Clinical study on the adjuvant treatment of chronic heart failure with Wenjing Tongluo Yunyu and Xunxi Formula

Objective To explore the effects of Wenjing Tongluo Huayu and Xunxi Prescription on cardiopulmonary function and microinflammation in patients with chronic heart failure.

Methods A total of 100 patients with chronic heart failure were selected, and were divided into conventional western medicine group (n=50, receiving standardized western medicine treatment) and integrated Chinese and western medicine group (n=50, given adjuvant treatment by Wenjing Tongluo Huayu and Xunxi Prescription on the basis of standardized western medicine treatment). The levels of macrophage inflammatory protein-1α (MIP-1α), interleukin-18 (IL-18) and soluble urokinase-type plasminogen activator receptor (suPAR) were examined before and after treatment, and peripheral resistance, stroke output, acceleration index and cardiac output index were detected. The ejection fraction (LVEF), ventricular myocardial mass index (LVMI), maximum mid-expiratory flow (MMF), and forced expiratory volume in one second (FEV₁) were measured. The slope of the relationship between the minute ventilation and carbon dioxide production(VE/VCO₂ slope), peak heart rate, and peak oxygen uptake(VO_{2 peak})were detected by cardiopulmonary exercise test (CPET). TCM syndrome score, 6 min walking distance (6MWT) test, and Minnesota Heart Failure Quality of Life Scale (MLHFQ) were evaluated for patients. The clinical efficacy and adverse reactions of conventional western medicine group and integrated Chinese and western medicine group were compared.

Results The contents of MIP-1α, IL-18 and suPAR in integrated Chinese and western medicine group were significantly lower, and the stroke output, acceleration index and cardiac output index were significantly higher than those in the conventional western medicine group (P < 0.05). LVEF, MMF and FEV₁ in the integrated Chinese and western medicine group were higher, while LVMI was lower than those in the conventional western medicine group (P < 0.05). VE/VCO₂ slope in integrated Chinese and western medicine group was significantly lower, and peak heart rate and VO_{2 peak} in integrated Chinese and western medicine group were higher than those in conventional western medicine group (P < 0.05). Palpitation, shortness of breath or wheezing, fatigue, coldness in abdomen or body, cold sweat, aversion to cold or preference of warmth, dark lips or face and MLHFQ score in the integrated Chinese and western medicine group were lower, and 6MWT was longer than that in the conventional western medicine group (P < 0.05). The total effective rate of the integrated Chinese and western medicine group was significantly higher than that of the conventional western medicine group (98.00% versus 86.00%, P < 0.05), and there were no obvious adverse reactions between the two groups during treatment.

Conclusion The adjuvant treatment for patients with chronic heart failure with Wenjing Tongluo Yunyu and Xunxi Formula can inhibit the micro-inflammatory state of the body, improve the hemodynamic index and the cardiopulmonary function, relieve the clinical symptoms, and improve the clinical efficacy and quality of life.