芪苈强心胶囊佐治心力衰竭合并心房颤动阳虚水泛证的临床效果OA

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(x2=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)](x2=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.