| Background:Chronic heart failure(referred to as CHF)is the ultimate manifestation of various clinical cardiovascular diseases and is the most common cause of death in cardiology,as well as a common and frequent clinical condition.Coronary at herosclerotic heart disease and hypertension have become the most prominent causes of chronic heart failure at present.Compared to TCM,Western medicine is more effective in treating chronic heart failure,but the symptoms of chronic heart failure are complex and the duration of the disease is long.Chinese medicine is based on a dialectical approach and individualized treatment based on a holistic concept,the three causes and the theory of yin and yang of the internal organs and qi and blood,which has obvious advantages in improving clinical symptoms,enhancing physical fitness,improving quality of life and improving prognosis.The trial aims to explore the rules of prescription and use of drugs in chronic heart failure with Qi deficiency and Blood stasis evidence,and to objectively evaluate the efficacy of the self-prepared formulaQishen Yi Qi and Blood Activation Formula through clinical control trials,to provide new therapeutic ideas and methods for the prevention and treatment of chronic heart failure.Objectives:1.To conduct a correlation analysis of the published prescriptions of Chinese herbal medicines for the treatment of chronic heart failure with Qi deficiency and Blood stasis evidence through data mining methods,to summarize their dosing patterns,and provide new directions for clinical trial research.2.To observe the clinical efficacy of Qishen Yi Qi and Blood Activation Formula in combination with Western medical treatment contention on Qi deficiency and blood stasis evidence of chronic heart failure through a clinical randomized controlled trial.Methods:1、Clinical data mining:The literature on Chinese medicine for the treatment of Qi deficiency and blood stasis in chronic heart failure from 2005.01.01—2022.11.30 was searched on China Knowledge Network(CNKI)for collation,and an excel table database was established for correlation analysis using SPSS and association rule analysis using SPSS Modeler module.2.Clinical trial:The medical records of patients diagnosed with chronic heart failure with Qi deficiency and blood stasis were collected and randomly grouped into a trial group and a control group.LVEF,6-minute walking distance,Minnesota Heart Failure Quality of Life Score,NYHA cardiac function classification changes and efficacy,and Chinese medicine evidence score before and after 8 weeks of treatment in both groups.Results:1.Data mining:(1)Among the 53 prescriptions counted,121 herbal medicines were involved,with a total drug frequency of 593 times and a total number of 323 occurrences of high-frequency drugs.The highest frequency of use of a single drug was 35 times and the lowest was only 1 time,among which 15 drugs with a frequency of≥10 times were Dan Shen,Huang Qi,Gui Zhi,Fu Ling,Chuan Xiong,Hong Hua,Angelica sinensis,Roasted Glycyrrhiza,Tao Ren,Scape Seed,Red Peony,Radix Codonopsis,Glycyrrhiza,Ginseng,and Atractylodes macrocephala.(2)Analysis of association:Drugs with strong association include Danshen,Astragalus,Safflower,Radix et Rhizoma,Radix et Rhizoma,Radix Angelicae Sinensis,Rhizoma Chuanxiong and Radix et Rhizoma Cinnamomi;drugs with strong association are Qi tonics and blood-stasis activators.2.Clinical trials:(1)Cardiac function:After 8 weeks of treatment,the NT-proBNP,LVEF,and NYHA cardiac function classification of both groups improved compared with those before treatment,and the test group was more advantageous compared with the control group(P<0.05),indicating that the total efficiency of the test group was higher than that of the control group.(2)6min walking test:the 6-min walking distance of both groups increased compared to the pre-treatment period,and the test group was better than the control group(P<0.05).(3)TCM symptoms score and quality of life score:In terms of the efficacy of TCM symptoms,the total effective rate of the test group 87.5%was significantly higher than that of the control group 65.625%;in terms of each TCM symptom,the test group was more advantageous than the control group in improving shortness of breath,chest tightness,lower limb oedema,spontaneous sweating,laziness and lazy speech,and dull complexion(P<0.05),while in terms of improving palpitation,weakness,blue lips and nails,and wheezing There was no significant difference between the two groups(P>0.05).The quality of life scores of patients in both groups increased after treatment,and the quality of life scores of patients in the test group was significantly lower than those in the control group after treatment,with a statistically significant difference(P<0.05).Conclusion:1.Astragalus membranaceus can improve left ventricular ejection fraction,lower NTproBNP levels,improve cardiac function,improve clinical manifestations,increase exercise tolerance and improve quality of life in patients with chronic heart failure with Qi deficiency and blood stasis evidence.2.According to the data mining results,in the clinical treatment of chronic heart failure with Qi deficiency and blood stasis evidence,the main medication is to benefit Qi and activate blood and can be combined with drugs to regulate Qi,promote water retention and eliminate swelling,and relieve superficiality. |
