Effect of Yiqi Huayu decoction on microvascular injury,ventricular remodeling and metabolic remodeling in treatment of chronic heart failure patient

Objective To observe the clinic effect and possible mechanism of Yiqi Huayu decoction in treatment of chronic heart failure(CHF) patient with Qi deficiency and blood stasis syndrome. Methods A total of 120 CHF patients with Qi deficiency and blood stasis syndrome in Hangzhou Hospital of Traditional Chinese Medicine from May 2017 to February 2019 were enrolled and randomly divided into control group and treatment group with 60 cases in each group. Based on conventional treatment, 60 patients in the treatment group received trimetazidine and Yiqi Huayu decoction, while 60 patients in control group received trimetazidine for 6 months of treatment. Traditional Chinese medicine(TCM) syndrome efficacy, vascular endothelial function indexes, ventricular remodeling indexes and energy metabolism remodeling indexes were detected and compared between the two groups. Results After 6 months of treatment, the TCM symptom efficacy rate of patients in the treatment group was 80.00%, better than that in the control group 58.33%(χ²=6.604, P=0.010). Moreover, the endothelin 1(ET-1), Angiotensin Ⅱ, aldosterone, left ventricular ejection fraction(LVEF), circumferential end-systolic wall stress(cESS), and myocardial energy expenditure(MEE) in the treatment group and the control group were(68.42±21.95) ng/L,(77.53±35.28) pg/mL,(197.38±71.84) pg/mL,(125.69±21.84) g/m²,(130.75±18.93) kdyne/cm²,(92.67±9.83) kcal/min and(82.68±22.53) ng/L,(101.14±36.11) pg/mL,(262.33±95.83) pg/mL,(131.47±25.36) g/m²,(144.58±21.63) kdyne/cm²,(101.28±11.45) kcal/min, respectively. The above indexes in the treatment group were lower than those in the control group(all P<0.05). Conclusion Yiqi Huayu decoction combined with trimetazidine in the treatment of CHF patients with Qi deficiency and blood stasis syndrome can inhibit the process of microvascular injury, ventricular remodeling and metabolic remodeling, correct the pathological state and symptoms of traditional Chinese medicine, so as to achieve the purpose of "symptomatic treatment" and "syndrome differentiation treatment".