A Cohort Study On The Effect Of Dilated Cardiomyopathy(Qi Deficiency And Blood Stasis Syndrome) Treated With Kangxianyixin Decoction

Objective: Through a cohort study,observe the effect of kangxianyixin decoction on dilated cardiomyopathy patients(qi deficiency and blood stasis type),Compare with the Chinese medicine symptom curative effect,cardiac function and left ventricular remodel condition,to evaluate the curative effect of the decoction in the treatment of dilated cardiomyopathy aspects,to discuss the mechanism of treatment.Provide scientific research basis for the treatment of dilated cardiomyopathy by traditional Chinese medicine.Methods:the dilated cardiomyopathy patients(Qi deficiency and blood stasis type)who were treated in our hospital from from June 2010 to September 2017,were divided into the the western medicine routine treatment cohort(cohort A)and Kangxianyixin decoction cohort(cohort B)according to whether to accept the Chinese medicine decoction.A total of 281 cases were included in the study,including 153 cases of Kangxianyixin decoction cohort and 128 cases of the western medicine routine treatment cohort.Western medicine routine treatment with western medicine: metoprolol tartrate,enalapril,Irbesartan / furosemide,spironolactone,digoxin etc..Kangxianyixin decoction cohort was treated with Kangxianyixin decoction therapy and the basis of conventional western medicine.The two cohorts were treated for 6 months.After 6 months,Comparing the symptom score,heart function,ventricular remodeling and medicine application between the two groups before and after the treatment.Results:(1)The Chinese medicine symptoms total score of both cohorts decreased after treatment(P<0.05),but the reduction rate of the cohort B was better than that of the cohort A(P<0.05).(2)the cohort A after treatment on the left ventricular end diastolic diameter,the left ventricular fractional shortening and ejection fraction,no significant difference compared with before treatment is showed(P>0.05);cohort B in LVEDD and LVEF,FS were obviously improved,there were significant differences(P<0.05);the cohort had significant difference in leftventricular end diastolic diameter,left ventricular ejection fraction,fractional shortening(P<0.05).(3)there were significant differences in systolic blood pressure,diastolic blood pressure and heart rate between the cohort A and cohort B(P<0.05);there was no significant difference between the two cohorts.(P >0.05).(4)The metoprolol dosages of both two cohorts were increased,there were significant difference(P<0.05),the dosages of cohort B compared with cohort A was significantly increased,there was significant difference(P<0.01).The digoxin and furosemide dosage of cohort A was no significant change(P>0.05),digoxin and furosemide dosage of cohort B decreased,the difference of the two cohorts was statistically significant(P<0.05).Conclusion:Compared with the conventional western medicine,application of kangxianyixindecoction in the treatment of dilated cardiomyopathy,can significantly improve the score of Chinese medicine syndrome of patients with dilated cardiomyopathy,improve patients' heart function,LVEDD,LVEF and FS.It can reduce the adverse reaction of the patient to the addition of the ?-blocker and ACEI or ARB,so that the dosage of the patients can be reached to the target dose.At the same time kangxianyixin decoction can reduce or alleviate the symptoms,reduce the dosage of digoxin and furosemide.The kangxianyixin decoction therapy has some effect on dilated cardiomyopathy and provides a new idea for the routine treatment of this disease.