| Purpose:The purpose of this study was to investigate the therapeutic effect of Qiangxin Tongmai Recipe combined with western medicine standardization in the treatment of heart failure after coronary intervention,and to determine the clinical efficacy of Qiangxin Tongmai Recipe.It can help patients with heart failure after coronary intervention to improve clinical symptoms and improve their quality of life,and provide an effective theoretical basis for the treatment of heart failure after coronary intervention with integrated Chinese and Western medicine.Material and method:The selected cases in this trial were from October 2017 to October 2018 in the Department of Cardiopulmonary K Outpatient the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,a total of 65 patients.In the past 10 years,coronary intervention was performed and the diagnosis of heart failure was performed.The patients were aged 40-80 years old,and the cardiac function was grade II or III.The syndrome differentiation syndrome of traditional Chinese medicine belongs to patients with qi deficiency and blood stasis type.In this paper,the random number table method was used to divide the control group into the observation group.The control group have 33 and The treatment group have 32.In each group and the course of treatment was 4 weeks.Treatment methods: Both groups were given general basic treatment and routine treatment after coronary intervention,such as removing the inducement of heart failure,limiting salt and water,resting and moderate exercise,monitoring the weight of subjects,quitting smoking,abstaining from alcohol,psychotherapy and psychotherapy,and using antiplatelet drugs,lipid-regulating drugs and gastric mucosal protective drugs.The control group was given Benazepril Hydrochloride Tablets on the basis of this: the initial dose was 2.5 mg once daily,orally.If the patient is tolerant,the dose can be adjusted to 5 mg once a day orally.The amount of treatment should follow the principle of individualization.2 times tacrolimus: the initial dose is 23.75 mg,once a day,orally.If the patient is tolerant,the dose can be adjusted to 47.5 mg once a day orally.The amount of treatment should follow the principle of individualization.3 spironolactone tablets: 20 mg,once a day,orally.The treatment group added Qiangxin Tongmai Recipe onthe basis of the control group.The drug composition: Salvia miltiorrhiza 30 g,Pseudostellariae20g,Astragalus 25 g,Motherwort 30 g,Safflower 15 g,Lycium 25 g,Hazelnut 15 g.Decoction from the decocting room of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,one dose per day,300 ml of water decoction,2 times warm clothes.Concomitant medication: For patients within 1 year after coronary intervention,continue to apply dual antiplatelet,lipid-lowering drugs and gastric mucosal drugs.Such as aspirin,clopidogrel hydrogen sulfate,atorvastatin and omeprazole enteric-coated capsules.For patients 1-3 years after coronary intervention,single antiplatelet,lipid-lowering and gastric mucosal drugs are continued.Such as aspirin,atorvastatin and omeprazole enteric-coated capsules.For primary diseases such as hypertension and diabetes,the original drug treatment should be continued.Efficacy evaluation index: cardiac function classification(NYHA classification method);6 minutes walking test distance;left ventricular ejection fraction LVEF;Nterminal brain natriuretic peptide(NT-proBNP);TCM syndrome score changes;6Minnesota Changes in quality of life in heart failure.Results:1.General information: pre-treatment gender,age,duration of disease,underlying disease,cardiac function grading,6-minute walking test distance,left ventricular ejection fraction,N-terminal brain natriuretic peptide,TCM syndrome score,Minnesota heart failure quality of life score There is no statistical significance in other aspects.(P>0.05)2.After 4 weeks of treatment,the scores of TCM syndromes in the treatment group and the control group decreased significantly.The scores of TCM syndromes in the control group decreased from 23.06±2.85 to 15.86±3.36;the scores of TCM syndromes in the treatment group decreased from 24.13±4.72 to 13.0±4.31.After treatment,there was significant difference between the treatment group and the control group(P=0.004).3.Minnesota Heart Failure Integral Decline: After 4 weeks of treatment,the Minnesota Scale Integral of the treatment group and the control group decreased significantly,the Minnesota Scale Integral of the control group decreased from 63.53 ± 11.15 to 53.53 ± 10.46;the Minnesota Scale Integral of the treatment group decreased from 63.20 ±13.64 to 47.30 ±11.39.After treatment,there was significant difference between the treatment group and thecontrol group(P=0.0341).4.Changes of left ventricular ejection fraction: After 4 weeks of treatment,the left ventricular ejection fraction of the treatment group and the control group increased significantly compared with before treatment.The left ventricular ejection fraction of the control group increased from 42.07±3.91% to 46.03±4.05% and the left ventricular ejection fraction of the treatment group increased from 42.97±4.72% to 49.60±3.29%.After treatment,the left ventricular ejection fraction of the treatment group and the control group increased significantly(P=0.0005)5.Changes of NT-proBNP: After 4 weeks of treatment,NT-proBNP in the treatment group and the control group decreased significantly compared with that before treatment.NT-proBNP in the control group decreased from 1770.17±438.19 pg/ml to 920.23±288.53pg/ml,while NT-proBNP in the treatment group decreased from 1735.93±473.12 pg/ml to760.27 ±240.76pg/ml.After treatment,there was significant difference between the treatment group and the control group(P=0.0255).6.Improvement of cardiac function: After 4 weeks of treatment,the total effective rate of NYHA classification in the treatment group was 90.00%,while that in the control group was80.00%,P < 0.05.The difference was statistically significant.7.6-minute walking test distance: After 4 weeks of treatment,the 6-minute walking test distance of the treatment group and the control group increased significantly.The distance of6-minute walking test in the control group increased from 314.57±64.41 m to 363.33±63.22 m and that in the treatment group increased from 311.63±64.92 m to 392.67±62.32 m.After treatment,there was significant difference between the treatment group and the control group(P=0.001).Conclusion:1.Qiangxin Tongmai Recipe combined with Western medicine routine basic treatment and simple Western medicine basic treatment for heart failure after coronary intervention are effective.2.Qiangxin Tongmai Decoction combined with routine basic treatment of Western medicine is more effective than simple routine basic treatment of Western medicine for patients withheart failure after coronary artery intervention.3.The decrease of TCM syndrome score,Minnesota heart failure score and NT-proBNP level in the treatment group was higher than that in the control group,and the increase of 6-minute walking test distance,left ventricular ejection fraction and cardiac function was higher than that in the control group.It showed that Qiangxintongmai prescription combined with conventional western medicine could better alleviate palpitation and thorax in patients with heart failure after PCI.Suffocation(pain),wheezing,fatigue,edema of lower limbs and other symptoms,improve the quality of life of patients.4.Qiangxin Tongmai has no adverse reactions and side effects,is safe and effective,and is worthy of clinical application. |
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