芪苈强心胶囊联合心脏康复对冠状动脉旁路移植术后心力衰竭患者心功能及心室重构的影响

doi:10.3969/j.issn.1006-5725.2026.16.003

Abstract

Abstract:

Objective To investigate the effects of Qili Qiangxin capsule combined with cardiac rehabilitation on cardiac function and ventricular remodeling in patients with heart failure with reduced ejection fraction （HFrEF） following coronary artery bypass grafting （CABG）. Methods This prospective randomized controlled trial consecutively enrolled 160 patients with HFrEF following CABG between August 2020 and August 2025. Eligible patients were randomly allocated to four groups （40 patients per group）： a control group receiving guideline-directed medical therapy （GDMT）， a rehabilitation group receiving GDMT plus 12-week supervised cardiac rehabilitation， a traditional Chinese medicine （TCM） group receiving GDMT plus Qili Qiangxin capsule， and a combination group receiving GDMT plus both 12-week cardiac rehabilitation and Qili Qiangxin capsule. Outcome assessments including TCM syndrome scores， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， left ventricular ejection fraction （LVEF）， left atrial diameter （LA）， early diastolic mitral inflow velocity to early diastolic mitral annular velocity ratio （E/e’）， 6-minute walk distance （6MWD） and 36-item Short Form Health Survey （SF-36） scores were conducted at baseline， after 12 weeks of intervention， and at 1 month， 3 months， and 6 months after treatment initiation. Results Following intervention， TCM syndrome scores and NT-proBNP levels decreased significantly in all four groups （all P < 0.05）， and the combination therapy group exhibited the lowest NT-proBNP level among all groups （P < 0.05）. Compared with the other three groups， the combination therapy group achieved significantly greater improvements in LVEF and 6MWD （P < 0.05）. Left atrial diameter （LA） and the E/e' ratio in the combination therapy group showed significantly more substantial improvements than those in the control group （P < 0.05）， while no statistically significant differences were detected when compared with the cardiac rehabilitation group and the TCM monotherapy group （all P > 0.05）. SF-36 score showed the most prominent improvement in the combination therapy group （P < 0.05）. No statistically significant difference in the incidence of adverse events was identified among the four groups （P > 0.05）. Conclusion On the basis of GDMT， Qili Qiangxin capsule combined with cardiac rehabilitation can further improve cardiac function， delay ventricular remodeling， and improve the quality of life of post-CABG patients with heart failure， with favorable safety profile.

Key words: Qili Qiangxin capsule, cardiac rehabilitation, coronary artery bypass grafting, heart failure, cardiac function, ventricular remodeling

CLC Number:

R2-031

Wei Sheng, Haiqin Yang, Zhentong Zhao, Hao Deng, Kun Fan, Zhiqiang Zheng, Long Sun. Effects of Qili Qiangxin capsule combined with cardiac rehabilitation on cardiac function and ventricular remodeling in post‑CABG patients with heart failure[J]. The Journal of Practical Medicine, 2026, 42(16): 2883-2890.

Figures/Tables 6

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Tab.6

Comparison of SF-36 scale scores at different time points among four groups"

维度	对照组（n = 38）	康复组（n = 39）	中药组（n = 39）	联合组（n = 38）
PF
治疗前	52.61 ± 8.46	53.18 ± 8.69	52.87 ± 8.44	52.92 ± 8.62
治疗结束	61.53 ± 9.16^*	68.46 ± 9.81^*△	67.26 ± 9.56^*△	74.68 ± 10.28^*△▲■
治疗后1个月	63.32 ± 9.39^*	70.51 ± 10.15^*△	69.28 ± 9.91^*△	77.21 ± 10.58^*△▲■
治疗后3个月	63.82 ± 9.36^*	71.18 ± 10.20^*△	70.15 ± 9.81^*△	78.03 ± 10.69^*△▲■
治疗后6个月	64.16 ± 9.46^*	71.64 ± 10.20^*△	70.36 ± 9.92^*△	78.71 ± 10.76^*△▲■
VT
治疗前	48.47 ± 7.57	49.23 ± 7.95	48.85 ± 7.70	49.05 ± 7.82
治疗结束	56.79 ± 8.40^*	63.56 ± 8.90^*△	62.97 ± 8.72^*△	70.21 ± 9.46^*△▲■
治疗后1个月	58.32 ± 8.62^*	65.41 ± 9.12^*△	64.67 ± 8.94^*△	72.53 ± 9.65^*△▲■
治疗后3个月	58.82 ± 8.65^*	65.92 ± 9.12^*△	65.26 ± 8.91^*△	73.11 ± 9.74^*△▲■
治疗后6个月	59.16 ± 8.65^*	66.38 ± 9.18^*△	65.64 ± 9.07^*△	73.45 ± 9.84^*△▲■
SF
治疗前	55.32 ± 8.87	56.10 ± 9.22	55.82 ± 8.99	56.37 ± 9.16
治疗结束	63.66 ± 9.43^*	69.82 ± 10.23^*△	69.08 ± 10.00^*△	75.84 ± 10.81^*△▲■
治疗后1个月	65.26 ± 9.73^*	71.49 ± 10.49^*△	70.69 ± 10.22^*△	77.95 ± 11.02^*△▲■
治疗后3个月	65.82 ± 9.75^*	72.15 ± 10.48^*△	71.26 ± 10.21^*△	78.37 ± 11.05^*△▲■
治疗后6个月	66.18 ± 9.86^*	72.51 ± 10.54^*△	71.62 ± 10.37^*△	78.84 ± 11.25^*△▲■
MH
治疗前	51.29 ± 8.10	52.10 ± 8.43	51.62 ± 8.17	52.32 ± 8.29
治疗结束	60.37 ± 9.03^*	66.87 ± 9.55^*△	65.97 ± 9.33^*△	73.26 ± 10.15^*△▲■
治疗后1个月	62.08 ± 9.23^*	68.51 ± 9.79^*△	67.59 ± 9.47^*△	75.42 ± 10.22^*△▲■
治疗后3个月	62.74 ± 9.23^*	69.10 ± 9.77^*△	68.28 ± 9.51^*△	75.95 ± 10.36^*△▲■
治疗后6个月	63.00 ± 9.30^*	69.49 ± 9.87^*△	68.56 ± 9.59^*△	76.37 ± 10.58^*△▲■

Tab.6

References 22

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指标	对照组（n = 38）	康复组（n = 39）	中药组（n = 39）	联合组（n = 38）	F/χ²值	P值
年龄/岁	62.41 ± 7.31	63.12 ± 6.91	62.79 ± 7.52	63.48 ± 7.11	0.181	0.909
男性/［例（%）］	28（73.68）	29（74.36）	30（76.92）	28（73.68）	0.148	0.986
BMI/（kg/m²）	24.61 ± 2.81	24.92 ± 3.12	24.38 ± 2.91	25.01 ± 3.02	0.332	0.802
高血压/［例（%）］	26（68.42）	27（69.23）	26（66.67）	27（71.05）	0.176	0.981
糖尿病/［例（%）］	18（47.37）	19（48.72）	18（46.15）	19（50.00）	0.119	0.989
NYHA分级/［例（%）］					0.278	0.964
Ⅱ级	22（57.89）	23（58.97）	24（61.54）	22（57.89）
Ⅲ级	16（42.11）	16（41.03）	15（38.46）	16（42.11）
LVEF/%	35.03 ± 3.61	34.89 ± 3.79	35.41 ± 3.52	34.99 ± 3.71	0.135	0.939
NT-proBNP/（pg/mL）	1 735.42 ± 456.31	1 699.79 ± 481.07	1 759.58 ± 467.14	1 720.03 ± 475.06	0.112	0.953
中医证候积分/分	24.61 ± 5.21	25.12 ± 5.41	24.79 ± 5.32	25.29 ± 5.51	0.156	0.925

指标	对照组（n = 38）	康复组（n = 39）	中药组（n = 39）	联合组（n = 38）
NT-proBNP/（pg/mL）
治疗前	1 735.43 ± 456.28	1 699.81 ± 481.13	1 759.57 ± 467.09	1 720.04 ± 475.12
治疗结束	1 000.02 ± 289.75^*	735.53 ± 245.38^*	709.12 ± 240.06^*	522.31 ± 186.57^*△▲■
治疗后1个月	746.22 ± 255.86^*	559.82 ± 208.19^*	533.13 ± 202.68^*	426.42 ± 160.09^*△▲■
治疗后3个月	693.13 ± 245.28^*	506.43 ± 191.87^*	479.92 ± 186.59^*	346.63 ± 133.28^*△▲■
治疗后6个月	666.44 ± 234.57^*	479.72 ± 181.39^*	453.33 ± 175.94^*	319.82 ± 122.74^*△▲■
LVEF/%
治疗前	35.22 ± 3.63	34.91 ± 3.79	35.39 ± 3.52	35.00 ± 3.71
治疗结束	41.33 ± 4.22^*	43.82 ± 4.53^*	44.22 ± 4.33^*	47.62 ± 4.82^*△▲■
治疗后1个月	42.52 ± 4.31^*	44.63 ± 4.62^*	45.13 ± 4.51^*	48.92 ± 5.02^*△▲■
治疗后3个月	43.03 ± 4.42^*	45.52 ± 4.72^*	46.02 ± 4.63^*	50.53 ± 5.12^*△▲■
治疗后6个月	43.22 ± 4.33^*	45.82 ± 4.62^*	46.52 ± 4.52^*	51.02 ± 5.03^*△▲■

指标	对照组（n = 38）	康复组（n = 39）	中药组（n = 39）	联合组（n = 38）
LA /mm
治疗前	45.61 ± 4.22	46.12 ± 4.55	45.80 ± 4.31	45.93 ± 4.44
治疗结束	43.82 ± 3.91^*	42.51 ± 4.04^*	42.32 ± 4.13^*	41.23 ± 3.83^*△
治疗后1个月	43.53 ± 3.85^*	42.14 ± 3.93^*	41.91 ± 4.06^*	40.82 ± 3.74^*△
治疗后3个月	43.42 ± 3.77^*	41.93 ± 3.89^*	41.73 ± 3.97^*	40.53 ± 3.69^*△
治疗后6个月	43.31 ± 3.88^*	41.83 ± 3.94^*	41.62 ± 3.91^*	40.44 ± 3.63^*△
E/e'
治疗前	14.82 ± 2.63	15.13 ± 2.83	14.91 ± 2.74	15.02 ± 2.82
治疗结束	13.22 ± 2.31^*	12.51 ± 2.44^*	12.42 ± 2.53^*	11.81 ± 2.23^*△
治疗后1个月	13.01 ± 2.35^*	12.33 ± 2.42^*	12.21 ± 2.45^*	11.52 ± 2.24^*△
治疗后3个月	12.98 ± 2.27^*	12.22 ± 2.39^*	12.12 ± 2.36^*	11.43 ± 2.16^*△
治疗后6个月	12.92 ± 2.25^*	12.11 ± 2.33^*	12.03 ± 2.31^*	11.34 ± 2.13^*△

时间点	对照组（n = 38）	康复组（n = 39）	中药组（n = 39）	联合组（n = 38）
治疗前	325.82 ± 56.27	332.43 ± 58.73	328.62 ± 57.19	330.13 ± 59.36
治疗结束	382.63 ± 62.38*	428.52 ± 65.29^*△	412.73 ± 63.75^*△	468.33 ± 68.15^*△▲■
治疗后1个月	396.43 ± 63.46*	445.23 ± 66.75^*△	428.62 ± 64.48^*△	482.53 ± 69.28^*△▲■
治疗后3个月	398.53 ± 63.78*	448.93 ± 66.48^*△	432.33 ± 64.77^*△	485.73 ± 69.49^*△▲■
治疗后6个月	401.83 ± 64.15*	452.62 ± 67.26^*△	435.82 ± 65.19^*△	489.63 ± 70.04^*△▲■

时间点	对照组（n = 38）	康复组（n = 39）	中药组（n = 39）	联合组（n = 38）
治疗前	24.62 ± 5.23	25.19 ± 5.48	24.81 ± 5.33	25.35 ± 5.56
治疗结束	16.83 ± 4.30^*	14.25 ± 3.85^*△	13.58 ± 3.69^*△	10.68 ± 3.25^*△▲■
治疗后1个月	15.67 ± 4.19^*	12.88 ± 3.66^*△	12.29 ± 3.50^*△	9.39 ± 2.98^*△▲■
治疗后3个月	15.26 ± 4.04^*	12.37 ± 3.60^*△	11.88 ± 3.41^*△	8.90 ± 2.87^*△▲■
治疗后6个月	14.95 ± 3.98^*	11.98 ± 3.52^*△	11.47 ± 3.33^*△	8.60 ± 2.82^*△▲■

Effects of Qili Qiangxin capsule combined with cardiac rehabilitation on cardiac function and ventricular remodeling in post‑CABG patients with heart failure

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