Journal of Traditional Chinese Medicine ›› 2022, Vol. 42 ›› Issue (3): 439-445.DOI: 10.19852/j.cnki.jtcm.20220311.003
• Research Article • Previous Articles Next Articles
Effectiveness of Zhuling decoction (猪苓汤) on diuretic resistance in patients with heart failure: a randomized, controlled trial
CHEN Yunhu1(
), FAN Lihua1, ZHANG Tao2, LIU Xueqian1
- 1 Department of Cardiovascular, Taicang Hospital affiliated with Nanjing University of Traditional Chinese Medicine, Suzhou 215400, China
2 Department of Cardiovascular, Changzhou Hospital affiliated with Nanjing University of Traditional Chinese Medicine, Changzhou 213003, China
-
Received:2021-06-02Accepted:2021-09-12Online:2022-06-15Published:2022-03-11 -
Contact:CHEN Yunhu -
About author:CHEN Yunhu, Department of Cardiovascular, Taicang Hospital affiliated with Nanjing University of Traditional Chinese Medicine, Suzhou 215400, China. chenyh_1208@126.com,Telephone: +86-512-53728582
Cite this article
CHEN Yunhu, FAN Lihua, ZHANG Tao, LIU Xueqian. Effectiveness of Zhuling decoction (猪苓汤) on diuretic resistance in patients with heart failure: a randomized, controlled trial[J]. Journal of Traditional Chinese Medicine, 2022, 42(3): 439-445.
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Figure 1 Study design CO: control group; OB: observation group; NT-proBNP: N-terminal pro-B type natriuretic peptide; NYHA: New York Heart Association; MLHFQ: Minnesota Living with Heart Failure Questionnaire.
Figure 1 Study design CO: control group; OB: observation group; NT-proBNP: N-terminal pro-B type natriuretic peptide; NYHA: New York Heart Association; MLHFQ: Minnesota Living with Heart Failure Questionnaire.
Table 1 Background data [means ± SDs or medians (IQRs)]
| Parameter | Group | n | Data | P value |
|---|---|---|---|---|
| Age (years) | OB | 48 | 71±11 | 0.580 |
| CO | 48 | 70±10 | ||
| Sex (n) (Male/female) | OB | 48 | 28/20 | 0.583 |
| CO | 48 | 25/23 | ||
| Course of disease (months) | OB | 48 | 1.50 (5.0) | 0.707 |
| CO | 48 | 1.50 (5.2) | ||
| Etiology of HF (%) | 0.817 | |||
| Hypertensive heart disease | OB | 48 | 29.17 | |
| CO | 48 | 31.25 | ||
| Valvular heart disease | OB | 48 | 20.83 | |
| CO | 48 | 22.92 | ||
| Ischemic cardiomyopathy | OB | 48 | 14.58 | |
| CO | 48 | 20.83 | ||
| Cardiomyopathy | OB | 48 | 18.75 | |
| CO | 48 | 14.58 | ||
| Other | OB | 48 | 16.67 | |
| CO | 48 | 10.42 | ||
| Complication (%) | 0.427 | |||
| Diabetes | OB | 48 | 35.42 | |
| CO | 48 | 27.08 | ||
| Atrial fibrillation | OB | 48 | 70.83 | |
| CO | 48 | 56.25 | ||
| Infection | OB | 48 | 16.67 | |
| CO | 48 | 25.00 | ||
| Serum creatinine (μmol/L) | OB | 48 | 71 ± 25 | 0.283 |
| CO | 48 | 68 ± 26 | ||
| Serum albumin (g/L) | OB | 48 | 39 ± 5 | 0.399 |
| CO | 48 | 40 ± 4 |
Table 1 Background data [means ± SDs or medians (IQRs)]
| Parameter | Group | n | Data | P value |
|---|---|---|---|---|
| Age (years) | OB | 48 | 71±11 | 0.580 |
| CO | 48 | 70±10 | ||
| Sex (n) (Male/female) | OB | 48 | 28/20 | 0.583 |
| CO | 48 | 25/23 | ||
| Course of disease (months) | OB | 48 | 1.50 (5.0) | 0.707 |
| CO | 48 | 1.50 (5.2) | ||
| Etiology of HF (%) | 0.817 | |||
| Hypertensive heart disease | OB | 48 | 29.17 | |
| CO | 48 | 31.25 | ||
| Valvular heart disease | OB | 48 | 20.83 | |
| CO | 48 | 22.92 | ||
| Ischemic cardiomyopathy | OB | 48 | 14.58 | |
| CO | 48 | 20.83 | ||
| Cardiomyopathy | OB | 48 | 18.75 | |
| CO | 48 | 14.58 | ||
| Other | OB | 48 | 16.67 | |
| CO | 48 | 10.42 | ||
| Complication (%) | 0.427 | |||
| Diabetes | OB | 48 | 35.42 | |
| CO | 48 | 27.08 | ||
| Atrial fibrillation | OB | 48 | 70.83 | |
| CO | 48 | 56.25 | ||
| Infection | OB | 48 | 16.67 | |
| CO | 48 | 25.00 | ||
| Serum creatinine (μmol/L) | OB | 48 | 71 ± 25 | 0.283 |
| CO | 48 | 68 ± 26 | ||
| Serum albumin (g/L) | OB | 48 | 39 ± 5 | 0.399 |
| CO | 48 | 40 ± 4 |
Figure 2 Trend of urine volume according to group On the x-axis, the change in time, and on the y-axis, the record of urine output of patients. The CO group routinely treated with albumin, dopamine, hydrochlorothiazide and other drugs. The OB group received Zhuling decoction for at least 7 d on the basis of CO group. With prolonged treatment time, the urine volume in both groups increased significantly, and the increase was more significant in the OB group (P = 0.018). CO: control group (n = 48); OB: observation group (n = 48).
Figure 2 Trend of urine volume according to group On the x-axis, the change in time, and on the y-axis, the record of urine output of patients. The CO group routinely treated with albumin, dopamine, hydrochlorothiazide and other drugs. The OB group received Zhuling decoction for at least 7 d on the basis of CO group. With prolonged treatment time, the urine volume in both groups increased significantly, and the increase was more significant in the OB group (P = 0.018). CO: control group (n = 48); OB: observation group (n = 48).
Figure 3 Changes in NT-proBNP before and after treatment in the 2 groups The CO group routinely treated with albumin, dopamine, hydrochlorothiazide and other drugs. The OB group received Zhuling decoction for at least 7 d on the basis of CO group. The median NT-proBNP was 8060 ng/L pretreatment and 4000 ng/L posttreatment in the OB group. Those in the CO group were 5690 and 4945 ng/L, respectively. NT-proBNP improved in both groups, with a greater improvement in the OB group (P < 0.001). NT-proBNP: N-terminal pro-B type natriuretic peptide. CO: control group (n = 48); OB: observation group (n = 48).
Figure 3 Changes in NT-proBNP before and after treatment in the 2 groups The CO group routinely treated with albumin, dopamine, hydrochlorothiazide and other drugs. The OB group received Zhuling decoction for at least 7 d on the basis of CO group. The median NT-proBNP was 8060 ng/L pretreatment and 4000 ng/L posttreatment in the OB group. Those in the CO group were 5690 and 4945 ng/L, respectively. NT-proBNP improved in both groups, with a greater improvement in the OB group (P < 0.001). NT-proBNP: N-terminal pro-B type natriuretic peptide. CO: control group (n = 48); OB: observation group (n = 48).
Figure 4 Changes in MLHFQ before and after treatment in the 2 groups The treatment measures of the two groups were as mentioned above. All subjects received the first MLHFQ scores on the 1st day after enrollment. The second (Day 30 after enrollment) was usually obtained by telephone after discharge. The median MLHFQ score was 60 pretreatment and 38.5 posttreatment in the OB group; the scores for the CO group were 59 and 43, respectively. MLHFQ improved in both groups, with a greater improvement in the OB group (P < 0.001). MLHFQ: Minnesota Living With Heart Failure Questionnaire. CO: control group; OB: observation group. n (OB group pretreatment; CO group pretreatment) = 48, n (OB group posttreatment) = 45, n (CO group posttreatment) = 46.
Figure 4 Changes in MLHFQ before and after treatment in the 2 groups The treatment measures of the two groups were as mentioned above. All subjects received the first MLHFQ scores on the 1st day after enrollment. The second (Day 30 after enrollment) was usually obtained by telephone after discharge. The median MLHFQ score was 60 pretreatment and 38.5 posttreatment in the OB group; the scores for the CO group were 59 and 43, respectively. MLHFQ improved in both groups, with a greater improvement in the OB group (P < 0.001). MLHFQ: Minnesota Living With Heart Failure Questionnaire. CO: control group; OB: observation group. n (OB group pretreatment; CO group pretreatment) = 48, n (OB group posttreatment) = 45, n (CO group posttreatment) = 46.
Figure 5 NYHA functional classification results This figure showed the changes of cardiac function in the two groups after 7 d of treatment. The treatment measures of the two groups were as mentioned above. Before treatment, there were 0, 5 and 43 patients in the OB group with grade II, III and IV heart function, respectively. The numbers of patients with corresponding heart function after treatment were 11, 32 and 5. The corresponding numbers in the CO group were 0, 4, 44, 6, 29 and 13. NYHA: New York Heart Association. CO: control group (n = 48); OB: observation group (n = 48).
Figure 5 NYHA functional classification results This figure showed the changes of cardiac function in the two groups after 7 d of treatment. The treatment measures of the two groups were as mentioned above. Before treatment, there were 0, 5 and 43 patients in the OB group with grade II, III and IV heart function, respectively. The numbers of patients with corresponding heart function after treatment were 11, 32 and 5. The corresponding numbers in the CO group were 0, 4, 44, 6, 29 and 13. NYHA: New York Heart Association. CO: control group (n = 48); OB: observation group (n = 48).
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