| Objective:To investigate the effects of auricular acupressure on the 6-minute walk test,symptom clusters,Chinese medicine symptoms and quality of life in patients with Yang-deficiency and blood-stasis chronic heart failure.To evaluate the effect of auricular acupressure on patients with Yang deficiency and blood stasis chronic heart failure.Methods: This study was a randomized controlled trial study.From October 2021 to December2022,112 patients with Yang deficiency and blood stasis type of chronic heart failure were selected from the cardiology department of a tertiary level A Chinese medicine hospital in Chongqing according to the inclusion and exclusion criteria,and were completely randomized into the experimental group(n=56)and the control group(n=56).The control group was given standardized treatment and care for chronic heart failure as prescribed by the doctor;the experimental group was given 3 weeks of auricular acupuncture point snap-acupuncture intervention on the basis of the control group.The effect of the intervention was evaluated by the6-minute walk test(6MWT),the Memorial Heart Failure Symptom Assessment Scale(MSASHF),the Chinese Medicine Evidence Score Scale and the Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ)before,after 2 weeks and after 3 weeks of intervention.IBM SPSS25.0 statistical software was applied to the data to analyse the differences between the two groups by two independent samples t-test,chi-square test,repeated measures ANOVA,paired ttest and Wilcoxon signed rank sum test.Results:1.A total of 8 cases were shed in this study and 104 cases were finally completed,including 52 cases in the test group and 52 cases in the control group.The differences in general sociodemographic and health-related information,6MWT,MSAS-HF and each symptom group score,TCM evidence score,MLHFQ and each dimension score between the two groups before the intervention were not statistically different(P>0.05)and were comparable.2.Comparison of 6MWT results between the two groups of patients(1)The results of the repeated measures ANOVA showed that the intervention effect,time effect and interaction effect of the 6MWT results between the two groups of patients were statistically significant(P<0.05);(2)In the comparison between groups at different measurement time points,the 6MWT results of patients in the test group were better than those in the control group after 2 weeks and 3 weeks of intervention,and the difference was statistically significant(P < 0.05);(3)In the intra-group comparison at different measurement time points,the 6MWT results of patients in the test group and control group after 2 weeks and 3 weeks of intervention improved to different degrees compared with baseline,and the differences were statistically significant(P <0.05).3.Comparison of MSAS-HF and scores of each symptom group between the two groups of patients(1)The results of the repeated measures ANOVA showed that there were statistically significant intervention,time and interaction effects for the total MSAS-HF score,cardiac ischaemia,digestive tract and mood-related symptom clusters in both groups(P < 0.05),while there were no statistically significant intervention,time and interaction effects for the visceral stasis-related symptom cluster(P > 0.05);(2)In the comparison between groups at different measurement time points,the MSAS-HF total score,cardiac ischemia symptom group,digestive tract-related symptom group and mood-related symptom group scores were lower in the test group than in the control group after 2 weeks and 3weeks of intervention,and the differences were statistically significant(P < 0.05);the differences in the scores of the organ stasis-related symptom group between the two groups were not statistically significant(P > 0.05);(3)In the intra-group comparison at different measurement time points,the MSAS-HF total score,cardiac ischemia symptom group,digestive tract-related symptom group and mood-related symptom group of the test group and the control group all decreased to a certain extent compared with the baseline,and the difference was statistically significant(P < 0.05);the difference between the scores of the organ stasis-related symptom group of the two groups was not statistically significant(P>0.05).4.Comparison of the Chinese medical evidence between the two groups of patients(1)The results of the repeated measures ANOVA showed that the TCM symptom scores of patients in both groups were affected by the intervention effect,time effect and interaction effect(P < 0.05),and the differences were statistically significant;(2)In the comparison between groups at different measurement time points,the Chinese medicine evidence scores of patients in the test group were lower than those in the control group after 2 weeks and 3 weeks of intervention,and the difference was statistically significant(P <0.05);(3)In the intra-group comparison at different measurement time points,the TCM syndrome scores of patients in the test and control groups decreased to different degrees after 2 weeks and3 weeks of intervention compared with baseline,and the difference was statistically significant(P < 0.05),and the TCM syndrome scores of patients in both groups were lower than those before intervention,and the difference was statistically significant(P < 0.05);(4)In the comparison of the clinical efficacy of the TCM symptoms between the two groups after the intervention,there were 0,20,31 and 1 cases each of cured,apparently effective,effective and invalid in the test group;there were 0,8,35 and 9 cases each of cured,apparently effective,effective and invalid in the control group;the total effective cases in the test group were 51,with an effective rate of 98.07%;the total effective cases in the control group were 43,with an effective rate of 82.69%.The clinical efficacy of the TCM symptoms in the test group after the intervention was better than that in the control group,and the difference was statistically significant(P < 0.05).5.Comparison of MLHFQ and scores of each dimension between the two groups(1)The results of repeated measures analysis of variance showed that there were statistically significant differences in the time effect and interaction effect of MLHFQ and scores of each dimension between the two groups(P < 0.05),and there were statistically significant differences in the intervention effect of the total score of MLHFQ and scores of physical domain and emotional domain between the two groups(P < 0.05).The intervention effect of other domains was not statistically significant(P > 0.05).(2)In the comparison between groups at different measurement time points,the scores of MLHFQ and all dimensions of the experimental group were lower than those of the control group after 2 weeks and 3 weeks of intervention,and the differences were statistically significant(P < 0.05).(3)In the intra-group comparison at different measurement time points,after 2 weeks and 3weeks of intervention,the MLHFQ and the scores of each dimension of the two groups were reduced to varying degrees compared with the baseline,and the differences were statistically significant(P < 0.05).The MLHFQ and the scores of each dimension of the experimental group and the control group were lower than those before the intervention,and the differences were statistically significant(P < 0.05).Conclusion:Auricular acupoint snap acupuncture can improve the cardiac function of patients with Yang deficiency and blood stasis type of chronic heart failure,enhance their exercise endurance,improve the patient’s cardiac ischaemia,digestive tract and emotion-related symptom clusters,and provide insignificant relief to the patient’s visceral stasis-related symptom clusters,which to a certain extent reduces the patient’s symptom burden and improves the quality of life.Its convenience,feasibility and reliability of efficacy make it worthy of further promotion and application in the clinic. |
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