| Objecive:In this study,qiliqiangxin capsules combined with the type ofl ARNI(Sacubitril Valsartan Sodium Tablets)was used to treat chronic heart failure,to determine the effect of the therapy on the plasma NT-proBNP,Ang-?,ALD,MMP-9 levels and cardiac function in patients with CHF.It is hoped that this integrated traditional Chinese and western medicine treatment program can improve the heart function of patients with chronic heart failure and alleviate their clinical symptoms.It will lay a foundation for the clinical research of integrated traditional Chinese and western medicine in the treatment of chronic heart failure.Methods:From January 2019 to October 2019,86 patients with chronic heart failure who met the inclusion criteria were selected from the heart disease department ward of Quanzhou hosoital of teaditional Chinese medicine hospital.The patients were randomly divided into observation group and control group.The control group received routine medical treatment +Sacubitril Valsartan Sodium Tablets,and the observation group received routine medical treatment + Sacubitril Valsartan Sodium Tablets + qiliqiangxin capsules.The total course of treatment was 12 weeks.Comparison of two groups of patients before and after treatment plasma NT-proBNP,Ang-?,ALD and serum level of MMP-9,and left ventricular ejection fraction(LVEF),6 minutes walking distance,heart function classification,the change of syndrome of traditional Chinese medicine efficacy evaluation.Results:1.During clinical observation,2 cases were removed from the observation group and 1 case fell off from the control group.83 cases were actually completed,including 42 cases in the control group and 41 cases in the observation group.Comparison of the two groups of patients before treatment:Such as age,gender are comparable(P>0.05).2.NT-proBNP:Before treatment,there was no statistically significant difference in plasma NT-proBNP level between the two groups(P>0.05).After treatment,the plasma levels of NT-proBNP in the observation group and the control group were significantly reduced,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,the observation group was 990.46±457.31,while the control group was 1232.10±426.28,indicating that the decrease in the observation group was significantly greater than that in the control group.After statistical analysis,the difference in plasma NT-proBNP level between the two groups after treatment was statistically significant(P<0.05).3.Ang-?:Before treatment,there was no statistically significant difference in plasma Ang-? level between the two groups(P>0.05).After treatment,the plasma levels of Ang-? in the observation group and the control group were significantly reduced,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,the observation group was 110.54 ± 9.90,while the control group was 117.29 ± 9.86,indicating that the decrease in the observation group was significantly greater than that in the control group.After statistical analysis,the difference in plasma Ang-? level between the two groups after treatment was statistically significant(P<0.05).4.ALD:Before treatment,there was no statistically significant difference in plasma ALD level between the two groups(P>0.05).After treatment,the plasma levels of ALD in the observation group and the control group were significantly reduced,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,theobservation group was 291.61±44.63,while the control group was 311.43±42.74,indicating that the decrease in the observation group was significantly greater than that in the control group.After statistical analysis,the difference in plasma ALD level between the two groups after treatment was statistically significant(P<0.05).5.MMP-9:Before treatment,there was no statistically significant difference in serum MMP-9level between the two groups(P>0.05).After treatment,the serum levels of MMP-9 in the observation group and the control group were significantly reduced,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,the observation group was 149.54±14.55,while the control group was 159.43±10.61,indicating that the decrease in the observation group was significantly greater than that in the control group.After statistical analysis,the difference in serum MMP-9 level between the two groups after treatment was statistically significant(P<0.05).6.LVEF:Before treatment,there was no statistically significant difference in left ventricular ejection fraction between the two groups(P>0.05).After treatment,the left ventricular ejection fraction of the observation group and the control group were significantly increased,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,the observation group was 44.78±4.56,while the control group was 39.26±3.99.This indicated that the increase of the observation group was significantly greater than that of the control group.After statistical analysis,the difference of left ventricular ejection fraction between the two groups after treatment was statistically significant(P<0.05).7.6 minutes walking distance:Before treatment,there was no statistically significant difference in 6-minute walking distance between the two groups(P>0.05).After treatment,the6-minute walking distance of the observation group and the control group were significantly increased,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,the observation group was 431.66 ± 57.07,while the control group was 378.98±49.10.This indicated that the increase of the observation group was significantly greater than that of the control group.After statistical analysis,the difference of 6-minute walking distance between the two groups after treatment was statistically significant(P<0.05).8.Efficacy of cardiac function grading:The total effective rate of the observation group was90.2%.The total effective rate of the control group was 64.3%,the curative effect of the observation group was better than that of the control group,and the difference in the total effective rate of the two groups was statistically significant(P<0.05).9.The efficacy of traditional Chinese medicine syndrome syndrome scores:The total effective rate of the observation group was 95.1%.The total effective rate of the control group was 90.5%,and the curative effect of the observation group was better than that of the control group(P<0.05).10.Traditional Chinese medicine syndrome scores:Before treatment,there was no statistically significant difference in traditional chinese medicine syndrome scores between the two groups(P>0.05).After treatment,the traditional chinese medicine syndrome scores of the observation group and the control group were significantly reduced,and the differences were statistically significant compared with those before treatment(P<0.05).After treatment,the observation group was 8.63 ± 5.15,while the control group was 14.43 ± 4.64.This indicated that the decrease in the observation group was significantly greater than that of thecontrol group.After statistical analysis,the difference of the scores between the two groups after treatment was statistically significant(P<0.05).Conclusion:Qiliqiangxin capsule combined with the new type of ARNI(Sacubitril Valsartan Sodium Tablets)is effective for patients with chronic heart failure.Not only can improve the plasma NT-proBNP in patients with CHF,Ang-?,ALD and serum level of MMP-9,also can improve the LVEF and TCM syndrome integral,improve 6 minutes walking distance.Thus,the clinical symptoms and prognosis of CHF patients were improved,and the cardiac function was improved and the quality of life was improved,with high safety and no obvious adverse reactions.For clinical use. |
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