Volume 22 Issue 6
Jun.  2024
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WU Dongdong, LIU Xuying, YU Guoqiang, TENG Jinyan, TAN Zengde, ZHOU Yabin, ZHANG Mingming. Clinical study on treating chronic heart failure of Qi deficiency and blood stasis type with modified Yangxin Decoction and Guan's ear needle combination therapy[J]. Chinese Journal of General Practice, 2024, 22(6): 987-990. doi: 10.16766/j.cnki.issn.1674-4152.003550
Citation: WU Dongdong, LIU Xuying, YU Guoqiang, TENG Jinyan, TAN Zengde, ZHOU Yabin, ZHANG Mingming. Clinical study on treating chronic heart failure of Qi deficiency and blood stasis type with modified Yangxin Decoction and Guan's ear needle combination therapy[J]. Chinese Journal of General Practice, 2024, 22(6): 987-990. doi: 10.16766/j.cnki.issn.1674-4152.003550

Clinical study on treating chronic heart failure of Qi deficiency and blood stasis type with modified Yangxin Decoction and Guan's ear needle combination therapy

doi: 10.16766/j.cnki.issn.1674-4152.003550
Funds:

 LBH-Z19216

  • Received Date: 2023-12-25
    Available Online: 2024-07-22
  •   Objective  To observe the effects of modified Yangxin Decoction combined with Guan's ear needle on heart function, activity endurance, Chinese medicine syndrome, and clinical efficacy in patients with chronic heart failure (CHF), and to explore the mechanism by which this combination improves these parameters in CHF patients.  Methods  During the period from January to December 2021, 100 patients with Qi deficiency and blood stasis type CHF were treated at the Internal Medicine Clinic. They were randomly divided into an observation group and a control group using a single-blind protocol. Finally, 48 patients in the observation group and 47 patients in the control group were completed. Both groups of patients were given basic treatment. The control group received routine western medicine treatment, including cardiac strengthening, diuresis, and vasodilation. The observation group received a combination of modified Yangxin Decoction and Guan's ear needle treatment in addition to the control group. Changes in Chinese medicine syndromes, cardiac function, activity endurance, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, and cardiac ultrasound were observed before and after treatment in two groups of patients. The clinical efficacy of the two groups was then compared.  Results  After treatment, the Chinese medicine syndrome score, NT-proBNP level, and Lee's heart failure score in the observation group were significantly lower than those in the control group, and the activity endurance was significantly improved compared to the control group (P < 0.05). The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular mass index (LVMI), and interventricular septal thickness (IVST) in the observation group were significantly decreased, while left ventricular ejection fraction (LVEF) was significantly increased compared to the control group (P < 0.05). The total effective rate of the observation group was 93.8% (45/48), significantly higher than the 78.7% (37/47) in the control group (P < 0.05).  Conclusion  The combination of modified Yangxin Decoction and Guan's ear needle can significantly improve the clinical efficacy for CHF patients. It effectively improves their Chinese medicine syndrome, activity endurance, and heart function, increases LVEF, and reduces LVEDD, LVESD, LVMI, IVST, and NT proBNP levels.

     

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  • [1]
    张永珍, 范媛媛. 心力衰竭通用定义和分类解读[J]. 中国心血管杂志, 2021, 26(5): 409-412. doi: 10.3969/j.issn.1007-5410.2021.05.001

    ZHANG Y Z H, FAN Y Y. General definition and classification interpretation of heart failure[J]. Chinese Journal of Cardiovascular Medicine, 2021, 26(5): 409-412. doi: 10.3969/j.issn.1007-5410.2021.05.001
    [2]
    MCDONAGH TA, METRA M, ADAMO M, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J, 2021, 42(36): 3599-3726. doi: 10.1093/eurheartj/ehab368
    [3]
    HEIDENREICH P A, BOZKURT B, AGUILAR D, et al. 2022 AHA/ACC/HFSA Guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines[J]. Circulation, 2022, 145(18): e895-e1032.
    [4]
    JOHANSSON I, JOSEPH P, BALASUBRAMANIAN K, et al. Health-related quality of life and mortality in heart failure: the global congestive heart failure study of 23 000 patients from 40 countries[J]. Circulation, 2021, 143(22): 2129-2142. doi: 10.1161/CIRCULATIONAHA.120.050850
    [5]
    ROGER V L. Epidemiology of heart failure: a contemporary perspective[J]. Circ Res, 2021, 128(10): 1421-1434. doi: 10.1161/CIRCRESAHA.121.318172
    [6]
    郭兴邦, 赵雅琳, 张少沛, 等. 中药联合沙库巴曲缬沙坦治疗慢性心力衰竭的临床研究[J]. 河北医药, 2023, 45(12): 1836-1839. doi: 10.3969/j.issn.1002-7386.2023.12.017

    GUO X B, ZHAO Y L, ZHANG SH P, et al. Clinical study of traditional Chinese medicine combined with sacubitril and valsartan in the treatment of chronic heart failure[J]. Hebei Medical Journal, 2023, 45(12): 1836-1839. doi: 10.3969/j.issn.1002-7386.2023.12.017
    [7]
    胡宇驰, 代松源, 赵玲, 等. 迷走神经刺激在慢性心力衰竭炎症及凋亡机制中的应用研究进展[J]. 中国全科医学, 2024, 27(24): 3044-3050. doi: 10.12114/j.issn.1007-9572.2023.0693

    HU Y C, DAI S Y, ZHAO L, et al. Advances in the application of vagus nerve stimulation in inflammation and apoptosis mechanism of chronic heart failure[J]. Chinese General Practice, 2024, 27(24): 3044-3050. doi: 10.12114/j.issn.1007-9572.2023.0693
    [8]
    KAZORY A. Combination diuretic therapy to counter renal sodium avidity in acute heart failure: trials and tribulations[J]. Clin J Am Soc Nephrol, 2023, 18(10): 1372-1381. doi: 10.2215/CJN.0000000000000188
    [9]
    杨杉杉, 范增光, 周亚滨, 等. 耳穴疗法在心血管疾病中的应用进展[J]. 中医药导报, 2020, 26(13): 168-170. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB202013038.htm

    YANG B B, FAN Z G, ZHOU Y B, et al. Progress in the application of ear acupoint therapy in cardiovascular diseases[J]. Guiding Journal of Traditional Chinese Medicine and Pharmacology, 2020, 26(13): 168-170. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB202013038.htm
    [10]
    刘敬萱, 王锐卿, 张子迪, 等. 中国耳针不同流派比较与分析[J]. 中国针灸, 2020, 40(12): 1363-1368. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE202012029.htm

    LIU J X, WANG R Q, ZHANG Z D. Comparison and Analysis of Different Schools of Ear Needles in China[J]. Chinese Acupuncture & Moxibustion, 2020, 40(12): 1363-1368. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE202012029.htm
    [11]
    高润琳, 吴宁, 胡大一, 等. 心血管病治疗指南和建议[M]. 北京: 人民军医出版社, 2005: 141-181.

    GAO R L, WU N, HU D Y, et al. Guidelines and recommendations for the treatment of cardiovascular diseases[M]. Beijing: People's Military Medical Press, 2005: 141-181.
    [12]
    郑筱萸. 中药新药临床研究指导原则[S]. 北京: 中国医药科技出版社, 2002: 77-85.

    ZHENG X Y. Guiding Principles for Clinical Research of New Traditional Chinese Medicine Drugs[S]. Beijing: The Medicine Science and Technology Press of China, 2002: 77-85.
    [13]
    VISTISEN D, CARSTENSEN B, ELISABETTA P, et al. Empagliflozin is associated with lower cardiovascular risk compared with dipeptidyl peptidase-4 inhibitors in adults with and without cardiovascular disease: EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study results from Europe and Asia[J]. Cardiovasc Diabetol, 2023, 22(1): 233. DOI: 10.1186/s12933-023-01963-9.
    [14]
    KOH N, GOH V J, TEOH C K, et al. Angiotensin receptor-neprilysin inhibitor improves New York Heart Association class and N-terminal-pro B-type natriuretic peptide levels: initial experience in a Singapore singlecentre cohort[J]. Singapore Med J, 2021, 62(7): 359-361.
    [15]
    许显芳, 卢景华, 祁琛虹, 等. 心电图额面QRS-T夹角、QRS波时限与慢性心力衰竭患者心功能及预后的关系[J]. 山东医药, 2023, 63(31): 1-5. doi: 10.3969/j.issn.1002-266X.2023.31.001

    XU X F, LU J F, QI S H, et al The relationship between frontal QRS-T angle and QRS wave duration on electrocardiogram and cardiac function and prognosis in patients with chronic heart failure[J]. Shandong Medical Journal, 2023, 63(31): 1-5. doi: 10.3969/j.issn.1002-266X.2023.31.001
    [16]
    LEWIS G D, VOORS A A, COHEN-SOLAL A, et al. Effect of omecamtiv mecarbil on exercise capacity in chronic heart failure with reduced ejection fraction: the meteoric-hf randomized clinical trial[J]. JAMA, 2022, 328(3): 259-269. doi: 10.1001/jama.2022.11016
    [17]
    TANI H, SADAHIRO T, YAMADA Y, et al. Direct reprogramming improves cardiac function and reverses fibrosis in chronic myocardial infarction[J]. Circulation, 2023, 147(3): 223-238. doi: 10.1161/CIRCULATIONAHA.121.058655
    [18]
    BATKAI S, GENSCHEL C, VIERECK J, et al. CDR132L improves systolic and diastolic function in a large animal model of chronic heart failure[J]. Eur Heart J, 2021, 42(2): 192-201. doi: 10.1093/eurheartj/ehaa791
    [19]
    李傲航, 田媛媛, 高琰, 等. H-FABP和RDW及NT-proBNP水平应用于急性非ST段抬高型心肌梗死诊断的价值分析[J]. 中华全科医学, 2021, 19(11): 1908-1911. doi: 10.16766/j.cnki.issn.1674-4152.002198

    LI A H, TIAN Y Y, GAO Y. Value analysis of H-FABP, RDW, and NT proBNP levels in the diagnosis of acute non ST segment elevation myocardial infarction. Chinese Journal of General Practice[J]. Chinese Journal of General Practice, 2021, 19(11): 1908-1911. doi: 10.16766/j.cnki.issn.1674-4152.002198
    [20]
    李玲, 张东, 刘亚丽, 等. 心源性栓塞型脑梗死患者NT-proBNP水平变化及对病情和预后评估价值[J]. 国际检验医学杂志, 2023, 44(9): 1143-1145. doi: 10.3969/j.issn.1673-4130.2023.09.025

    LI L, ZHANG D, LIU Y L, et al. Changes in NT proBNP levels in patients with cardioembolic cerebral infarction and their value in evaluating the condition and prognosis[J]. International Journal of Laboratory Medicine, 2023, 44(9): 1143-1145. doi: 10.3969/j.issn.1673-4130.2023.09.025
    [21]
    LINDENFELD J, ZILE M R, DESAI A S, et al. Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial[J]. Lancet, 2021, 398(10304): 991-1001. doi: 10.1016/S0140-6736(21)01754-2
    [22]
    莘翼翔, 刘恒, 于祯, 等. 芪苈强心胶囊联合参附注射液治疗慢性肺源性心脏病心力衰竭疗效观察[J]. 现代中西医结合杂志, 2023, 32(9): 1273-1277. doi: 10.3969/j.issn.1008-8849.2023.09.022

    SHEN Y Y, LIU H, YU Z H, et al. Observation on the therapeutic effect of Qili Qiangxin Capsule combined with Shenfu Injection in the treatment of chronic pulmonary heart disease and heart failure[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2023, 32(9): 1273-1277. doi: 10.3969/j.issn.1008-8849.2023.09.022
    [23]
    任高灿, 刘锦, 尚青华, 等. 基于"虚瘀毒"病机理论探讨细胞焦亡与慢性心力衰竭的关系[J]. 吉林中医药, 2023, 43(9): 1001-1005. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL202309003.htm

    REN G C, LIU M, SHANG Q H, et al. Exploring the relationship between cell pyroptosis and chronic heart failure based on the theory of "deficiency, stasis, and toxin" pathogenesis[J]. Jilin Journal of Traditional Chinese Medicine, 2023, 43(9): 1001-1005. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL202309003.htm
    [24]
    祁含章, 施琦, 严志鹏, 等. 基于"血-脉-心-神"一体观论治慢性心力衰竭[J]. 中华中医药杂志, 2023, 38(8): 3703-3706. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202308041.htm

    QI H Z, SHI Q, YAN Z P, et al. Treatment of chronic heart failure based on the concept of "blood pulse heart spirit" integration[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2023, 38(8): 3703-3706. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202308041.htm
    [25]
    姜云武, 管遵惠, 管钟洁, 等. 管氏耳针理论体系的构建与创新[J]. 中华中医药杂志, 2022, 37(2): 887-889. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202202073.htm

    JIANG Y W, GUAN Z H, GUAN Z J, et al. Construction and Innovation of Guan's Ear Needle Theory System[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2022, 37(2): 887-889. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202202073.htm
    [26]
    吴咚咚, 于国强, 滕金艳, 等. 子午流注择时耳穴压豆对慢性心力衰竭患者炎症细胞因子及NT-proBNT水平的影响[J]. 中华全科医学, 2023, 21(6): 1026-1029. doi: 10.16766/j.cnki.issn.1674-4152.003041

    WU D D, YU G Q, TENG J Y, et al. The effect of timing ear acupoint pressure on inflammatory cytokines and NT proBNT levels in patients with chronic heart failure during the noon flow[J]. Chinese Journal of General Practice, 2023, 21(6): 1026-1029. doi: 10.16766/j.cnki.issn.1674-4152.003041
    [27]
    石炜琦, 刘水花, 张诗雨, 等. 强心汤联合耳穴埋针治疗慢性心力衰竭合并抑郁状态患者的临床疗效研究[J]. 实用心脑肺血管病杂志, 2023, 31(4): 101-106. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXL202304020.htm

    SHI W Q, SHUI H, ZHANG S Y, et al. Clinical efficacy study of Qiangxin Tang combined with ear acupuncture in the treatment of patients with chronic heart failure complicated with depression[J]. Practical journal of cardiac cerebral pneumal and vascular disease, 2023, 31(4): 101-106. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXL202304020.htm
    [28]
    刘红霞, 牛璐, 陈亮, 等. 益气活血温阳利水方配合耳穴压丸治疗气虚血瘀水泛型慢性心力衰竭临床观察[J]. 山西中医, 2023, 39(3): 16-18. https://www.cnki.com.cn/Article/CJFDTOTAL-SHIX202303006.htm

    LIU H X, NIU L, CHEN L, et al. Clinical Observation on the Treatment of Chronic Heart Failure with Qi Deficiency, Blood Stasis, and Water Deficiency by Yiqi Huoxue Wenyang Lishui Formula Combined with Ear Point Pressing Pills[J]. Shanxi J Tradit Chin Med, 2023, 39(3): 16-18. https://www.cnki.com.cn/Article/CJFDTOTAL-SHIX202303006.htm
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