| ObjectiveFrom the perspective of real world research,we used propensity score matching(PSM)to study the changes of gastrointestinal function score and TCM health score in patients with chronic heart failure.To evaluate the efficacy and safety of real clinical center spleen-related mild moxibustion on gastrointestinal function in patients with chronic heart failure.And explore the relevant treatment mechanism,for more effective improvement of chronic heart failure patients gastrointestinal function to provide clinical solutions.MethodsThe protocol of the cohort study was selected for this study,and the main study subjects were chronic heart failure patients who met the diagnostic and inclusion criteria of this study who were hospitalized at Zhaoqing hospital of Chinese Medicine from September 2019 to April 2021,and were divided into two cohorts according to whether mild moxibustion was added or not.Both groups were treated routinely,and the control group was treated with corresponding western medicine regimens based on different gastrointestinal symptoms on the basis of routine treatment,and the test group selected Shenque,Zhongwan,Zusanli(BIS),Xinyu(BIS),Neiguan(BIS)for mild moxibustion based on the treatment of the control group.Propensity score matching was applied to the two cohorts of cases by 1:1 matching for bias before treatment to remove covariates affecting the outcome of the trial.Both treatment groups were followed for 14 days,and the gastrointestinal function scores,the traditional Chinese medicine health status scores,and the reduction rate of gastrointestinal function were compared between the two groups of patients with chronic heart failure before and after treatment.Two groups were evaluated for treatment effect.ResultA total of 81 patients with chronic heart failure who met the criteria were included in this study.A total of 46 cases were included after propensity score matching method matching,and there were no significant differences in the baseline characteristics between the two groups(P > 0.05).All the included cases presented with multiple digestive symptoms,which,in order of frequency,were abdominal distension in 44 cases(95.65%),epigastric pumping pain in 35 cases(76.09%),eructation in 33 cases(71.74%),dyssynergia in 19 cases(41.30%)and acid reflux in 17 cases(36.96%).The median gastrointestinal function scores of patients with different concentric functional grades were not statistically different and were comparable(P > 0.05).Patients with cardiac function grade III before treatment,except for the reflux dimension,there was no significant difference in all dimensions of gastrointestinal function score and total score(P > 0.05),which were comparable.The treatments in both groups improved the dimensions of dyspepsia and abdominal pain in patients with cardiac function grade III,and the total scores of gastrointestinal function in the two groups before and after treatment were significantly different(P < 0.01).After treatment between the two groups,the difference in dimension of abdominal pain in the test group was significantly higher than that in the control group(P < 0.01),which was confirmed by one-way analysis of covariance showing that the test group had significant difference in dimension of reflux than the control group(P< 0.01),suggesting that moxibustion is more effective in improving the symptoms of reflux and abdominal pain in patients with heart failure than that in the control group.The difference of gastrointestinal function score in the test group was significantly different from that in the control group,suggesting that the addition of mild moxibustion method can effectively improve gastrointestinal function in patients with cardiac function grade III.The total scores of gastrointestinal function in the two groups of patients before and after treatment were compared,and the scores of gastrointestinal function in the two groups before treatment were not statistically significant(P > 0.05)and comparable.Comparing the gastrointestinal function scores of the two groups before and after treatment,the gastrointestinal function score of the two groups after treatment was significantly higher than that before treatment(P < 0.01),the difference between the gastrointestinal function score of the two groups before and after treatment was significantly different,and the difference between the test group before and after treatment was significantly higher than that of the control group(P < 0.01),suggesting that the addition of mild moxibustion can better improve the gastrointestinal function score of patients with heart failure.The TCM health status scores of the two groups were evaluated,and before treatment,the two groups had statistically significant differences in the dimensions of diet and sleep(P < 0.05),but not in energy,pain,stool,urination,physical constitution,mood and health evaluation(P > 0.05),which were comparable.Comparison of the scores of TCM health status before and after treatment between the two groups,significant statistical differences were found in the scores of the dimensions of energy,pain,taste of diet,and urination between the two groups before and after treatment(P < 0.01).It is suggested that both treatments improve QOL in heart failure patients with the above dimensions.Comparing the TCM health scores between the two groups after treatment,the difference between the test group in stool dimension was significantly different from that of the control group(P <0.01),and the test group was significantly different from the control group in diet taste dimension by one-way analysis of covariance(P < 0.01),suggesting that the test group has significant efficacy in improving the quality of life in terms of both diet taste and stool of patients with heart failure.The decrease rate of gastrointestinal function in experimental group was higher than that in control group,and the result was statistically significant(P<0.01).ConclusionThe therapeutic effect of mild moxibustion on gastrointestinal dysfunction in chronic heart failure patients can be more defined by propensity score matching method.Moxibustion is more effective for gastrointestinal symptoms accompanied by chronic heart failure patients than conventional treatment with western medicine alone,and can relieve gastrointestinal discomfort symptoms and improve the quality of life of patients with heart failure.Its mechanism of action heart spleen related mild moxibustion promotes the recovery of brain intestine interaction in patients with chronic heart failure. |
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