Comparison Of The Clinical Efficacy And Electrolytes In Patients With Heart Failure With Preserved Ejection Fraction Due To Qi Deficiency And Blood Stasis Between Plus-flavoured Wuling San And Furosemide

Objective:To compare the clinical efficacy and the effect on electrolyte level of " plus-flavoured wuling san " and "Furosemide" on patients with heart failure with preserved ejection fraction due to Qi deficiency and blood stasis.Method:Sixty-two patients with preserved ejection fraction heart failure of the qi deficiency and blood stasis type were selected to meet the inclusion criteria of this study.They were randomly divided into 31 cases in the control group and 31 cases in the experimental group.On the basis of basic conventional treatment,the control group was given furosemide and the test group was given plus-flavoured wuling san for a period of 8 weeks.The electrolytes at week 4 and electrolytes at week 8,TCM evidence score and NT-proBNP were used as observation indexes,and the results were statistically analyzed.Results:1.There were no statistical differences in gender,age,disease duration,cardiac function classification(NYHA classification),comorbidities(hypertension,coronary artery disease),TCM evidence score,NT-ProBNP and blood electrolytes between the two groups before treatment,which were comparable(P>0.05).2.Chinese medicine evidence points:after treatment,the test group was significantly lower than the control group(P<0.01).Compared with the pre-treatment period,all symptoms within the test group improved significantly.(P<0.01),while in the control group,shortness of breath,oedema,chest tightness and shortness of breath improved significantly(P<0.01),dry mouth was significantly worse(P<0.01)and palpitations,weakness and lip colour did not improve significantly(P>0.05).3.Chinese medical evidence efficacy:the total effective rate after treatment was 86.67% in the test group and 63.33% in the control group,the test group was significantly better than the control group(P<0.01).4.NT-ProBNP:Significant improvement in the test group compared to the control group after treatment(P<0.01).Both groups were significantly improved(P<0.01)compared to the previous within-group comparison.5.Blood electrolytes:There was no statistically significant difference in electrolytes in the test group after treatment(P>0.05);here was a significant change in potassium and magnesium in the control group before and after treatment(P<0.01),but the rest was not statistically different(P>0.05).For comparison between groups,there was a significant difference in potassium between the two groups at 4 weeks of treatment(P<0.05),and no statistical difference in the rest(P>0.05);there was a significant difference in potassium and magnesium between the two groups at two months of treatment(P<0.01),and no statistical difference in the rest(P>0.05).6.There were no life-threatening adverse reactions in the two groups,and the three major routine,ECG,liver function and renal function indexes in the test group were all within normal limits,with no statistical difference(P>0.05);there was a significant difference in uric acid in the control group(P<0.01),and 16 patients developed high uric acid without symptoms and were advised to follow a low purine diet.At the end of treatment,one patient had low potassium,low sodium and low magnesium,two patients had low potassium and low magnesium and one patient had low sodium.All four patients had electrolyte levels slightly below the low normal line,which did not cause serious consequences and were treated accordingly.Conclusion:1.Plus-flavoured wuling san was significantly better than furosemide in improving the efficacy of Chinese medical evidence in patients with Qi deficiency and blood stasis type of ejection fraction preserved heart failure,significantly improving patients’ symptoms.2.Plus-flavoured wuling san was significantly better than furosemide in improving NTproBNP in patients with Qi deficiency and blood stasis type of ejection fraction preserved heart failure.3.Compared with furosemide,Plus-flavoured wuling san had less effect on electrolytes in the treatment of patients with Qi deficiency and blood stasis type of preserved ejection fraction heart failure,with the effect of Plus-flavoured wuling san on potassium and magnesium being significantly less than that of furosemide.4.In this study,no adverse drug reactions were found during the short-term treatment with Plus-flavoured wuling san,which has a good safety profile.