关键词:

心力衰竭, 心房颤动, 阳虚水泛证, 芪苈强心胶囊, 心功能, 心电图, 心肌损伤

Abstract:

Objective　To analyze the clinical effect of Qiliqiangxin capsules on patients with heart failure complicated with atrial fibrillation with Yang-deficiency and water-generalized syndrome. Methods　This study was a randomized controlled trial. From August 2022 to February 2024, 78 patients with heart failure complicated with atrial fibrillation with Yang-deficiency and water-generalized syndrome in the Internal Medicine Department of Hanzhong Hospital of Traditional Chinese Medicine were divided into a western medicine group and a combined group with 39 cases in each group by the random number table method. In the western medicine group, there were 20 males and 19 females, aged (61.84±4.55) years, the duration of heart failure was (2.95±0.66) years, and the frequency of atrial fibrillation was (4.93±1.33) times/week. In the combined group, there were 22 males and 17 females, aged (62.12±4.23) years, the duration of heart failure was (3.11±0.51) years, and the frequency of atrial fibrillation was (5.13±1.47) times/week. The western medicine group received basic treatment combined with oral sacubactril/valsartan sodium tablets, and the initial dose of sacubactril/valsartan sodium tablets was 50 mg/time, twice a day, whose dosage was increased according to the therapeutic effect (the initial dose as a single increase), but was not more than 4 times of the initial dose. The combined group was supplemented with Qiliqiangxin capsules on the basis of the western medicine group, 1.2 g/time, 3 times/day. Both groups were treated for 8 weeks. The effects of the two groups were compared, as well as the indexes of cardiac function, electrocardiogram, and myocardial injury before and after treatment, and the occurrence of adverse reactions during treatment. Chi-square test and t test were used for statistical analysis. Results　The total effective rate of the combined group was higher than that of the western medicine group [94.87% (37/39) vs. 76.92% (30/39)], with a statistically significant difference (χ2=5.186, P=0.023). After treatment, the left ventricular end-systolic diameter, QT dispersion, maximum P-wave duration, P-wave dispersion, and serum matrix metalloproteinase-9, soluble growth stimulation-expression gene 2 protein, and growth differentiation factor 15 levels in the combined group were lower than those in the western medicine group [(35.34±2.52) mm vs. (39.08±2.50) mm, (62.56±5.41) ms vs. (68.82±5.25) ms, (102.43±12.87) ms vs. (113.96±11.46) ms, (28.20±3.98) ms vs. (32.97±3.26) ms, (37.90±5.46) µg/L vs. (51.02±5.52) µg/L, (15.34±3.48) µg/L vs. (19.91±3.45) µg/L, (143.85±19.32) ng/L vs. (173.14±18.31) ng/L]; the cardiac index and left ventricular ejection fraction were higher than those in the western medicine group [(3.23±0.51) L/min vs. (2.91±0.43) L/min, (44.51±3.52)% vs. (38.72±3.46)%], with statistically significant differences (all P<0.001). During treatment, the treatment was not terminated due to obvious adverse reactions in both groups, and there was no statistically significant difference in the incidence of adverse reactions between the two groups [12.82% (5/39) vs 7.69% (3/39)] (χ²=0.139, P=0.709). Conclusion　On the basis of basic treatment and sacubactril/valsartan sodium tablets, Qiliqiangxin capsules has higher efficacy in patients with heart failure complicated with atrial fibrillation with Yang-deficiency and water-generalized syndrome, which can improve the cardiac function and electrocardiogram indexes, alleviate the myocardial injury, and has higher safety.

Key words:

Heart failure, Atrial fibrillation, Yang-deficiency and water-generalized syndrome, Qiliqiangxin , capsules, Heart function,  , Electrocardiogram, Myocardial injury