| Objective:The purpose of this study is to observe the clinical efficacy of Tongyang Huoxue Lishui Decoction in treating acute heart failure patients with Xueyu Shuiting syndrome and its effect on concentration of sST2 and galectin-3,and to explore the mechanism,so as to provide a basis for the promotion and application of this decoction.Methods:Sixty patients who met the diagnostic criteria of western medicine and the diagnostic criteria of TCM syndrome were randomly divided into control group(n=30)and treatment group(n=30).The two groups were given basic treatment recommended by the guidelines,including diuretics,vasodilators,positive inotropic drugs,ACEI/ARB,? blockers,aldosterone receptor antagonists,etc.Tongyang Huoxue Lishui Decoction(Fuling 15g,Guizhi 10g,Baizhu 10g,Gancao 3g,Mabiancao 30g,Yimucao 30g,Zhuling 30g,Fulingpi 15g,Zelan 30g,Zexie 30g)100ml,oral or nasal feeding,twice a day.The course of treatment is 7 days.The TCM syndrome scores,New York Heart Association Class,serum sST2,Gal-3,BNP,cTn1,ALT,AST,creatinine level,and re-admission of patients with acute heart failure within 6 weeks of the two groups before and after treatment were observed.Results:General conditions:There was no significant difference in gender,age,blood pressure,heart rate,primary disease,type of acute heart failure between the two groups before treatment(P>0.05).TCM symptom classification score:After treatment,the quantitative scores of TCM symptom in the two groups were lower than before,with statistically significant intra-group difference(P<0.01).After treatment,quantitative scores of TCM symptom in the treatment group were lower than that in the control group,with statistically significant difference among groups(P<0.01).TCM syndrome efficacy:After treatment,The total effective rate of the control group was 76.66%,and the total effective rate of the treatment group was 93.33%.The effective rate of the treatment group was significantly higher than that of the control group,with statistical difference(P=0.041).New York Heart Association Class:After treatment,3 patients with NYHA Class ?,24 patients with NYHA Class ?,3 patients with NYHA Class ?,9 patients with NYHA Class ?,20 patients with NYHA Class ?.There was statistically significant difference in intra-group difference(P<0.01).There was statistical difference between the two groups(P=0.039).sST2:After treatment,concentration of sST2 in the control group was 299.85±26.96pg/ml,and concentration of sST2 in the treatment group was 238.61±26.73pg/ml.The sST2 levels in the two groups were lower than those before treatment,with statistically significant difference(P<0.01).The sST2 level in the treatment group was lower than that in the control group,with statistically significant difference(P<0.01).Gal-3:After treatment,concentration of Gal-3 in the control group was 37.56±4.80ng/L,and concentration of Gal-3 in the treatment group was 20.89±4.17ng/L.The levels of Gal-3 in the two groups were lower than those before treatment,with statistically significant difference(P<0.01).The level of Gal-3 in the treatment group was lower than that in the control group,with statistically significant difference(P<0.01).BNP:After treatment,concentration of BNP in control group was was 513.53±593.38pg/ml,and concentration of BNP in treatment group was 366.86±213.15pg/ml.The levels of BNP in the two groups were lower than those before treatment(P<0.01).Compared with the control group,the BNP level in the treatment group was lower after treatment,but there was no statistical difference(P=0.208).cTnI:After treatment,concentration of cTnI of the control group was 0.0247±0.1717ng/ml,and concentration of cTnI in the treatment group was 0.0220±0.1627ng/ml.The levels of cTnI in the two groups were significantly lower than those before treatment with statistically significant difference(P<0.01).In comparison,the cTnI level was lower in the treatment group after treatment,but there was no statistical difference(P=0.539).Re-admission of patients with acute heart failure within 6 weeks:After treatment,number of Re-admission of patients with acute heart failure within 6 weeks in control group was 4,while that in treatment group was 1.The number in treatment group was lower than the control group,but there was no statistical difference(P=0.177).Safety indicators:There was no statistical difference between serum ALT,AST,creatinine(P>0.05).Conclusion:1.Tongyang Huoxue Lishui Decoction combined with western medicine standard treatment and simple western medicine treatment can improve the clinical symptoms of acute heart failure patients with Xueyu Shuiting syndrome,New York Heart Association Class,and reduce serum sST2,Gal-3,BNP and cTnI levels.2.Tongyang Huoxue Lishui Decoction combined with western medicine standard treatment is better than western medicine treatment in reducing BNP and cTnI levels in acute heart failure patients with Xueyu Shuiting syndrome,and reduced the number of re-admitted patients with acute heart failure within 6 weeks,but no statistical difference.3.Tongyang Huoxue Lishui Decoction combined with western medicine standard treatment is better than western medicine treatment in improving the clinical symptoms of in acute heart failure patients with Xueyu Shuiting syndrome,New York Heart Association Class,and lowering serum sST2 and Gal-3 levels. |
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