Clinical observation and prognosis analysis of the Ercheng Yangxin decoction in the treatment of heart failure with preserved ejection fraction
Objective:To observe the clinical curative effect of the Ercheng Yangxin decoction(二乘养心汤)on heart failure with preserved ejection fraction patients with deficiency of Yang-qi(阳 气)and fluid retention invading heart to investigate patients'prognosis in 6 months and explore possible factors affecting prognosis.Methods:A total of 100 patients who met the inclusion criteria were divided into the treatment group and the control group.The control group was treated with standard western medicine,and the treatment group was treated with the Ercheng Yangxin decoction besides standard western medicine.The treatment course was 2 weeks,and cardiovascular events were observed in 6 months after treatment.The heart function and syndrome score of traditional Chinese medicine were observed.Left ventricular ejection fraction(LVEF),N-terminal pro-B-type Natriuretic Peptide(NT-proBNP)and the indicators of cardiac diastolic function(average value of e',E/e',LAVI,LVMI),as primary therapeutic indexes,were also observed and compared.Results:The total effective rates for traditional Chinese medicine syndromes in the treatment group and the control group were 90%(45/50)and 82%(41/50),respectively.The treatment group was superior to the control group(P<0.05).The total effective rates for cardiac functional efficacy in the treatment group was 88%(44/50),and the control group was 78%(39/50).The treatment group was superior to the control group(P<0.05).Compared with before treatment,the LVEF was increased prominently after treatment in each group,and that in the treatment group was superior to the control group(P<0.05).Compared with before treatment,the plasma NT-proBNP level was reduced obviously after treatment in each group,and that in the treatment group was superior to the control group(P<0.05).Compared with before treatment,the indicators of cardiac diastolic function(average value of e',E/e'and LAVI)were improved significantly after treatment in each group,and those in the treatment group were superior to the control group(P<0.05).The rates of cardiovascular events in the treatment group was 20.41%(10/49)and the control group 31.91%(15/47).There was a remarkable difference between the two groups.Multi-factorial logistic regression analysis showed that the higher NT-proBNP level for the heart failure with preserved ejection fraction patients was risk factor of poor prognosis(OR=4.312,P<0.05).Conclusion:The Ercheng Yangxin decoction can improve HFpEF patients'cardiac systolic and diastolic function,relieve clinical symptoms,raise LVEF,reduce plasma NT-proBNP level,and also improve short-term prognosis.Plasma NT-proBNP level is superior to course,heart function and LVEF in evaluating prognosis.
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