| Heart failure is a series of complicated clinical syndroms caused by various etiologies,leading to structural or functional abnormalities of the heart,systolic or diastolic dysfunction of the heart,such as fluid retention,decreased activity endurance and so on.With the increasing incidence of coronary heart disease,hypertension and diabetes,the aging of the population,the number of patients with heart failure is increasing year by year,and the mortality rate is high,seriously threatening people’s life and health.With the change of the treatment concept of heart failure,the rehospitalization rate and mortality rate of heart failure have decreased compared with the past,but the situation is still not optimistic.According to overseas reports of cardiovascular diseases,the mortality rate of heart failure patients within one year is 22%,and the rehospitalization rate is 44%.Therefore,more and more effective drugs are needed to treat heart failure.In recent years,with the development of traditional Chinese medicine in the treatment of heart failure,more and more evidence-based medicine evidence shows that Chinese patent medicine made by the guidance of traditional Chinese medicine theory and the application of modern technology can improve the heart function of patients with chronic heart failure,improve the quality of life.Among them,Qishen Yiqi Drop Pill is a kind of Chinese patent medicine made by extracting the effective components of astragalus,salvia miltiorrhiza,panax notoginseng and jiangxiang.Although previous clinical studies have shown that Qishen Yiqi Drop Pill can improve the clinical efficacy of patients with chronic heart failure,there is no definite basis for its long-term efficacy.Objective:To observe the efficiency of Qishen Yiqi Drop Pill to patients withchronic heart failure and provide scientific basis for Qishen Yiqi Drop Pill treating of chronic heart failure.Methods:1 Subjects: A total of 416 chronic heart failure patients,aged 39-80 years,who were admitted to Baoding NO.1 Central Hospital from September 1.2017 to October1.2018,including 262 males and 154 females,were diagnosed based on guidelines for heart failure,including their previous medical history,clinical symptoms and signs,combined with chest X-ray and echocardiography,accord with qi deficiency blood stasis syndromes license.2 Observation indexes: Recorded patients’ general conditions,including name,gender,age,BMI,course of heart failure,primary disease,systolic blood pressure,diastolic blood pressure,heart rate,hemoglobin,creatinine,total cholesterol,blood glucose,sodiumions,and other heart failure drug application.Before treatment,6 monthsand 12 months after treatment,NT-pro BNP,LVEF,LVEDD,6-MWT,MLHFQ scores,NYHA cardiac function grading and adverse cardiovascular events were recorded during follow-up.Observe the patient’s blood pressure,heart rate,blood routine,urine routine,stool routine,liver and kidney function,electrolyte status during medication,and pay attention to whether the patient has any adverse reactions during medication(nausea,hypotension,electrolyte disorder,dizziness,headache,cough,etc).3 Grouping and treatment of the subjects: The 416 patients were divided into 208 cases in the control group and 208 cases in the experimental group by the random number table method.The control group with conventional western medicine.The experimental group was treated with the conventional western medicine accompanied with Qishen Yiqi Drop Pill,4 weeks for a course of treatment,long-term using.They were followed up for 12 months.Results:1 After 12 months,follow-up was completed in 360 cases.There were no significant differences between the two groups in age,gender,cardiac functiongrade,primary disease,BMI,hemoglobin,creatinine,total cholesterol,blood glucose,sodiumions,and application of basic drugs(P>0.05).2 Before treatment,there was no significant difference in NT-pro BNP,LVEF,LVEDD,6-MWT,MLHFQ scores between the experimental group and the control group(P>0.05),and the two groups were comparable.Intra-group comparison : NT-pro BNP,6-MWT,LVEF,LVEDD and MLHFQ scores showed significant differences before treatment,after treatmentof 6monthsand after treatmentof 12 months between the experimental group and the control group(P<0.05).Inter-group comparison: After 6 months of treatment,NT-pro BNP level(668.09±535.10)pg/m L in the experimental group was significantly lower than that in the control group(989.48±557.20)pg/m L,LVEF(44.07±4.42)% in the experimental group was significantly higher than that in the control group(43.13±4.92)%,and LVEDD(57.54±3.40)mm in the experimental group was significantly lower than that in the control group(59.75±4.05)mm.The 6-MWT(292.91±53.84)m of the experimental group was significantly higher than that of the control group(271.38±58.56)m,with statistically significant differences(P<0.05),MLHFQ score(36.14±6.33)in the experimental group was lower than that in the control group(39.71±5.95),and the difference was not statistically significant(P>0.05);After 12 months of treatment,NT-pro BNP level(325.14±293.62)pg/m L in the experimental group was significantly lower than that in the control group(478.54±346.71)pg/m L,LVEF(49.70±4.62)% in the experimental group was significantly higher than that in the control group(48.05±5.38)%,and LVEDD(54.05±3.35)mm in the experimental group was significantly lower than that in the control group(56.55±4.21)mm.The6-MWT(360.17±51.50)m of the experimental group was significantly higher than that of the control group(321.47±56.58)m,and the MLHFQ score(23.45±5.51)was significantly lower than that of the control group(25.97±6.51),with statistically significant differences(P<0.05).3 After 12 months of treatment,the efficacy was determined according to NYHA cardiac function grading: the total effective rate(92.0%)of theexperimental group was higher than that of the control group(81.0%),with no statistically significant difference(P>0.05).4 After 12 months of treatment,the incidence of cardiac death in the experimental group(1.7%)was lower than that in the control group(2.7%),with no significant difference(P>0.05),the incidence of malignant arrhythmia in the experimental group(1.7%)was higher than that in the control group(1.6%),with no significant difference(P>0.05),the rehospitalization rate for cardiovascular diseases in the experimental group(22.7%)was significantly lower than that in the control group(35.9%),with statistically significant difference(P<0.05),the total incidence of adverse cardiovascular events in the experimental group(26.1%)was significantly lower than that in the control group(40.2%),with a statistically significant difference(P<0.05).5 The total incidence of adverse reactions(9.1%)in the experimental group was higher than that in the control group(8.2%),with no significant difference(P>0.05).Conclusion:1 Qishen Yiqi Drop Pill can improve the heart function of patientswith chronic heart failure,reducethe rate of re-hospitalization due to cardiovascular diseases and the total incidence of adverse cardiovascular events in patients with chronic heart failure.2 Qishen Yiqi Drop Pill can improve the exercise tolerance and quality of life of patients with chronic heart failure and has good safety in treating chronic heart failure. |
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