Literature Study Of Traditional Chinese Medicine Therapy In Acute Exacerbation Of Chronic Heart Failure

Purpose:A retrospective study was conducted on the literatures about the treatment of acute exacerbation of chronic heart failure with traditional Chinese medicine(TCM)in the past 20 years to evaluate the efficacy and safety of various TCM therapies.Material and method: Use computer comprehensive retrieve China journal full-text database(CNKI),a database of ten thousand and the electronic literature database,liaoning university of Chinese medicine library search range from January 1998 to December 2018,the collection and analysis in recent 20 years with TCM therapy for the treatment of chronic heart failure in acute aggravating period of randomized controlled trials literature,through the sieve,sieve,at the beginning of complete information and cross check,will be included in the standard of literature with a new version of the Jadad quality rating scale evaluation of literature quality,and to Revman5.3.5 meta analysis software.Conclusion:All the 33 literatures were treated with traditional Chinese medicine therapy,among which 19 literatures were treated with traditional Chinese medicine injection form,in which shenfu injection was the most widely used,followed by shenmai injection,shenmai injection,compound danshen injection,etc.2 literatures were treated with modified prescription,9 literatures were treated with self-made decoction,and 3 literatures were treated with Chinese patent medicine.All the included documents were scored by the newly revised Jadad quality assessment form,among which 12 were of low quality and 21 were of high quality.In the included literatures,the main treatment principles were yiwen Yang,huoxue and shuishui.Literature are clarified ending index,by using the BNP as ending index with 15 references,using TCM syndrome score of 11,the cardiac function classification has24,26 articles outcome indicators by echocardiogram(LVEF),7 articles were 6 minutes walk test as indicators of exercise tolerance end,take the quality of life score 5 articles,25 articles using other standards as outcome indicators.Among the 33 references,21 references mentioned adverse events,among which 8 references mentioned specific symptoms and cases of adverse reactions in the group,13 references mentioned no obvious adverse reactions,and 11 references did not mention adverse reactions.Meta analysis results:1 Yiwenyang and huoxue lishui groups improved cardiac function(RD=0.14,95%ci [0.10,0.18],Z=7.03,P<0.00001),LVEF(MD=4.77,95%ci [3.40,6.13],Z=6.85,P<0.00001),brain natriuretic peptide(SMD=-1.57,95%ci [-1.74,-1.40],Z=18.07,P<0.00001),and TCM syndrome integral(MD=-3.58,95%ci [-5.05]).-2.11],Z=4.77,P<0.00001),and the influence on the six-minute walking distance(MD=39.85,95%ci [32.40,47.30],Z=10.48,P<0.00001)were statistically significant.2 In the groups of qi-nourishing Yin and fumai gutuo,cardiac function was improved(RD=0.24,95%ci [0.17,0.31],Z=6.79,P<0.00001),LVEF(MD=3.73,95%ci [2.44,5.02],Z=5.69,P<0.00001),and brain natriuretic peptide(SMD=-1.52,95%ci [-1.91,-1.12],Z=7.56,P<0.00001).The improvement of TCM syndrome scores(MD=0.98,95%ci [0.59,1.62],Z=0.10,P=0.92)showed no statistical significance.3 Other treatment groups improved cardiac function(RD=0.18,95%ci [0.10,0.26],Z=4.59,P<0.00001),improved LVEF(MD=6.11,95%ci [5.06,7.15],Z=11.42,P<0.00001),and improved TCM syndrome score(MD=-4.42,95%ci [-4.73,-4.11],Z=27.91,P<0.00001).There was no significant difference in the effect of qi-yangyin and other treatment groups on the six-minute walking distance(MD=54.16,95%ci [25.85,82.47],Z=3.75,P=0.002).Results:Yi Yang,invigorate the circulation of the water temperature as the main therapeutic principle,combined with conventional western medicine treatment for chronic heart failure in patients with acute aggravating period of exercise tolerance to improve cardiac function,syndromes,and brain natriuretic peptide(BNP)and left ventricular ejection fraction(LVEF)value to have good effect,statistical significance difference,heterogeneity and published sex bias is low,curative effect is superior to other therapeutic principles,is worth further clinical application.Qi and nourishing Yin,double pulse solid improves cardiac function in patients with other therapeutic at,BNP,LVEF has certain clinical curative effect,in improving the differences of TCM syndrome integral and exercise tolerance in patients with no statistical significance,and heterogeneity and bias is bigger,although clinical has certain curative effect,can be used in clinical dialectic,but it remains to be further detailed research,and other therapeutic group relative to the qi and more statistical significance for improving the traditional Chinese medicine syndrome,but due to the sample size is little,therapeutic owe unification,still needs further research.