Clinical Research Of Modified Xiaoqinglong Decoction Combined With Acupoint Application In The Treatment Of Chronic Heart Failure (Yang Deficiency Water Flood Type)

Objective:To observe the clinical efficacy and safety of Modified Xiaoqinglong Decoction combined with Acupoint Application in the treatment of Chronic Heart Failure(CHF)(yang deficiency water flood type).To explore the value of the theory of "treating heart failure from heart and lung" in the treatment of CHF(yang deficiency water flood type).Method:64 cases of CHF(yang deficiency water flood type)were selected as the research object,which were chosen from the cardiovascular department of our hospital,and the patients were divided into the treatment group and the control group with random number table method,with 32 cases in each group.The control group was given routine western medicine treatment;The treatment group was treated with Modified Xiaoqinglong Decoction combined with Acupoint Application on the basis of Western medicine routine treatment,which was stuck on bilateral Xinshu and Feishu,5 hours each time,once a day,10 days as a course of treatment.With comparing the changes of the B-type brain natriuretic peptide(BNP)level,left ventricular ejection fraction(LVEF)value,6-minute walking distance(6MWD),Living with Heart Failure Questionnaire scale score,Traditional Chinese Medicine(TCM)symptom score and Heart Failure grade,we evaluated the clinical effect of Modified Xiaoqinglong Decoction combined with Acupoint Application in the treatment of CHF(yang deficiency water flood type).With comparing the changes of general physical signs(blood pressure,pulse,heart rate,respiratory frequency),laboratory examination(blood routine,liver function,kidney function,electrolyte)and local skin reaction before and after the treatment,we evaluated the safety of Modified Xiaoqinglong Decoction combined with Acupoint Application.Result:In this study,64 patients with CHF(yang deficiency water flood type)who met the inclusion criteria from December 2016 to September 2019 were selected.In the treatment group,one patient lost the follow-up,the other one was short of treatment days.In the control group,one patient lost the follow-up too,the other one was transferred to another department due to the deterioration of other conditions and quit the trial.Finally,60 cases completed the experiment,30 cases in the treatment group and 30 cases in the control group.1.There was no significant difference between the two groups(P>0.05)in general condition(gender,age,course of disease),plasma BNP level,LVEF value,6MWD,Living with Heart Failure Questionnaire scale score,TCM syndrome score and Heart Failure grading before the treatment,and the two groups were comparable.2.After treatment,the level of plasma BNP,Living with Heart Failure Questionnaire scale score and TCM symptom score in the two groups were significantly lower than those before treatment(P<0.05),and the treatment group was better than the control group(P<0.05),with statistical significance.3.There was no significant change of LVEF value before and after treatmen in each group(P>0.05),and there was no significant difference between the two groups(P>0.05).4.After treatment,6MWD of the two groups were significantly higher than that before treatment,with statistical difference(P<0.05).The treatment group was better than the control group(P<0.05).5.After 10 days of treatment,the results of TCM symptom evaluation showed that the total effective rate of the treatment group was 83.33%,the control group was 66.67%,there was statistical difference between the two groups(P<0.05).6.After 10 days of treatment,the evaluation results of cardiac function showed that the total effective rate of the treatment group was 86.67%,and that of the control group was76.67%.There was statistical difference between the two groups(P<0.05).Conclusions:1.Modified Xiaoqinglong Decoction combined with Acupoint Application in the treatment of CHF(yang deficiency water flood type)lowers patients' plasma BNP levels,improves the patients' heart failure symptoms and heart function,enhances their exercise tolerance and qualities of lives.2.During this research,the general physical signs(respiration,pulse,heart rate,blood pressure)and laboratory indexes(blood routine,liver function,kidney function,electrolyte)of the patients are not abnormal.It was observed that burning sensation was the most common sensation in local skin,followed by itching sensation,and tingling sensation was the least.The local skin types were mostly flushing,followed by slight redness and swelling,with the least blisters.NO obvious toxic,no side effects and no serious adverse events have been observed,such as large blisters,local infection,systemic skin allergy or systemic reaction.which indicates that Modified Xiaoqinglong Decoction combined with Acupoint Application is safe in the treatment of CHF(yang deficiency water flood type).3.Modified Xiaoqinglong Decoction combined with Acupoint Application in the treatment of CHF(yang deficiency water flood type)embodies the treatment theory of "treating heart failure from the heart and lung",embodies the Holistic Concept of Traditional Chinese Medicine and the Characteristics of Dialectical Treatment,exerts the multiple overlapping effect of efficacy,acupoint effect and meridians effect,which is expected to provide a new intervention scheme for the treatment of CHF(yang deficiency water flood type)by Traditional Chinese Medicine.