Abstract：Objective To observe the clinical effects of Lixinshui Decoction combined with conventional Western medicine in the treatment of heart failure of coronary heart disease, and the effects of exercise tolerance, quality of life, N-terminal B-type natriuretic peptide (NT-proBNP), and vascular endothelial growth factor (VEGF) in patients. Methods A total of 82 coronary heart disease patients with heart failure admitted to Yancheng Hospital Affiliated to Nanjing University of Chinese Medicine from February to December 2020 were divided into control group and treatment group according to random number table method, with 40 patients in each group. Both groups were treated with conventional Western medicine as the basic treatment, the treatment group was treated with Lixinshui Decoction, the course of treatment in both groups was 12 weeks. Clinical efficacy, traditional Chinese medicine syndrome score, left ventricular ejection fraction (LVEF), Minnesota living with heart failure questionnaire (MLHFQ), 6-minute walking test (6MWT) distance, NT-proBNP, and VEGF were observed in both groups. The incidence of adverse reactions during treatment was recorded. Results There were two cases of detachment in the treatment group (one case of loss of follow-up, one case of gastrointestinal discomfort) and one case of detachment in the control group (loss of follow-up). A total of 79 patients were eventually included in this study. The clinical efficacy of the treatment group was better than that of the control group, and the difference was statistically significant (P ＜ 0.05). After treatment, the traditional Chinese medicine syndromes scores in both groups were better than before, and the traditional Chinese medicine syndromes scores of shortness of breath, fear of cold and cold hand and foot, cyanotic lips and nails, malaise in the treatment group were better than those in the control group, and the differences were statistically significant (P ＜ 0.05). After treatment, MLHFQ scores and NT-proBNP in both groups were lower than those before the treatment, 6MWT distance, LVEF, and VEGF were higher than those before the treatment, and MLHFQ and NT-proBNP in the treatment group were lower than those in the control group, 6MWT distance, LVEF, and VEGF were higher than those in the control group, the differences were statistically significant (P ＜ 0.05). No adverse reactions occurred in the two groups during treatment. Conclusion Lixinshui Decoction combined with conventional Western medicine is effective in the treatment of heart failure of coronary heart disease, which can improve patients’ exercise tolerance and cardiac function, improve the quality of life, and promote angiogenesis.
宋晓龙 宋俊 潘仁友 孙伟新 伍德明 倪其猛. 利心水方联合常规西药治疗冠心病心力衰竭的临床效果[J]. 中国医药导报, 2022, 19(11): 68-72.
SONG Xiaolong SONG Jun PAN Renyou SUN Weixin WU Deming NI Qimeng. Clinical effects of Lixinshui Decoction combined with conventional Western medicine in the treatment of heart failure of coronary heart disease#br#. 中国医药导报, 2022, 19(11): 68-72.
[1] 彭玉霞，卢桂林，张斌霞.中医药治疗慢性心力衰竭的研究进展[J].中国中医急症，2020，29（2）：373-376.
[2] 田晶，张青，张岩波，等.慢性心力衰竭结局评价指标研究进展[J].心血管病学进展，2019，40（6）：931-935.
[3] Ahmed S，Ahmed A，S?覿leby J，et al. Elevated plasma tyrosine kinases VEGF-D and HER4 in heart failure patients decrease after heart transplantation in association with improved haemodynamics [J]. Heart Vessels，2020，35（6）：786-799.
[4] 曾学文.心脏病气血水厥演变与辨证的临床研究[J].中医药学报，1989，4（5）：25-27.
[5] 国际心脏病学会和协会及世界卫生组织临床命名标准化联合专题组.缺血性心脏病的命名及诊断标准[J].中华心血管病杂志，1984，9（1）：75-76.
[6] 中华医学会心血管病学分会心力衰竭学组.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志，2018，10（46）：760-789.
[7] 郑筱萸.中药新药临床研究指导原则（试行）[M].北京：中国医药科技出版社，2002：68-73，77-85.
[8] 冠心病中医临床研究联盟，中国中西医结合学会心血管疾病专业委员会，中华中医药学会心病分会，等.慢性心力衰竭中医诊疗专家共识[J].中医杂志，2014，55（14）：1258-1260.
[9] Andrade GN，Rodrigues T，Takada JY，et al. Prolonged heart rate recovery time after 6-minute walk test is an independent risk factor for cardiac events in heart failure：A prospective cohort study [J]. Physiotherapy，2021，S0031（21）：31-36.
[10] Wu J，Yu Y，Xu H. Influence of targeted motivational interviewing on self-care level and prognosis during nursing care of chronic heart failure [J]. Am J Transl Res，2021，13（6）：6576-6583.
[11] 张伯礼，吴勉华.中医内科学[M].北京：中国中医药出版社，2017.
[12] 何泽慧，张戈，欧爱华.关于中医临床疗效评价研究的思考[J].中国民族民间医药，2020，29（1）：115-118.
[13] 王珏莲，侯政昆，肖嘉欣，等.医生报告结局量表在中医临床结局评价中的研究现状分析及展望[J].中医杂志，2018，59（19）：32-36.
[14] Zalmstra TAL，Elema A，van Gils W，et al. Development and sensibility assessment of a health-related quality of life instrument for adults with severe disabilities who are non-ambulatory [J]. J Appl Res Intellect Disabil，2021， 34（4）：1127-1135.
[15] 李燕村，张伟.《时病论》对《黄帝内经》“三因制宜”思想的继承与发挥[J].中国中医基础医学杂志，2017，23（1）：31-32.
[16] 刘文娟，徐众淼.《伤寒论》中的辨证施治[J].中国中医药现代远程教育，2020，18（7）：33-35.
[17] 何俊余.循证医学与中医学的反思[J].河北中医，2019， 41（10）：1569-1573.
[18] 石磊，叶巍，刘果果.中医药在慢性心力衰竭患者中的应用进展分析[J].中国医药科学，2020，10（14）：47-50.
[19] 郭叙喜，叶仁群，张越.基于中医治未病家庭-社区-医院三级防控模式对糖尿病患者治疗效果及生活质量的影响[J].世界中西医结合杂志，2021，16（3）：545-549， 553.
[20] 李志更，潘桂娟，刘理想.《内经》因人制宜思想探究[J].辽宁中医杂志，2008（7）：997-999.
[21] 李春燕，寇兰俊，王跃旗，等.黄芪保心汤治疗对心梗后心衰（气虚血瘀证）患者LVEF、LVEDd、BNP的影响[J].中国中医急症，2020，29（12）：2158-2161.
[22] 李江平.黄芪联合丹参川芎嗪治疗慢性充血性心力衰竭疗效观察[J].中国医药科学，2020，10（18）：72-74，78.
[23] Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult：a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines（Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure）[J]. J Am Coll Cardiol，2005，46（6）：e1-e82.
[24] Ponikowski P，Voors AA，Anker SD，et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure：The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology（ESC）. Developed with the special contribution of the Heart Failure Association（HFA）of the ESC [J]. Eur J Heart Fail，2016，18（8）：891-975.
[25] Kularatna S，Senanayake S，Chen G，et al. Mapping the Minnesota living with heart failure questionnaire（MLHFQ）to EQ-5D-5L in patients with heart failure [J]. Health Qual Life Outcomes，2020，18（1）：115.
[26] Garin O，Herdman M，Vilagut G，et al. Assessing health-related quality of life in patients with heart failure：a systematic，standardized comparison of available measure s[J]. Heart Fail Rev，2014，19（3）：359-367.
[27] De Pascale MR，Della Mura N，Vacca M，et al. Useful applications of growth factors for cardiovascular regenerative medicine [J]. Growth Factors，2020，38（1）：35-63.
[28] Varricchi G，Loffredo S，Bencivenga L，et al. Angiopoietins，Vascular Endothelial Growth Factors and Secretory Phospholipase A（2） in Ischemic and Non-Ischemic Heart Failure [J]. J Clin Med，2020，9（6）：1928-1934.
[29] Pajula JJ，Halonen PJ，H?覿tinen OP，et al. Adenoviral Gene Transfer of Gremlin Modulates Vascular Endothelial Growth Factor-A-Induced Angiogenesis in Porcine Myocardium [J]. Hum Gene Ther，2020，31（3/4）：211-218.
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