| Purpose:By retrospectively analysing ejection fraction decline in heart failure in the addition of a standardised treatment regimen with Nocinto,Further adding the clinical efficacy of the Chinese herbal medicine Astragalus yiqi drops,To confirm the role of Qi-enhancing and blood-boosting herbs in the treatment of heart failure.Material and method:Patients who attended the inpatient ward and outpatient clinic of the Second Department of Cardiology at the Affiliated Hospital of Liaoning University of Chinese Medicine between September 2021 and December 2022 and whose first diagnosis was heart failure were randomly selected.A total of 106 patients were screened with reference to the inclusion and exclusion criteria who met the TCM diagnosis of Qi deficiency and blood stasis type and whose cardiac ultrasound indicated a left ventricular ejection fraction of less than 40%,and complete patient data were collected.Depending on the treatment regimen,there is a combination of Chinese and western medicine group(basic western medicine with Sacubitril Valsartan Sodium combined with Qishen Yiqi Droplet)and a western medicine group(basic western medicine with Sacubitril Valsartan Sodium)with a 4-week treatment course.Heart rate,blood pressure,the TCM symptom score,cardiac function rating,plasma NT-pro BNP level,Left ventricular ejection fraction(LVEF),Left ventricular end-diastolic internal diameter(LVEDD)and quality of life score were collected before and after four weeks of medicationrespectively.Summarise the information obtained into an Excel sheet.The SPSS 22.0 software was then used to statistically analyse the changes in vital signs,TCM symptoms,cardiac function,NT-pro BNP levels,LVEF,LVEDDand quality of life scores before and after treatment in both groups.To assess the effectiveness of their clinical treatment.Results:1.Changes in TCM evidence points:(1)TCM evidence points.:The mean TCM evidence points in the combined Chinese and western medicine group was(27.00±6.73)and in the western medicine group was(26.82±7.27)before treatment.After four weeks of medication,the mean TCM evidence points in the combined Chinese and western medicine group were(7.06±2.02)and those of the western medicine group were(11.60±3.53).Patients in both groups showed a reduction in TCM evidence points after treatment(P<0.001),and thew efficacy of the combined Chinese and western medicine group was significantly better than that of the western medicine group(P=0.000<0.01).(2)TCM evidence of efficacy:After four weeks of medication,in the combined Chinese and western medicine group,44 cases(86.27%)were significantly effective,5 cases(9.80%)were effective,2 cases(3.92%)were ineffective and 0 cases deteriorated,with an overall effective rate of 96.08%.In the western medicine group,10 cases(18.18%%)were effective,39 cases(70.91%%)were effective,6 cases(10.91%)were ineffective and 0 cases deteriorated,with an overall effective rate of 89.09%.After the two groups were treated according to different dosing regimens,the efficacy of their TCM symptoms was compared,and the combined Chinese and western medicine group was more effective(P<0.05).2.Changes in cardiac function:In the combined Chinese and western medicine group,29 cases(56.86%)were effective,16 cases(31.37%)were effective and 6 cases(11.76%)were ineffective,with no deterioration.In the western medicine group,19 cases(34.55%)were effective,22 cases(40%)were effective,14 cases(25.45%)were ineffective with no deteriorated,with an overall effective rate of 74.54%.And the efficacy of the combined Chinese and western medicine group was significantly better than the western medicine group(P=0.001<0.01).3.Changes in heart rate and blood pressure:(1)Heart rate:The mean heart rate of(97.55±11.65)times/min in the combined Chinese and western medicine group and(102.50±14.20)times/min in the western medicine group before treatment.After four weeks of medication,the mean heart rate was(60.73±6.24)times/min in the combined Chinese and western medicine group and(66.78±11.85)times/min in the western medicine group.Heart rate decreased in both groups after treatment(p<0.001),and the efficacy of the combined Chinese and western medicine group was significantly better than the western medicine group(P=0.00<0.01).(2)Systolic blood pressure:The mean systolic blood pressure was(133.14±20.16)mm Hg in the combined Chinese and Western medicine group and(132.60±19.13)mm Hg in the western medicine group before treatment.After four weeks of medication,the mean systolic blood pressure was(119.57±13.91)mm Hg in the combined Chinese and western medicine group and(124.04±15.48)mm Hg in the western medicine group.Systolic blood pressure decreased in both groups after treatment(P<0.001).The difference in efficacy between the combined Chinese and Western medicine groups was not significant by statistical analysis(P=0.122>0.05).(3)Diastolic blood pressure:The mean diastolic blood pressure was(79.82±13.12)mm Hg in the combined Chinese and Western medicine group and(79.98±13.69)mm Hg in the Western medicine group before treatment.After four weeks of medication,the mean diastolic blood pressure was(70.98±6.84)mm Hg in the combined Chinese and western medicine group and(79.98±13.69)mm Hg in the western medicine group.Diastolic blood pressure decreased in both groups after treatment(p<0.001),and the efficacy of the combined Chinese and western medicine group was better than the western medicine group(P=0.02<0.05).4.Changes in NT-pro BNP levels:The mean NT-pro BNP value was(2492.31±1028.15)pg/m L in the combined Chinese and western medicine group and(2428.13±916.18)pg/m L in the western medicine group before treatment.After four weeks of medication,the mean NT-pro BNP was(1447.30±518.50)pg/m L in the combined Chinese and western medicine group and(1715.80±629.21)pg/m L in the western medicine group.NT-pro BNP levels decreased in both groups after treatment(p<0.001),and the efficacy of the combined Chinese and western medicine group was better compared to the western medicine group(p=0.031<0.05).5.Left ventricular ejection fraction(LVEF)、Left ventricular end-diastolic internal diameter(LVEDD):(1)Left ventricular ejection fraction(LVEF):The mean LVEF(35.69%±2.78%)in the combined Chinese and Western medicine group and(35.99%±2.83%)in the Western medicine group before treatment.After four weeks of medication,the mean LVEF was(45.39%±4.59%)in the combined Chinese and western medicine group and(39.95%±3.11%)in the western medicine group.LVEF increased in both groups after treatment(p<0.001),and the efficacy of the combined Chinese and western medicine group was significantly better than the western medicine group(P=0.00<0.01).(2)Left ventricular end-diastolic internal diameter(LVEDD):The mean LVEDD was(53.98±1.98)mm in the combined Chinese and western medicine group and(53.98±2.59)mm in the western medicine group before treatment.After four weeks of medication,the mean LVEDD was(49.76±2.19)mm in the combined Chinese and western medicine group and(51.98±2.38)mm in the western medicine group.LVEDD decreased in both groups after treatment(p<0.001),and the efficacy of the combined Chinese and western medicine group was significantly better than the western medicine group(P=0.00<0.01).6.Changes in Quality of Life Points:The mean quality of life score was(63.61±7.05)in the combined Chinese and western medicine group and(63.71±6.00)in the western medicine group before treatment.After four weeks of medication,the mean quality of life score was(31.33±4.09)for the combined Chinese and western medicine group and(42.18±5.67)for the western medicine group.Patients in both groups showed a decrease in quality of life scores after treatment(p<0.001),and the efficacy of combined Chinese and western medicine group was significantly more effective than the western medicine group(P=0.00<0.01).Conclusion:1.The addition of the Chinese herbal medicine Qishen Yiqi Droplet to the standardised treatment regimen of Noxinto for heart failure with reduced ejection fraction was able to improve the clinical symptoms and TCM symptoms of patients with Qi deficiency and blood stasis evidence,and the quality of life of the patients was significantly improved.2.In heart failure with reduced ejection fraction,the addition of the Chinese herbal medicine Qishen Yiqi Droplet to the standardized treatment regimen of Noxinto improved blood pressure and heart rate,reduced plasma NT-pro BNP levels and left ventricular end-diastolic internal diameter(LVEDD),and increased left ventricular ejection fraction(LVEF)in patients with Qi deficiency and blood stasis,confirming the efficacy of Qi and blood activating herbs in the treatment of heart failure. |
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