| Part 1 Effect of simple western medicine treatment and Western medicine combined with Xin Yin tablets on the quality of life and cardiac function indexes in patients with heart failure combined Qi Yin deficiency,blood stasis,and water retention typeObjective:This part is mainly through the method of comparative study,compared with simple standard western medicine treatment and combined with Xin Yin tablets treatment of Qi Yin deficiency,blood stasis,and water retention type of heart failure patients’ clinical effect.Including: TCM syndrome score(main symptoms and secondary symptoms);6 minutes walk test distance;Minnesota heart failure quality of life score;B-type brain natriuretic peptide(BNP);cardiac color Doppler ultrasound indicators.Method:We observed the CHF patients from June 2015 to June 2017,who discharged from the ward of cardiovascular department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine.They were identified as heart failure,outpatient follow-up after discharge.The patients must accord with western medicine diagnosis of chronic heart failure with TCM syndrome diagnosis standard.which according to TCM syndrome differentiation of heart failure in our hospital for pre clinical studies and the classification scheme into Qi Yang and Yin deficiency,blood stasis of yin deficiency and and water retention.The cardiac function classification of the subjects was grade Ⅱ-Ⅲ in the New York cardiac function classification standard,and the TCM syndrome differentiation was Qi yin deficiency,blood stasis and water retention.A total of 110 patients were selected as the research object.All of the subjects with chronic heart failure according TCM syndrome in our hospital for pre-clinical studies and experts to discuss the classification scheme into Qi yin deficiency,blood stasis and water retention and Qi yang deficiency,blood stasis and water retention.Followed the standard treatment of Western medicine followed 2014 Chinese heart failure guidelines.Among them,30 cases were treated as simple western medicine group(C group),and 80 cases as experimental group,namely western medicine combined with heart Yin tablet treatment group(group T).With stable condition into the group,at least a4-weeks stable treatment with Western medicine,then plan into the group.Before admission,all patients were examined with basic clinical data such as height,weight,blood pressure,heart rate,blood analysis,urine analysis,electrolyte,liver and kidney function,and excluded severe anemia and serious impairment of liver and kidney function.Recorded the basic medication of Western medicine in the treatment of heart failure.Evaluated the cardiac function classification,staging,heart failure syndrome main symptoms and secondary disease score;Minnesota heart failure quality of life score;Determination of 6 minutes walk test distance;BNP examination;Cardiac color Doppler ultrasound indexs were measured such as the thickness measurement of cardiac ultrasound cardiac color ultrasonic room(IVS),interval left ventricular posterior wall thickness(LVPWd),left ventricular end diastolic diameter(LVd),left ventricular end systolic diameter(LVs),left ventricular ejection fraction(EF%),short axis systolic rate(FS%)to reflect the cardiac structure and systolic function index.these dates is used for baseline as the two different methods.Subsequently,the control group continued to give standard western medicine treatment,the experimental group in the original standard western medicine treatment on the basis of adding "xin yin tables" treatment,3 tablets each time,3 times a day,the total course of treatment for 12 weeks.During the treatment of heart Yin tablets,traditional Chinese medicine decoction and other Chinese medicine for Supplementing qi and nourishing Yin,activating blood and promoting diuresis should be avoided.Before and after the Xin Yin tablets for 8 weeks’ treatment,the TCM symptoms were scored.All above indexes were measured again after 12 weeks of treatment,and two independent samples t-test was used to analyze the clinical symptoms and quality of life score of the two groups after treatment,as well as the difference and change rate of the 6-minute walk test,BNP and heart color ultrasound related indicators,paired t-test was used to analyze the differences between the two groups before and after treatment.Result:1.A total of 110 patients were enrolled,30 cases in group C,of which1 cases were unable to follow up due to return to field work,2 cases were hospitalized due to deterioration of heart function,and 27 cases completed12-weeks’ treatment observation.T group of 80 cases,2 cases were lost(including 1 cases because the phone cannot be accessed,1 cases withdrew due to refusal to further cooperate with the examination);because of the severity of deterioration of cardiac function to NHYA Ⅳ hospital readmission.During hospitalization,we analized the cause of heart failure is just pneumonia.Finally,a total of 80 patients were enrolled,and 77 patients were successfully treated for 12 week’s treatment.2.Most of the subjects were male,the age distribution was normal in the two groups.The average age of C group(61.1±9.42)years old,the minimum is 38 and the maximum is 83 years old,the average age of T group was(62.3±12.8)years old,with the minimum was 30 and the maximum age was 86;C group for the average height(161.9±9.9)cm,the average weight of(67.3±9.8)kg,systolic blood pressure(128.4±13.9)mm Hg,diastolic blood pressure(79.7±14.2)mm Hg,the heart rate was(73.7±14.5)/min;T group for the average height(164.6±7.9)cm,average weight(64.9±11)kg,systolic blood pressure(126.1±16)mm Hg,diastolic blood pressure(77.1±12.7)mm Hg,the heart rate was(75.3±14.1)/min;There was no significant difference between the two groups before treatment(P>0.05).There was no significant difference in blood parameters between the two groups(P>0.05).The basic causes of heart failure were coronary heart disease,hypertension and cardiomyopathy.Rheumatic heart disease excluded severe valvular disease,the inclusion criteria were in accordance with the inclusion and exclusion criteria.3.Among the 30 patients treated with western medicine,12 cases were grade NYHAⅡ,18 cases were grade Ⅲ,1 cases were lost to follow-up,2 cases were hospitalized due to worsening of heart function infection,and the other 27 cases completed 12 weeks of combined treatment;In the combined treatment group,There were 39 cases in grade NYHAⅡ and 41 cases in grade NYHAⅢ,During the treatment period,2 patients were lost to follow-up,1 patients were hospitalized for cardiac function NYHAIV due to deterioration of cardiac function,and the remaining 77 patients were successfully treated for 12 weeks.The improvement of cardiac function was 10 cases,11 cases,7 cases and 2 cases in 12 weeks’ treatment with western medicine alone,of which total effective rate was 70%.After 12 weeks of combined treatment,the improvement of cardiac function was 37 cases,35 cases,7 cases,1 cases,the total effective rate was 90%.The difference between the two treatment regimens was statistically significant(P<0.05).4.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before treatment,the scores of main symptoms in group C and group T were(4.63±1.91)and(4.40±1.73),respectively,there was no significant difference between the two groups by independent sample t test(P>0.05).The main symptom scores were(3.98±1.07)and(3.25±1.47)after standard western medicine treatment and Western medicine combined with Xin Yin tablets treatment for 8 weeks,after comparison,the difference between the two groups was statistically significant(P<0.05).After 12 weeks of treatment,the scores of the two groups were(3.29±1.58)and(2.41±1.45),respectively,the difference between the two groups was statistically significant(P<0.05).8 weeks and 12 weeks of treatment,there were significant differences between the two groups in the improvement of main symptom scores(before treatment and after treatment)(P<0.01).There was no significant difference in the scores of main symptoms between the control group and the C group at 8 weeks after treatment,but there was a statistically significant difference between 12 weeks after treatment(P<0.01).In the combined T group,compared with before treatment,8 weeks and 12 weeks after treatment showed significant statistical difference(P<0.01)5.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before treatment,C group and T group were symptom score(2.94±1.51)and(2.75±1.35),There was no significant difference between the two groups by independent sample t test(P>0.05).The scores of secondary diseases were(2.34±1.31)and(1.96±1.14)after 8 weeks of standard western medicine treatment and Western medicine combined with Xin Yin tablets treatment,the difference between the two groups was not statistically significant(P>0.05).After 12 weeks of treatment,the scores of the two groups were(1.78±0.69)and(1.17±0.87),respectively.The difference between the two groups was statistically significant(P<0.05).after 8 weeks and 12 weeks of treatment,the two groups of TCM syndrome improvement were statistically significant difference(P<0.01).In the control group,the scores of secondary symptoms in group C at 8 weeks after treatment were not significantly different from those before treatment,but there was a statistically significant difference between 12 weeks after treatment(P<0.01);In the combined treatment group T group,8 weeks and 12 weeks after treatment,compared with before treatment showed significant statistical difference(P<0.01).6.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before the initiation of treatment,the quality of life scores in group C and group T were(37.2±15.4)and(36.9±19.6),respectively(Minnesota).there was no significant difference between the two groups(P>0.05).After 12 weeks of treatment,the quality of life scores was(29.8±11.3)and(24.3±12.1),respectively,after two weeks of treatment,The difference between the two groups was statistically significant(P<0.05).The score difference between the two groups before and after treatment was statistically significant(P<0.01).Compared with before treatment,the improvement in group C was statistically significant(P<0.05),while that in group T was significantly improved(P<0.01).7.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before treatment,the 6MWD in group C and group T were(299.2±80.4)m and(297.3±83.8)m,respectively,there was no significant difference between the two groups(P>0.05).After 12 weeks of treatment with the two regimens,the 6MWD values were(344.1±77.1)m and(379.3±77.3)m,respectively,the difference between the two groups was statistically significant(P<0.05).The score difference between the two groups before and after treatment was statistically significant(P<0.01).Compared with before treatment,the improvement in group C was statistically significant(P<0.05),while that in group T was significantly improved(P<0.01).8.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before treatment,the BNP of group C and group T were(901.2±100.2)ng/dl and(874.9±115.4)ng/dl,respectively,there was no significant difference between the two groups(P>0.05).After 12 weeks of treatment with the two regimens,the BNP values were(398.3±111.3)ng/dl and(271.8±128.9)ng/dl,respectively,The difference between the two groups was statistically significant(P<0.01).The score difference between the two groups before and after treatment was statistically significant(P<0.01),Compared with before treatment,the two groups were significantly improved(P<0.01).9.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before treatment,C group,IVS,LVPWd,LVd and LVs were(8.83±2.02)mm,(7.77±2.21)mm,(62.4±8.26)mm,and(51.2±9.76)mm,respectively,the values of the above indexes in group T were(8.82±2.01)mm,(7.78±2.06)mm,(61.9±8.13)mm,and(52.2±8.87)mm,there was no significant difference between the two groups(P>0.05).After 12 weeks of treatment,the IVS,LVPWd,LVd,and LVs in the C group were(8.79±1.99)mm,(7.68±2.09)mm,(59.9±10.5)mm,and(48.4±9.81)mm,respectively,Group T were(8.68±1.86)mm,(7.71±2.01)mm,(59.1±9.97)mm,(46.6±10.4)mm,and(8.79±1.99)mm,after two independent sample t test,there was no significant difference in the improvement of IVS,LVPWd,LVd and LVs between the two treatment schemes(P>0.05).Paired t test showed that there was no significant difference in the improvement of IVS,LVPWd and LVd between the two treatments after 12 weeks of treatment(P>0.05),The improvement of LVs was statistically significant(P<0.05).10.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.In group C,systolic function indexes such as EF% and FS% were(34.9±14.6)%,(20.8±7.76)%,respectively,the values of the above indexes in group T were(36±13.3)%,(21.9±8.85)%,After 12 weeks of treatment,the EF% and FS% in the C group were(40.1±12.9)%,(24.8±7.18)%,Group T were(45.8±13.1)%,(28.3±8.01)%,After two independent sample t test,the two treatment regimens had statistically significant improvement on EF%and FS%(P<0.05),Paired t test showed that there was no significant difference in the improvement of EF% and FS% before and after treatment in group C(P>0.05).Before and after treatment,the improvement of EF% and FS% in group T was statistically significant(P < 0.01),the difference between the two groups after treatment was statistically significant(P < 0.01).Conclusion:1.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Compared with simple western medicine treatment,12 weeks‘treatment combined with Xin Yin tablets showed more effective and significant improvement of NYHA cardiac function.2.Among those heart failure patients with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.On the basis of regulating western medicine treatment scheme,combined with Xin Yin Tablets Treatment for 8 weeks,the clinical symptoms of traditional Chinese medicine symptoms and secondary disease score has obviously improved.The treatment effect was more obvious in 12 weeks,and showed good time effectiveness;3.Compared with western medicine standard treatment,routine western medicine standard treatment combined with Xin Yin tablets with 12 weeks’ treatment,the quality of life score and 6 minutes’ walk test distance of Qi Yin deficiency blood stasis and water retention patients all have good improvement effect;4.Compared with western medicine standard treatment,routine western medicine standard treatment combined with Xin Yin tablets with 12 weeks’ treatment can obviously reduce the BNP level in patients with Qi Yin deficiency,blood stasis and water retention.5.Compared with western medicine standard treatment,after 12 weeks’ treatment of routine western medicine standard treatment combined with Xin Yin tablets.There was no significant effect on the structural parameters of IVS,LVPWd,LVd and LVs,and the improvement of left ventricular systolic function was significantly improved by EF%,FS% and other indexes.However,there was a statistically significant difference in the improvement of LVs between the combined treatment group and the control group.Part 2 Effect of Xin Yin tablet on cardiac and pulmonary function indexes in patients with chronic heart failureObjective This part mainly through the control method,to observe the cardiopulmonary exercise test(CPET)related indicators between simple western medicine treatment and the combination of Xin Yin tablets after 12 weeks treatment of Qi Yin deficiency,blood stasis and water retention type heart failure patients.such as anaerobic threshold(HRAT),no oxygen threshold metabolic equivalents(MetAT),anaerobic threshold power(WAT),anaerobic threshold when the respiratory exchange ratio(RER-AT),anaerobic threshold level of VO2/Kg(VO2/KgAT).Peak heart rate(HRmax),peak metabolic equivalents(Metmax),peak power(Wmax),the peak respiratory exchange ratio(RER-max),the peak level of VO2/Kg(VO2/Kgmax),peak oxygen pulse(O2Pulse),VE/VCO2 slope,Delta VO2/Delta WR.To observe whether Xin Yin tablets can improve symptoms and improve the quality of life in patients with heart failure by improving the related indicators of heart and lung metabolism,pulmonary ventilation efficiency and muscle work ability.Method The method of comparative study,in accordance with the first part based on the inclusion criteria,taking into account the influence of gender on exercise ability,in these subjects,a total of 43 male patients with cardiorespiratory exercise test were selected,including 17 cases in western medicine group and 26 cases in the combined treatment group.After signing the informed consent form(Appendix 8),CPET examination was performed at the beginning and 12 weeks after the treatment between the two groups,the relative indexes of cardiopulmonary exercise test before and after treatment were compared,such as heart rate(HRAT),anaerobic metabolic equivalents(MetAT),anaerobic threshold power(WAT),anaerobic threshold when the respiratory exchange ratio(RER-AT),anaerobic threshold level of VO2/Kg(VO2/KgAT).Peak heart rate(HRmax),peak metabolic equivalents(Metmax),peak power(Wmax),the peak respiratory exchange ratio(RER-max),the peak level of VO2/Kg(VO2/Kgmax),peak oxygen pulse(O2Pulse),VE/VCO2 slope,Delta VO2/Delta WR index.Results1.In this study,43 patients with CPET were enrolled,17 patients in the control group,and 26 patients in the experimental group.Before admission,we analyzed the basic cause of CHF,cardiac function classification,basic drug treatment use ratio and found that there was not statistically significant between the two groups.Age,height,weight,systolic blood pressure,diastolic blood pressure,heart rate,hemoglobin content,serum potassium,serum sodium and serum creatinine were comparable between the two groups,and there was no significant difference between the two groups either.2.Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.After 12 weeks of simple western medicine treatment,IVS,LVPWd,LVd,LVs,EF% and FS% were(9.04±1.43)mm,(8.28±1.90)mm,(61.48±8)mm,(49.48±8.46)mm,(38.64±10.13)%,(19.52±5.74)%,respectively,After 12 weeks of combined treatment,the left ventricular systolic indexes such as LVs,EF% and FS% were(43±9.67)mm,(48.72±10.32)%,and(25.92±6.36)%,respectively,Compared with western medicine treatment,the combined therapy group improved significantly,the difference was statistically significant(P<0.05).the IVS,LVPWd and LVd in combination treatment group were(8.92±1.89)mm,(8.08±1.66)mm,(57.96±9.35)mm,compared with simple western medicine treatment,the difference was not statistically significant(P>0.05).3.Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.Before the treatment of anaerobic threshold levels in the two groups of HRAT were(107.7±21.5)bpm and(109.4±23.2)bpm.There was no significant difference between the two groups(P>0.05).The two treatments after 12 weeks were(114.8±23.3)bpm and(117.5±19.6)bpm,respectively.The difference after treatment was(5.98±2.67)bpm and(8.08±4.41)bpm,by comparison after treatment and the difference was not statistically significant(P>0.05).The RER-AT of the two groups before treatment were(0.937±0.26)and(0.954±0.38),the difference between the two groups was not statistically significant(P>0.05);after treatment,they were(0.951±0.23)and(0.984±0.35),and there was no significant difference between the two groups after treatment(P>0.05).4.Before treatment,the anaerobic threshold levels of MetATin the two groups were(3.43±1.45)Mets and(3.60±1.34)Mets,respectively,and there was no significant difference between the two groups(P>0.05).After treatment,the two groups were(4.34±1.38)Mets and(5.08±1.45)Mets,respectively.The difference between the two groups after treatment was(0.95±0.21)Mets and(1.37±0.34)mets,compared with the two treatment methods,the effect was statistically significant(P<0.05),the difference between the two groups after treatment was statistically significant(P<0.01).Before treatment,the anaerobic threshold levels of WATin the two groups were(40.8±11.7)W and(41.9±12.5)W,respectively,and there was no significant difference between the two groups,after treatment,the two groups were(51.4±12.9)W and(68.5±18.7)W,respectively,and the difference between the two groups was(10.41±2.06)W and(25.72±4.17)W,compared with the two treatment methods,the effect was statistically significant(P<0.01),the difference between the two groups after treatment was statistically significant(P<0.01).5.Before treatment,the VO2/KgATof the two groups were(8.69±3.64)ml/min/kg and(9.34±3.52)ml/min/kg,the difference between the two groups was not statistically significant(P>0.05);After treatment,the two groups were(11.68±3.76)ml/min/kg and(14.56±4.01)ml/min/kg,The difference between the two groups was respectively(11.68±3.76)ml/min/kg和(14.56±4.01)ml/min/kg,By comparison,the influence of two treatment methods on VO2/KgATand the difference before and after treatment were statistically significant(P<0.01).6.Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.The two groups before treatment,maximum exercise levels of HRmaxwere(129.5±34.3)/min and(134.2±23.2)/min,there is no significant difference between the two groups,P>0.05.Two kinds of treatment 12 weeks after treatment respectively(133.8±43.3)/min and(140.5±35.2)/min,treatment difference was(4.27±0.98)/min and(6.28±4.14)/min,by comparison after treatment and the difference was not statistically significant,P>0.05.The RER-max of the two groups before treatment were(1.018±0.29)and(1.016±0.24),the difference between the two groups was not statistically significant,P>0.05;after treatment,they were(1.053±0.26)and(1.041±0.28),respectively.There was no significant difference between the two groups before and after treatment,P>0.05.7.Before treatment,the maximal exercise levels of Metmax in the two groups were(4.62±1.38)Mets and(4.81±1.57)Mets,respectively,and there was no significant difference between the two groups(P>0.05),After treatment,the two groups were(5.39±2.87)Mets and(7.48±3.21)Mets,respectively.The difference between the two groups after treatment was(0.75±0.16)Mets and(2.58±1.43)Mets,compared with the two treatment methods,the effect was statistically significant(P<0.05),the difference between the two groups after treatment was statistically significant(P<0.01).Before treatment,the maximum exercise level Wmax of the two groups were(68.4±15.3)W and(71.2±19.4)W,the difference between the two groups was not statistically significant.The maximum horizontal movement in two groups before treatment Wmax were(68.4±15.3)W and(71.2±19.4)W,the difference between the two groups was not statistically significant,the two groups after treatment respectively(84.7±23.2)W and(106.5±27.63)W,the difference between the two groups after treatment respectively(15.9±5.43)W and(35.1±12.13)W,by comparison of two treatment methods on the impact of significant difference(P<0.01),the two groups after treatment the difference was statistically significant(P<0.01).8.Before treatment,the VO2/Kgmax of the two groups were(13.61±4.31)ml/min/kg and(14.52±3.98)ml/min/kg,the difference between the two groups was not statistically significant(P>0.05);After treatment,the two groups were(16.89±4.89)ml/min/kg and(19.92±4.72)ml/min/kg,the difference between the two groups was(3.19±0.89)ml/min/kg and(5.38±2.14)ml/min/kg.After comparison,the influence of two treatment methods on VO2/Kgmax was statistically significant(P<0.05),the difference before and after treatment was statistically significant(P<0.01).9.Heart failure gas Yin deficiency and blood stasis of left ventricular systolic function in stable condition of water reducing stop type,two groups of patients before treatment of maximal exercise level,ability to work efficiency of the oxygen extraction reaction muscle Delta VO2/Delta WR =(6.86±2.3)ml/W and(7.06±2.13)ml/W,between the two groups had no statistical difference meaning(P>0.05).After two weeks of 12 different treatments,they were(7.43±2.08)ml/W and(8.92±2.15)ml/W,the difference between the two groups was statistically significant(P<0.05),the difference between the two treatment methods before and after treatment was statistically significant(P<0.01).Before treatment,the VE/VCO2 efficiency of the two groups was(41.5±8.13)and(39.8±9.34),respectively.There was no significant difference between the two groups(P>0.05);after treatment,the two groups were(35.8±5.51)and(32.5±4.92),and the difference between the two groups was statistically significant(P<0.05),the difference between the two groups before and after treatment was statistically significant(P<0.05).There was no significant difference in the effect of delta VO2/and delta WR before and after the treatment of simple western medicine(P>0.05),but the effect on VE/VCO2 was statistically significant(P<0.05);the effect of combined treatment group on the two was statistically significant(P<0.01).10.Before treatment,the cardiovascular response indexes of the two groups were O2Pulse(8.49±3.27)ml and(9.10±3.78)ml,respectively,and there was no significant difference between the two groups(P>0.05).The two groups after treatment respectively(11.99±4.41)ml and(14.87±4.02)ml,there are significant differences between the two groups(P<0.05).After the treatment,there were significant differences between the two groups before the difference(P<0.01),and the two treatment methods of O2 Pulse effect(P<0.05).Conclusion:1.Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention.There was no significant difference in IVS,LVPWd and LVd in 12 weeks after the two treatmeants.But there was a significant difference in the improvement of LVs,EF% and FS% which represented left ventricular systolic function.The conclusion is consistent with part one.2.Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention,Compared with the standardized western medicine treatment,the combination of Xin Yin tablet after treatment for 12 weeks increased the level of MetAT,WATand VO2/KgATof patients at anaerobic threshold level.On the basis of regulating western medicine treatment,Xin Yin tablet was beneficial to improve the level of anaerobic threshold of patients.3.Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention,Compared with the standardized western medicine treatment,combined with Xin Yin tablet treatment for 12 weeks,the Metmax,Wmaxand VO2/Kgmaxincreased at the maximal exercise level of the patients.On the basis of the standardized western medicine treatment,Xin Yin tablet was beneficial to improve the maximal exercise level of the patients.4.After 12 weeks of treatment with combined heart Yin,two different Among heart failure patients who participated in CPET with stable condition and left ventricular systolic dysfunction classified Qi Yin deficiency,blood stasis and water retention,treatments improved the level of the patients’ maximum movement level of delta VO2/ WR,VE/VCO2 and O2 Pulse,indicating that the heart work efficiency and ventilation efficiency of CHF patients were improved,but the combined treatment group improved more obviously. |
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