Clinical Observation Of Yiqi Tongmai Decoction In The Treatment Of Heart Failure Of Qi Deficiency And Blood Stasis Type After PCI In Patients With Acute Myocardial Infarction

Objective: To observe the clinical efficacy of Yiqi Tongmai decoction in the treatment of acute myocardial infarction(AMI)patients with heart failure of qi deficiency and blood stasis type after percutaneous coronary intervention(PCI),and to provide clinical basis for the treatment of AMI patients with heart failure after PCI with integrated traditional Chinese and western medicine.Methods: In strict accordance with the inclusion criteria and exclusion criteria,60 patients with acute myocardial infarction(after PCI)and hemodynamically stable heart failure of qi deficiency and blood stasis type admitted to the Second Department of Cardiology of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2021 to September 2022 were selected.The included patients were randomly divided into a control group and a treatment group,with 30 patients in each group.The treatment group was treated with Yiqi Tongmai decoction on the basis of conventional western medicine in the control group.After 8 weeks of treatment,the TCM syndrome score,TCM syndrome efficacy,Lee’s heart failure score,heart failure efficacy,Minnesota Living with Heart Failure(MLHFQ)score,6-minute walk distance(6MWT)and N terminus were observed in the two groups The changes of B-type natriuretic peptide(NT-pro BNP),left ventricular ejection fraction(LVEF)(Simpson’s method),left ventricular end-systolic diameter(LVESD)and left ventricular enddiastolic diameter(LVEDD)were observed.Results: A total of 59 patients were enrolled in this study,including30 in the control group and 29 in the treatment group.There was no significant difference in general data between the two groups before treatment(P>0.05).1.TCM syndrome score: there was no significant difference in the total TCM syndrome score between the two groups before treatment(P>0.05).After treatment,the total TCM syndrome score was lower than that before treatment,and the treatment group was lower than the control group(P<0.05).2.Efficacy of TCM syndromes: the total effective rate of TCM syndromes was 86.2% in the treatment group and 56.6% in the control group,and the difference was statistically significant(P<0.05).3.Heart failure score: there was no significant difference in Lee’s heart failure score between the two groups before treatment(P>0.05).After treatment,the total score of Lee’s heart failure was lower than that before treatment,and the treatment group was lower than the control group(P<0.05).4.Curative effect of heart failure: the total effective rate of the treatment group was 89.7%,which of the control group was 66.6%,the treatment group was higher than the control group,the difference was statistically significant(P<0.05).5.Quality of life score: there was no significant difference in the total score of quality of life between the two groups before treatment(P>0.05).After treatment,the scores of the two groups were lower than those before treatment,and the treatment group was lower than the control group(P<0.05).6.6 minutes walk distance: there was no significant difference in 6minutes walk distance between the two groups before treatment(P>0.05).After treatment,the 6 minutes walk distance of the two groups increased compared with that before treatment,and the 6 minutes walk distance of the treatment group was higher than that of the control group(P<0.05).7.NT-pro BNP: there was no significant difference in NT-pro BNP between the two groups before treatment(P>0.05).After treatment,NT-pro BNP was lower than that before treatment,and the treatment group was lower than the control group(P<0.05).8.Cardiac color Doppler ultrasound indexes: there was no significant difference in LVEF between the two groups before treatment(P>0.05),and LVEF was increased after treatment,and the treatment group was higher than the control group(P<0.05).There was no significant difference in LVESD and LVEDD between the two groups before treatment(P>0.05).LVESD and LVEDD after treatment were lower than those before treatment,and those in the treatment group were lower than those in the control group(P<0.05).Conclusion: Yiqi Tongmai Decoction combined with conventional western medication can effectively reduce the TCM syndrome score of AMI patients with heart failure of qi deficiency and blood stasis after PCI,reduce the levels of NT-pro BNP,LVESD and LVEDD,improve LVEF and 6MWT,improve symptoms and quality of life,and has no obvious adverse reactions.