| Objective:The purpose of this study was to observe whether Qiliqiangxin capsule combined with furosemide could improve the sensitivity to diuretics by using Qiliqiangxin capsule in the treatment of patients with chronic heart failure with diuretic resistance,taking the filtered sodium excretion fraction(FENa)and the change of body weight before and after treatment as the main indexes.Methods:From January 2021 to December 2021,64 patients with chronic heart failure with diuretic resistance in the Department of Cardiology of Quanzhou Hospital of traditional Chinese medicine were selected.They were randomly divided into observation group(32cases)and control group(32 cases).The control group was furosemide tablets and the observation group was furosemide tablets combined with Qiliqiangxin capsule.The course of treatment was 1 month.The changes of FENa and body weight were taken as the main indexes,and the changes of neuroendocrine system monitoring indexes such as renin activity(PRA),angiotensin Ⅱ(AngⅡ),plasma aldosterone(ALD)and plasma antidiuretic hormone(ADH)were observed during the experiment.Results:1.In the course of clinical observation,5 cases fell off in the observation group and 5cases in the control group,and 54 cases were finally completed,including 27 cases in the observation group and 27 cases in the control group.Before treatment,the basic conditions of the two groups were compared: gender,age,course of disease,NYHA cardiac function grade and whether there were complications(coronary heart disease,hypertension and arrhythmia),which were comparable(P>0.05).2.Main outcome measures: after treatment,FENa and body weight in the experimental group decreased significantly compared with those before treatment,and the difference was statistically significant(P<0.05);There was no significant difference in FENa and body weight in the control group after treatment(P>0.05);The comparison between the two groups was statistically significant(P<0.05).3.Secondary outcome measures: TCM syndrome score: after treatment,the TCM syndrome score in the experimental group was significantly improved compared with that in the previous group(P<0.05),while there was no significant change in the control group(P>0.05).There was significant difference between the two groups(P<0.05).Curative effect of TCM syndrome: after treatment,the total effective rate of the experimental group was92.6% and that of the control group was 74.1%,indicating that the curative effect of TCM syndrome in the experimental group was better than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the N-terminal B-type natriuretic peptide(NT-Pro BNP)and 6-minute walking distance of the two groups were significantly improved compared with those before treatment(P<0.05),and the experimental group was better than the control group.The comparison between the two groups was statistically significant(P<0.05).4.Monitoring indexes of neuroendocrine system: before treatment,there was no significant difference in PRA,ang Ⅱ,ALD and ADH between the two groups(P<0.05).After treatment,PRA,ang Ⅱ,ALD and ADH in the two groups were lower than those before treatment(P<0.05),and the reduction range in the experimental group was significantly higher than that in the control group.There was significant difference between the two groups(P<0.05).5.There were no life-threatening adverse reactions between the two groups,and there was no significant difference in blood routine,liver and renal function between the two groups(P>0.05).After treatment,there were 2 cases of hypokalemia in the experimental group,1 case of hypokalemia and 1 case of hyponatremia in the control group.There was no significant difference in blood potassium and sodium between the two groups before and after treatment(P>0.05).Therefore,it can not be considered that the electrolyte indexes of the two groups were abnormal before and after treatment.Conclusions:Qiliqiangxin capsule can improve the sensitivity of chronic heart failure patients to diuretics and improve the symptoms of heart failure,and the mechanism is mainly related to the neuroendocrine system.At the same time,no obvious adverse reactions were found during the treatment,which proves that the treatment scheme of integrated traditional Chinese and Western medicine has more advantages and can be used for clinical application. |
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