Clinical Study On The Efficacy Of Lingguilancao Decoction In The Treatment Of Acute Heart Failure And Its Effect On Vasopressin Level

Objective:By observing the clinical efficacy of Lingguilancao decoction on acute heart failure with water retention syndrome and its effect on urine volume and vasopressin level,to explore its possible mechanism,and to provide basis for clinical application.Methods:64 patients with acute heart failure who were hospitalized in the Department of Cardiology of Affiliated Hospital Of Nanjing University Of TCM from March 2018 to January 2019 were selected.All the patients who met the inclusion criteria and were not within the exclusion criteria were randomly divided into two groups with 32 cases in the treatment group and 32 cases in the control group.The control group was treated with standardized western medicine,and the treatment group was treated with Lingguilancao decoction on the basis of the control group.The course of treatment was 7 days in both groups.The TCM syndrome score,Lee's heart failure score,clinical bedside grade,NT-proBNP,LVEF,LVIDd,24h urine volume and vasopressin level were observed before and after treatment.Statistical data were used to analyze and compare the clinical efficacy,changes of vasopressin level and safety of the two groups.Results:During the study,3 cases in the treatment group and 4 cases in the control group were excluded and fell off.Finally,29 cases in the treatment group and 28 cases in the control group were included in the statistics.The results were as follows:1.TCM syndrome score:The TCM syndrome score of the two groups had a decrease after treatment(P<0.01),and the treatment group was superior to the control group(P<0.01).Comparing the reduced value of TCM syndrome score,the treatment group was superior to the control group too(P<0.05).For the curative effect of TCM syndromes,the total effective rate of the treatment group was 93.10%,and that of the control group was 71.43%.The curative effect of the treatment group was better(P<0.05).2.Lee's heart failure score:The Lee's heart failure score decreased in both groups after treatment(P<0.01),and the treatment group was superior to the control group(P<0.05).3.NT-proBNP:The NT-proBNP level of the two groups both decreased after treatment(P<0.01),and the treatment group was superior to the control group(P<0.05).Comparing the reduced value of NT-proBNP,the treatment group was superior to the control group too(P<0.05).4.Clinical bedside grade:The clinical bedside grade was significantly improved in both groups(P<0.01).Howerer,there was no statistical difference between the two groups(P>0.05).5.LVEF and LVIDd:The LVEF and LVIDd of the two groups showed no statistical difference before and after the treatment(P>0.05),and there was no significant difference between the two groups(P>0.05).6.24h urine volume:The 24h urine volume of the two groups increased significantly after treatment(P<0.01),and the treatment group was superior to the control group(P<0.05).For the increased value of urine volume between different time points,the treatment group was superior to the control group too(P<0.05).7.Vasopressin level:The vasopressin level of the two groups both decreased after treatment(P<0.01),and the treatment group was superior to the control group(P<0.01).Comparing the reduced value of vasopressin level,the treatment group was superior to the control group too(P<0.01).8.Safety:No serious adverse reactions and adverse events related to drugs were found in both groups.Conclusion:Lingguilancao decoction combined with conventional western medicine is effective in treating acute heart failure.It can more effectively relieve clinical symptoms and signs,improve the curative effect of TCM syndromes,reduce the level of NT-proBNP.Moreover,it can further reduce the secretion of vasopressin,increase 24h urine volume,and has good safety in clinical application.