To Evaluate The Efficacy Of Yiqi Yangyin, Huoxue Lishui Method And Blood Ultrafiltration In The Treatment Of Acute Decompensation In Elderly Patients With Chronic Heart Failure

Objective:To observe the effect of Chinese herbs of benefiting qi and nourishing yin,activating blood and promoting urination or blood ultra-filtration on heart and renal function in elderly advanced CHF(chronic heart failure).Methods:49 elderly patients with advanced CHF were divided into 2 groups.On the basis of conventional western medicine treatment,one group containing 26 patients(called Chinese medicine group)accepted Chinese herbs therapy of benefiting qi and nourishing yin,activating blood and promoting urination,the other group containing 23 patients(called ultra-filtration group)accepted ultra-filtration.The basic Chinese medicine are milkvetch root 10-30 gram,tangshen 10-30 gram,dendrobium 15-30 gram,Mao Dongqing 10-20 gram,Indian bread 15-30 gram,cassia twig 10-20 gram,zhuling 10-20g,hirsute shiny bugleweed herb 10-20 gram,largehead atractylodes rhizome 10-20 gram,licorice moxibustion 5-6 gram,and change according to symptoms.Ultra-filtration dehydration rate is 200-350 ml/h,and the capacity of ultra-filtration dehydration is 500ml-2000ml.Detect the levels of the cardiac function,NT-proBNP,eGFR,the changes of electrolyte(Na+,K+,Cl-)in the serum before the treatment and after 10 days.Use SPSS 22.0 statistical software to analyze the differences between the intra group and inter group.Results:1.Intra-group comparison,after treatment,NT-proBNP decreased significantly in both groups(P<0.01)(33.2 ± 33.8%、41.1 ± 25.5%);950%confidence interval of Chinese medicine group is 19.6～46.9%,and 95%confidence interval of ultra-filtration group is 29.8%～52.5%,ultra-filtration group is higher and more concentrated,but two groups have no significant difference(P>0.05).2.Intra-group comparison,the eGFR of two groups have no significant difference after treatment(P>0.05),and two groups have no significant difference(P>0.05).3.The total effective rate of the improvement of cardiac function after treatment in the two groups is 84.6%and 91.3%respectively,and there is no significant difference between the two groups(P>0.05).Conclusion:On the base of conventional therapy,cooperating with Chinese herbs of benefiting qi and nourishing yin,activating blood and promoting urination or ultra-filtration treatment maybe can both obviously improve cardiac function,decrease the NT-proBNP,at the same time,would not cause GFR decline in this study.