Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study

Hui GUAN; Guo-hua DAI; Wu-lin GAO; Tong ZHANG; Cong SUN; Li-li REN; Xiao-ming HOU; Zhang LIU

doi:10.1007/s11655-021-2875-y

Your Location：

Home >

Browse articles >

Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study

Original Article | Updated：2022-03-29

- Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study
- Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study
- Chinese Journal of Integrative Medicine 2022年28卷第4期页码：312-318
- Affiliations：
  
  1.The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan (250014), China
  2.Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan (250011), China
- Author bio：
  
  Prof. DAI Guo-hua, E-mail: daigh2004@163.com
- Funds：
  
  National Key R&D Program of China(2019YFC1710400;2019YFC1710401);National Natural Science Foundation of China(81774047)
- DOI：10.1007/s11655-021-2875-y
  中图分类号：
- 纸质出版日期：2022-04，
  
  网络出版日期：2021-12-07，
  
  录用日期：2020-07-20
Scan for full text
Hui GUAN, Guo-hua DAI, Wu-lin GAO, 等. Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study[J]. Chinese Journal of Integrative Medicine, 2022,28(4):312-318.

Hui GUAN, Guo-hua DAI, Wu-lin GAO, et al. Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study[J]. Chinese Journal of Integrative Medicine, 2022,28(4):312-318.
Hui GUAN, Guo-hua DAI, Wu-lin GAO, 等. Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study[J]. Chinese Journal of Integrative Medicine, 2022,28(4):312-318. DOI： 10.1007/s11655-021-2875-y.

Hui GUAN, Guo-hua DAI, Wu-lin GAO, et al. Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter,Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study[J]. Chinese Journal of Integrative Medicine, 2022,28(4):312-318. DOI： 10.1007/s11655-021-2875-y.

摘要

目的:

探讨参麦注射液对慢性心力衰竭患者远期预后的影响.

方法:

利用医院信息系统提取慢性心力衰竭患者资料

实施回顾性队列研究. 非暴露组采用西医规范化治疗

辅助口服中成药或中药汤剂治疗

但不合并参麦注射液; 暴露组在非暴露组基础上应用参麦注射液7天及以上. 疗效评价指标依次为纽约心脏协会心功能分级(NYHA分级)、左心室射血分数(LVEF)、N端脑钠肽前体(NT-proBNP)、心源性死亡和心力衰竭再入院. 使用Kaplan-Meier分析和Cox回归分析

探讨参麦注射液与结局事件的关系.

结果:

共纳入符合条件的慢性心力衰竭患者1211例

成功随访1047例. 治疗后暴露组和非暴露组NYHA分级下降例数分别占64.30%和43.45%

LVEF改善值分别为8.89%和7.91%

NT-proBNP改善值分别为909pg/mL和735pg/mL. 使用参麦注射液治疗

可使心源性死亡和心力衰竭再住院率分别由15.43%降至10.18%和38.93%降至32.37%. 根据Kaplan-Meier分析

参麦注射液与心源性死亡的log rank P=0.014

参麦注射液与心衰再入院的log rank P=0.025. Cox回归分析显示

年龄、心肌病、糖尿病和NYHA分级是心源性死亡的危险因素

β受体阻滞剂、醛固酮受体拮抗剂、口服中成药/中药汤剂和参麦注射液是保护因素. 同样

对于心衰再入院

年龄、心肌病和NYHA分级是其危险因素

而参麦注射液是保护因素.

结论:

西医规范化治疗基础上结合参麦注射液能有效降低慢性心力衰竭患者心源性死亡和再住院发生率

从而改善远期预后.

Abstract

Objective:

To explore the effect of Shenmai Injection (SMI) on the long-term prognosis of patients with chronic heart failure (CHF).

Methods:

The Hospital Information System was used to extract data of CHF patients

and the retrospective cohort study was conducted for analysis. In non-exposed group

standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group

SMI were applied for more than 7 days. Evaluation indicators are followed with New York Heart Association functional classification (NYHA classification)

left ventricular ejection fraction (LVEF)

N-terminal brain natriuretic peptide precursor (NT-ProBNP)

cardiogenic death and heart failure (HF) readmission. Statistical analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome events.

Results:

A total of 1

211 eligible CHF patients were involved and finally 1

047 patients were followed up successfully. After treatment

the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30% and 43.45%

respectively; the improvement values of LVEF were 8.89% and 7.91%

respectively; the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL

respectively. After exposure on SMI

the rates of cardiogenic death and HF readmission reduced from 15.43% to 10.18% and 38.93% to 32.37%. According to Kaplan-Meier analysis

the log-rank P value of SMI and cardiogenic death was 0.014

while the counterpart of SMI and HF readmission was 0.025. Cox regression analysis indicated that for cardiogenic death

age

cardiomyopathy

diabetes

and NYHA classification were risk factors while β-blockers

aldosterone receptor antagonists

Chinese patent medicine/ decoction and SMI were protective factors. Likewise

for HF readmission

age

cardiomyopathy

and NYHA classification were risk factors while SMI was a protective factor.

Conclusion:

Combination with SMI on the standardized Western medicine treatment can effectively reduce cardiogenic mortality and readmission rate in CHF patients

and thereby improve the long-term prognosis.

关键词

Keywords

Shenmai Injectionchronic heart failurecohort studyoutcome eventslong-term prognosis

references

Hu SS, Gao RL, Liu LS, Zhu ML, Wang W, Wang YJ, et al. Summary of "Chinese Cardiovascular Disease Report 2018". Chin Circ (Chin) 2019;34:209-220.

Sun RH, Shan QJ. Current status and prospects of heart failure readmission. Med Recapitulate (Chin) 2014;20:2757-2760.

Al-Omary MS, Davies AJ, Evans TJ, Bastian B, Fletcher PJ,Attia J, et al. Mortality and readmission following hospitalisation for heart failure in Australia: a systematic review and meta-analysis. Heart Lung Circ 2018;27:917-927.

Gao WL. Cohort research method and key technologies of clinical efficacy evaluation of traditional Chinese medicine[dissertation]. Jinan: Shandong University of Traditional Chinese Medicine; 2019.

Dai GH, Guan H, Gao WL. Investigation and analysis of the application of traditional Chinese medicine during the hospitalization of 2,700 patients with chronic heart failure in traditional Chinese medicine hospital. http://jsp.365heart.com/detail/article/97C2BC68-26DA-42B7-BDE3-C64C7BE67100http://jsp.365heart.com/detail/article/97C2BC68-26DA-42B7-BDE3-C64C7BE67100.

Li XL, Shen Y, He F, Li F, Zhu YC. Effectiveness and safety of Shenmai injection in treatment of shock: A meta-analysis.J Tradit Chin Med 2018;38:155-166.

Zhou YS, Zhao BM, Wu WY, Yang XB, Long SQ, Deng H,et al. Shenmai Injection for the treatment of cancer-related fatigue in advanced non-small cell lung cancer patients undergoing chemotherapy: study protocol for a randomized controlled trial. Trials 2018;19:474.

Chen L, Wang LR, Zhuo Q, Zhang Q, Chen FF, Li LL, et al. Effect of Shenmai injection on cognitive function after cardiopulmonary bypass in cardiac surgical patients: a randomized controlled trial. BMC Anesthesiol 2018;18:142.

Chen HD, Xie YM, Wang LX, Wu JB. Systematic review of efficacy and safety of shenmai injection for chronic heart failure. China J Chin Mater Med (Chin) 2014;39:3650-3661.

Cardiovascular Branch of Chinese Medical Association, Editorial Board of Chinese Journal of Cardiovascular Diseases.Guidelines for Diagnosis and Treatment of Chinese Heart Failure 2014. Chin J Cardiovasc Med (Chin) 2014;42:3-10.

Mei YR. A retrospective study on the effect of traditional Chinese medicine on mortality of patients with chronic heart failure [dissertation]. Beijing: Beijing University of Traditional Chinese Medicine; 2015.

Hou XM. Statistical methods in a cohort study of clinical efficacy evaluation of traditional Chinese medicine and their application in chronic heart failure [dissertation]. Shandong:Shandong University of Traditional Chinese Medicine; 2020.

Kevin SS, Xu HL, Roland AM, Deepak LB, Paul AH, Adrian FH, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol 2017;70:2476-2486.

Ge WJ. The clinical value of Shenmai Injection in the treatment of refractory heart failure. Electronic J Clin Med Literature (Chin) 2017;4:12211.

Wang Q, Wu Y, Zhang HZ. Observation on the curative effect of Shenmai injection on 35 cases of chronic heart failure. Zhejiang J Tradit Chin Med (Chin) 2017;52:923-924.

Ma RG, Wang CX, Shen YH, Wang ZQ, Ma JH, Huang LS.Effect of Shenmai Injection on ventricular diastolic function in patients with chronic heart failure: an assessment by tissue Doppler imaging. Chin J Integr Med 2010;16:173-175.

Long MZ, Wang DB, Yang JM, Zhou LY. Clinical study on effect of Shenmai Injection in treating congestive heart failure. Chin J Integr Med 2004;1:62.

Wei X, Xie TM, Tian F, Shen H, Jiang JJ, Sun SL, et al.Thoughts and methods of constructing chronic disease risk prediction model combining disease and syndrome. J Basic Chin Med (Chin) 2017;23:798-801.

Yu XN, Feng XG, Zhang JM, Huang JJ, Zhang Q. New progress in the research on the chemical constituents and pharmacological effects of ginseng. Ginseng Res (Chin)2019;31:47-51.

Zhang J. Research progress of the pharmacological effects of ginsenosides in the cardiovascular system. Clin J Chin Med (Chin) 2019;11:141-144.

Ding DZ, Shen TK, Cui YZ, Li XN, Jin HM, Jin CY, et al.Study on curative effect and mechanism of red ginseng on congestive heart failure. Chin J Integr Med 1995;6:325-327.

Fan S, Zhang J, Xiao Q, Liu P, Zhang Y, Yao E, et al. Cardioprotective effect of the polysaccharide from Ophiopogon japonicus on isoproterenol-induced myocardial ischemia in rats. Int J Biol Macromol 2020;147:233-240.

Zhao Y, Zhang F, Zhao XP, Yuan W, Zhang JH, Wang Y.Shenmai Injection protects mitochondria from oxidative injury in myocardial cells and its mechanism. J Zhejiang Univ (Chin) 2018;47:507-513.

Xuan JJ, Gao CX, Guan HM, Jie JH, Chen YS, Luo MH,et al. Long-term clinical efficacy of Shenmai Injection in patients with heart failure after acute myocardial infarction.Chin Patent Med (Chin) 2015;37:465-467.

More>

浏览量

Downloads

CSCD

文章被引用时，请邮件提醒。

Submit

工具集

关联资源

Qishen Taohong Granule as Adjuvant Therapy for Improving Cardiac Function and Quality of Life in Patients with Chronic Heart Failure: A Randomized Controlled Trial

Association between Chinese Medicine Therapy and Survival Outcomes in Postoperative Patients with NSCLC: A Multicenter, Prospective, Cohort Study