 73.3%,and that of the control group was 43.3%.The effective rate of the treatment group was obvious higher than that of the control group(P<0.05).(5)Quality of Life Score of Heart Failure Patients(Minnesota Heart Failure Quality of Life Questionnaire Score):After treatment,the scores of the two groups decreased significantly(P<0.01).The scores of the treatment group decreased from 76.83(＋18.054)to 44.20(＋18.761)and the control group decreased from 77.77(+17.653)to 56.07(+23.625)before treatment.Compared with the control group,the score of the treatment group decreased more obvious(P<0.05).(6)6-minute walking test(m):After treatment,the distance between the two groups increased significantly(P<0.01).The distance between the two groups increased from 136.73(±121.815)to 382.57(±148.090)in the treatment group and from 112.53(±114.259)to 282.77(±185.975)in the control group.Compared with the control group,the distance of the treatment group increased more obvious(P<0.05).(7)Serum levels of sST2,GAL-3,ADH7RDW and BNP:In terms of sST2(pg/ml),after treatment,the sST2 levels in both groups decreased significantly(P<0.01),from 71.90(±4.041)to 42.91(±6.352)in the treatment group and from 71.94(±4.000)to 52.21(±2.487)in the control group.Compared with the control group,the sST2 levels in the treatment group decreased more significantly(P<0.01).In terms of GAL-3(ng/ml),after treatment,GAL-3 levels in the two groups decreased significantly(P<0.01),from 9.07(±1.206)to 3.67(±0.897)in the treatment group and from 9.17(±1.152)to 4.87(±1.125)in the control group.Compared with the control group,GAL-3 levels in the treatment group decreased more significantly(P<0.01).In terms of ADH(ng/L),the ADH levels in the two groups decreased significantly after.treatment(P<0.01).The ADH levels in the treatment group decreased from 67.47(±9.838)to 48.77(±9.700)and in the control group decreased from 66.71(±10.847)to 55.49(±10.287).Compared with the control group,The ADH levels in the treatment group decreased more obvious(P<0.05).In terms of RDW(%),after treatment,the level of RDW in the two groups decreased significantly(P<0.01).In the treatment group,the level of RDW decreased from 14.98(±0.696)to 13.46(±0.785)before treatment,and in the control group,from 15.07(±0.572)to 13.93(±0.526)before treatment.Compared with the control group,the level of RDW in the treatment group decreased more significantly(P<0.01).In terms of BNP(pg/ml),the BNP levels in the two groups decreased significantly after treatment(P<0.01),from 569.13(±148.069)to 295.27(±76.436)in the treatment group and from 583.00(±144.953)to 370.77(±94.201)in the control group.Compared with the control group,the BNP levels in the treatment group decreased more significantly(P<0.01).(8)Safety evaluation:During the study,no serious adverse reactions occurred in the control group and the experimental group.There was no significant difference in liver and kidney function(ALT,AST,BUN and Cr levels)between the two groups after treatment(P>0.05).Conclusion:Bushen Huoxue Lishui Recipe in the treatment of chronic heart failure with water stasis syndrome can reduce serum sST2,GAL-3,ADH,RDW,BNP and other heart failure related markers,improve patients’ heart function,heart failure efficacy score and quality of life,The 6-minute walking distance,the improvement of TCM syndromes and symptom scores were superior to the control group,and no adverse reactions such as abnormal safety indicators were observed.It is suggested that Bushen Huoxue Lishui Recipe combined with conventional western medicine for the treatment of chronic heart failure has good clinical efficacy and safety,and reflects the advantages of integrated Chinese and Western medicine treatment,which is worthy of further clinical research and promotion. |
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