| Objective:to evaluate the efficacy and safety of Lishui Qiangxin recipe in the treatment of heart failure with reduced ejection fraction.Methods:64 patients suffered from heart failure with reduced ejection fraction(HFrEF)were randomly divided into control group(n=32)and experimental group(n=32)from June 2018 to March 2021,who were admitted to the department of cardiology and outpatient department of Guang’anmen Hospital,Chinese Academy of Chinese Medical science.The control group was treated with routine western medicine:diuretics,aldosterone receptor antagonists(spironolactone),renin-angiotensin system inhibitors,β-receptor blockers and digitalis(digoxin)for 8 weeks.The treatment group was treated with Lishui Qiangxin recipe for 8 weeks on the basis of routine western medicine treatment.The efficacy and safety of the two groups were observed before and after treatment.The therapeutic efficacy indexes included TCM syndrome score,cardiac ultrasound index(LVEF,LVEDd,FS),N-terminal pro-brain natriuretic peptide(NT-proBNP)in plasma,cardiac function grade(NYHA),Minnesota quality of life score,diuretic,spironolactone and digoxin reduction rate.Safety indicators included blood routine,liver function and renal function.The data were analyzed by software SPSS20.0.Results:1.Comparison of main efficacy indicators(LVEF,plasma NT-proBNP):①The LVEF of the two groups of patients improved after treatment,and the difference was statistically significant(P<0.01);and the improvement of LVEF in the treatment group was better than the control group,the difference Statistically significant(P<0.01).②Plasma NT-proBNP of patients in the treatment group improved after treatment,and the difference was statistically significant(P<0.01).The plasma NT-proBNP of the control group did not change significantly from before,and the difference was not statistically significant(P>0.05);The improvement was better than the control group,and the difference was statistically significant(P<0.01).2.Comparison of FS and LVEDd:①The FS of the two groups of patients improved after treatment,and the difference was statistically significant(P<0.01);and the improvement in the treatment group was better than the control group,and the difference was statistically significant(P<0.01).②The LVEDd of patients in the treatment group improved compared with before,the difference was statistically significant(P<0.01),the control group had no significant change before and after treatment,and the difference was not statistically significant(P>0.05);the improvement of LVEDd in the treatment group was better than the control group,the difference was statistically significant(P<0.01).3.Comparison of the efficacy of TCM syndromes:①The scores of TCM syndromes of the two groups of patients were improved after treatment,and the difference was statistically significant(P<0.01),and the improvement of the treatment group was better than that of the control group,and the difference was statistically significant(P<0.01);②The total effective rate of the treatment group was 84.38%,and the total effective rate of the control group was 50.00%.The treatment group was better than the control group,and the difference was statistically significant(P<0.01).4.Comparison of heart function classification(NYHA):The heart function classification of the two groups of patients was improved after treatment.The total effective rate of the treatment group was 78.13%,and the total effective rate of the control group was 50.00%,and the improvement of the treatment group was better than that of the control group.It is statistically significant(P<0.05).5.Comparison of Minnesota quality of life scores:①The Minnesota scores of the two groups of patients improved after treatment,and the difference was statistically significant(P<0.01),and the improvement in the treatment group was better than the control group,the difference was statistically significant(P<0.01));②The total effective rate of the treatment group was 81.25%,and the total effective rate of the control group was 46.80%.The Minnesota score of the treatment group improved better than that of the control group,and the difference was statistically significant(P<0.01).6.Comparison of the reduction rate of western medicine:①After treatment,use of diuretics,spironolactone and digoxin were reduced in some patients of two groups.The diuretic and spironolactone reduction rate in the treatment group was 29.62%,and the control group was 12.50%.The treatment group is better than the control group,the difference is statistically significant(P<0.05),the digoxin reduction rate in the treatment group is 30.76%,and the control group is 0.00%,the difference is not statistically significant(P>0.05);②The total effective rate of treatment group was 34.37%,and the control group was 12.50%.The treatment group was better than the control group,and the difference was statistically significant(P<0.01).7.Safety comparison:①No patients in two groups had obvious liver and kidney damage or abnormal blood routine after treatment.②The uric acid level of the patients in the treatment group was lower than before,and the difference was statistically significant(P<0.05).The uric acid level of the patients in the control group did not change significantly after the treatment,and the difference was not statistically significant(P<0.05).Conclusion:Lishui Qiangxin Decoction can significantly increase the left ventricular ejection fraction of patients with HFrEF,reduce the level of NT-proBNP,significantly reduce the left ventricular end-diastolic diameter,reduce the clinical symptoms of patients with HFrEF,improve the cardiac function classification(NYHA).It is helpful to reduce the dosage of diuretics,spironolactone and digoxin,so could reduce the side effects of western medicine.It could significantly improve the quality of life of patients with HfrEF and has no significant adverse effects on the liver and kidney functions and blood routine of patients. |
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