| Objective: At present,the combination of traditional Chinese medicine and Western medicine has a definite effect on chronic heart failure.This study aims to observe the effect of modified Fuzi Decoction(Rhizoma Aconitum,Poria cocos,Radix Salviae Miltiorrhizae,Radix Atractylodis Alba,Rhizoma Alismatis,Poria*The effects of TCM syndrome score,TCM syndrome efficacy,clinical cardiac function efficacy,BNP level,24 h urine volume,serum uric acid,plasma D2 polymer,left ventricular ejection fraction(LEVF)and re-hospitalization rate and mortality within 30 days of follow-up were observed to observe the clinical efficacy of Jiawei Fuzi Decoction in treating chronic heart failure with qi stagnation and blood stasis,Yang deficiency and water flooding.Methods: From December 2018 to December 2019,60 patients who met the diagnostic criteria of "Chronic Heart Failure"(Class II-III of Cardiovascular Function)Qi Deficiency,Blood Stasis and Yang Deficiency and Water Pan-type were selected from the Department of Cardiovascular Department of Sichuan Traditional Chinese Medicine Hospital.They could be divided into experimental group(30 cases)and control group(30 cases)by random number table method,and were followed up for 90 days.Both groups were given basic treatment: low-salt and low-fat diet,reasonable exercise,attention to rest,daily routine low-flow oxygen inhalation for more than two hours.The control group was treated with traditional western medicine for heart failure(according to blood pressure,electrolyte,heart rate,etc.,selective use of diuretics,ACEI/ARB according to the Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2018).Drugs or ARNI,beta blockers,vasodilators,inotropic agents,aldosterone antagonists,and other drugs ivabradine,calcium antagonists [amlodipine or felodipine],isosorbide monosalicylate,etc.),slowly increase to the target dose,and if there are adverse reactions,replace or discontinue the drug.The experimental group was treated with Decoction-free Chinese herbal granules for 14 days on the basis of the traditional western medicine treatment in principle,and the safety and efficacy index data of the two groups were collected before and during the observation period,and the differences were systematically analyzed*Comparisons were calculated and adverse drug reactions were recorded.Result:After the end of the study,60 clinical cases were successfully completed,and the data were summarized and analyzed as follows:1.TCM syndrome score and treatment effect: after treatment,TCM syndrome score of both groups decreased significantly(P < 0.05).After treatment,the data of TCM syndrome score between the two groups were compared,P < 0.05 had statistical significance,indicating that the decrease of the experimental group was greater than that of the control group.The total effective rate of the treatment of TCM syndrome in the experimental group was as follows:96.7%.The total effective rate of TCM syndrome treatment in the control group was 70.0%.The rank sum test Z=-4.503,P=0.000<0.05 showed that the total effective rate of TCM syndrome treatment in the experimental group was superior to that in the control group,indicating that Jiawei Fuzi Decoction combined with standard western medicine treatment for chronic heart failure(qi deficiency and blood stasis,Yang deficiency and water flooding syndrome)patients had better improvement of some clinical symptoms than that in the control group.Pure standard western medicine has better curative effect.2.Therapeutic effect of clinical cardiac function: after treatment,cardiac function of both groups of patients improved(P < 0.05),and the effective rate of both groups of patients was not obvious,only about 50.0%-60.0%.After treatment,the rank sum test Z=-1.793,P=0.073>0.05 between the two groups showed no statistical difference.The effective rate was not significant in both groups,only about 50.0%-60.0%.It was proved that the improvement of cardiac function in the experimental group was not superior to that in the control group,possibly because the clinical cardiac function classification selected by the study subjects was only II-III patients,and the data difference was relatively small,or possibly because of the long course of heart failure and shorter medication time,the final statistical difference between the two groups did not show.3.NT-pro BNP level: After treatment,NT-pro BNP level decreased significantly in both groups(P < 0.05),and independent t-test P = 0.213 > 0.05 in both groups after treatment,with no statistical difference.It was proved that the decrease of NT-pro BNP level in the experimental group was not superior to that in the control group.4,24 h urine volume: after treatment,the 24 h urine volume in both groups decreased significantly(P < 0.05),and the independent t-test P = 0.016 < 0.05 after treatment in both groups was statistically significant.It is proved that the 24-hour urine volume increase in the experimental group is better than that in the control group,indicating that the treatment of Jiawei Fuzi Decoction combined with standard western medicine is better in diuresis for patients with chronic heart failure(qi deficiency and blood stasis,Yang deficiency and water flooding syndrome).5.Serum uric acid: After treatment,there was no significant decrease in serum uric acid in both groups(P > 0.05),and the serum uric acid level also increased significantly,which may be the reason why both groups of patients used diuretics.The independent t-test P=0.398>0.05 between the two groups after treatment showed no statistical difference.This indicated that the control of serum uric acid in the experimental group was not superior to that in the control group.6.Plasma D2 polymer: After treatment,plasma D2 polymer decreased significantly in both groups(P < 0.05).After treatment,independent t test P = 0.074 > 0.05 showed no statistical difference between the two groups.It was proved that the decrease of plasma D2 polymer in the experimental group was not superior to that in the control group.7.Left ventricular ejection fraction(LEVF): LEVF level increased in both groups after treatment(P < 0.05).Rank sum test Z=-1.013,P = 0.311 > 0.05 showed no distinct difference between the two groups after treatment.The improvement of LEVF level in the experimental group was not superior to that in the control group.8.Rehospitalization rate and mortality rate within 90 days of follow-up: after treatment,the rehospitalization rate within 90 days in the experimental group was significantly lower than that in the control group,with statistical significance(P < 0.05);the mortality rate within 90 days in the experimental group was not significantly lower than that in the control group,with no statistical significance(P > 0.05).Conclusion:(1)Jiawei Fuzi Decoction combined with traditional western medicine in treating heart failure patients with Qi deficiency and blood stasis and yang deficiency and water flooding syndrome can significantly reduce the TCM syndrome score,improve the efficacy of TCM symptoms,increase 24-h urine volume,and also reduce the rate of re-hospitalization within 90 days of follow-up;(2)Effect of Jiawei Fuzi Decoction combined with traditional western medicine on clinical cardiac function,NT-pro BNP level,serum uric acid and plasma in patients with heart failure due to Qi deficiency and blood stasis and yang deficiency and water flooding syndrome D2 polymer,left ventricular ejection fraction(LEVF)and mortality rate within 90 days of follow-up had no significant improvement.It was inferred that this prescription had no significant effect on increasing cardiac output and improving circulatory ischemia and hypoxia.Combined with modern research,it may also have no significant effect on improving long-term mortality.(3)Jiawei Fuzi decoction combined with traditional western medicine has no obvious adverse reactions in the treatment,and its safety is the same as traditional western medicine treatment,which can be widely used in clinical practice. |
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