Clinical Study On The Treatment Of Yang Deficiency Blood Stasis And Water Stagnation In Chronic Heart Failure With The Heart-kidney Co-therapy Method

Objective: To analyze the clinical effect and mechanism of action of the Heart-Kidney method in the treatment of patients with Yang deficiency,blood stasis and water suspension in chronic heart failure,with the aim of providing valuable theoretical reference and clinical basis for the treatment of chronic heart failure.Method:In this study,74 cases of inpatient and outpatient cardiology cases in the Department of General Internal Medicine of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine who met the inclusion criteria were selected and divided into control and experimental groups according to the random number table method.The control group was treated with the standard treatment regimen of drugs under the guidance of the 2019 Guide to Rational Use of Drugs in Heart Failure(2nd edition),and the experimental group was treated with the self-prepared warming formula for the heart and kidney under the guidance of the theory of the same treatment for the heart and kidney on top of the control group.After 4 weeks of treatment,we observed and compared the cardiac function classification,heart failure symptom score,Chinese medicine evidence score,NT-pro BNP,echocardiography(ejection fraction EF,beat-to-beat output SV,shortening fraction FS),6-minute walk test and other indexes of the two groups before and after treatment,and observed and monitored the safety indexes of the two groups,and used statistical methods for overall evaluation of clinical efficacy.Results:1.In terms of the TCM syndrome points,both groups could significantly reduce the total TCM syndrome points after treatment(P<0.01),and the test group was significantly better than the control group in the comparison between groups(P<0.01).Among the single symptom groups,the efficacy of the test group was better than that of the control group(P<0.05)in the palpitation group,the group with exposed neck tendons,the group with swollen face and limbs,the group with blue lips,the group with little urination,and the group with abdominal distension;the efficacy of the test group was significantly better than that of the control group(P<0.01)in the chest tightness(pain)group,the group with shortness of breath and weakness,and the group with fear of cold extremities.2.Both groups could significantly improve the classification of cardiac function(P<0.01);however,there was no significant difference between the two groups(P>0.05).3.In terms of heart failure symptom scores,both groups could significantly reduce heart failure symptom scores after treatment(P<0.01);however,there was no significant difference between the two groups(P>0.05).4.NT-pro BNP was significantly reduced in both groups(P<0.01),but there was no significant difference between the two groups(P>0.05).5.Both groups could improve significantly improve exercise tolerance(6-minute walk test)after treatment(P<0.01),and the test group was better than the control group in the comparison between groups(P<0.05).6.Both groups were able to significantly improve echocardiographic indexes(ejection fraction EF,beat-to-beat output SV,shortening fraction FS)(P<0.01),but there was no significant difference between the two groups(P>0.05).7.During the treatment,there were no significant adverse reactions in both groups,and there was no significant difference in safety indexes between the two groups before and after treatment(P>0.05).Conclusion:1.The combination of Chinese and Western medicine and standard Western medicine treatment protocols can effectively treat chronic heart failure,and the clinical efficacy of using the heart-kidney approach in combination with Western medicine is better than that of Western medicine alone in chronic heart failure with Yang deficiency,blood stasis and water stagnation.2.The use of the heart-kidney combination therapy can effectively improve the clinical symptoms and signs;the TCM syndrome score;the symptoms of heart failure and exercise tolerance of patients with Yang deficiency,blood stasis and water stagnation type of chronic heart failure;and no significant adverse effects occurred during the treatment.3.Both groups could improve the indexes of cardiac function classification,NT-proBNP and echocardiography.4.The combined Chinese and Western medicine treatment plan has effectively improved the quality of life of heart failure patients and is a safe,effective and economical treatment that deserves further promotion and application.