Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction

Yongqiang He

doi:doi:10.11648/j.sd.20261403.11

Research Article |

| Peer-Reviewed

Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction

Yongqiang He^*

Published in Science Discovery (Volume 14, Issue 3)

Received: 18 March 2026 Accepted: 3 May 2026 Published: 15 May 2026

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Abstract

Objective: To evaluate the clinical efficacy and safety of Qiangxin concentrated decoction combined with conventional western medicine in the treatment of patients with heart water disease (syndrome of yang deficiency and water flooding). Methods: A total of 81 patients from April 2024 to June 2025 were enrolled and randomly divided into the experimental group (treated with Qiangxin concentrated decoction+conventional treatment) and the control group (treated with conventional treatment). The treatment course lasted for 2 weeks. The TCM syndrome scores, cardiac function indicators (left ventricular ejection fraction [LVEF], brain natriuretic peptide [BNP]), degree of edema and safety indicators were observed. Results: The total effective rate in the experimental group was 85.37%, which was significantly higher than that in the control group (60.00%) (P<0.05). The improvement in LVEF (47.49±4.18% vs 44.88±6.07%), the cardiac function classification (2.90±0.37 vs 3.10±0.38), the 6MWT (337.39±65.14m vs 304.98±60.59m), and the decrease in NT-proBNP (5905.66±3827.84 vs 11067.53±6898.61pg/mL) were all superior to those in the control group (P<0.05). No serious adverse reactions occurred. Conclusion: Qiangxin concentrated decoction can effectively improve the cardiac function and edema symptoms of patients with heart water disease of the syndrome of yang deficiency and water flooding, and has good safety.

Published in	Science Discovery (Volume 14, Issue 3)
DOI	10.11648/j.sd.20261403.11
Page(s)	54-58
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Qiangxin Concentrated Decoction, Heart Water Disease, Syndrome of Yang Deficiency and Water Flooding, Warming Yang and Promoting Diuresis, Heart Failure, Chronic Heart Failure

1．引言

慢性心力衰竭归属中医“心水”、“水肿”、“心悸”、“心胀”、“心痹”、“胸痹”等辩病范畴

[1]

，多属本虚标实，由元气不足、肾阳衰微、心脉痹阻、水饮内停而致，其中急性加重期包括阳虚水泛、气阴两虚证、痰浊壅肺证等证型

[2]

。而心水病（慢性心衰）阳虚水泛证较为常见且病情较重，严重影响患者的生活质量及预后，治疗应以温阳利水为主。本科室自主研发的方药强心汤浓煎剂具有温阳利水，活血养心，泻肺平喘之功效，常用于治疗本科室收治的心水病阳虚水泛证病患。本研究采用强心汤浓缩剂联合西医常规诊疗方案对心衰水停阳虚证患者进行干预，临床疗效确切；2024年4月至2025年6月，笔者以强心汤浓缩剂单独施治该证型共81例，现将相关研究结果整理如下：

2．临床资料

2.1．一般资料

选取邵阳市中医医院心病科住院部2024年4月至2025年6月收治的心水病（慢性心衰）阳虚水泛证病患,依据随机数字表法分成治疗组和对照组一共80例，分成试验组41例及对照组39例。试验组男性22例，女性19例；年龄45～78岁，平均（67.12±7.5）岁。病程1-6年,平均(2.76±1.46)年;其中心功能分级Ⅱ级10例，Ⅲ级16例，Ⅳ级15例。对照组男性21例，女性18例；年龄46～79岁，平均（67.26±7.62）岁。病程1-6年，平均(2.82±1.52)年，心功能分级为Ⅱ级者 11例,Ⅲ级16例，Ⅳ级12例。两组研究对象入组时的基线特征经统计学分析未显示显著组间差异（P＞0.05），可认为每组间的基线水平具有均衡可比性。

①符合西医诊断：依照《中国心力衰竭诊断和治疗指南2024》

[3]

，存在有显著心力衰竭的症状与体征，NT-proBNP≥125ng/L；无其他特殊急慢性疾病。②符合中医诊断慢性心衰

[4]

，中医辨证为阳虚水泛证（主症：心悸气喘、下肢水肿；次症：尿少、肢冷、畏寒，舌淡舌体胖大、苔白滑，脉沉细）；③原发病为扩张型心肌病、冠心病、高血压性心脏、肺源性心脏病、风湿性心脏病、持续性心房颤动；④临床资料完整。

2.2．排除标准

①对强心汤中任一药物成分过敏者；②合并心源性休克、恶性心律失常、急性ST段抬高型心肌梗死；③合并有较严重肝、肾、造血系统等原发性疾病，功能严重受损影响药物代谢及疗效观察；④研究中途退出或改变治疗方案；⑤患有精神疾病，无法配合完成研究所需的各项检查及治疗；⑥中医辨证为气阴两虚证、气虚血瘀证、痰浊壅肺证、阳虚喘脱证。

3．治疗方法

对照组：给予常规西医治疗，根据《慢性心力衰竭中西医结合诊疗专家共识》

[4]

规范应用利尿剂、ACEI/ARB/ARNI、β受体阻滞剂、SGLT2、洋地黄类、醛固酮受体拮抗剂、伊伐布雷定等药物，以改善患者心功能、减轻水肿、控制血压及心率等，具体用药剂量及用法遵循临床诊疗规范及个体差异进行调整。

治疗组：于对照组的常规西药治疗基础上再加用强心汤浓煎剂。强心汤药物组成如下：淡附片10g（先煎30分钟）、红参片3g、黄芪30g、三七粉 3g（另包冲服）、葶苈子10g、茯苓20g、麻黄6g、生白术10g、泽泻10g、白芍10g、干益母草15g、肉桂5g、桂枝10g、煅磁石10g（先煎30分钟）、炙甘草10g。每日一剂，按照处方精确称取传统饮片药材，经邵阳市中医医院制剂室浓煎后，每剂汤剂浓缩至100ml，真空包装为50ml两袋，分早晚各服用一袋。

4．疗效标准

4.1．中医证候积分

依照《中医证候积分评定标准》

[5]

，对患者治疗前后的心悸、气喘、肢体浮肿、畏寒肢冷、腰膝酸软、小便短少、腹胀便溏等中医证候进行量化评分，每组症状按无、轻、中、重分别计0、2、4、6分，统计总积分，以评价中医证候改善情况。

4.2．心功能指标

4.2.1．NYHA 心功能分级

依据纽约心脏病协会（NYHA）心功能分级标准，于治疗前后分别将患者进行心功能的分级评估，观察其分级变化情况

[6]

。

4.2.2．心肌损伤标志物

治疗前后抽空腹静脉血,采取罗氏电化学发光法检测N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,简写NT-proBNP)指标

[7]

。

4.2.3．心脏超声指标

采用彩色多普勒超声心动图检测出病人治疗前后左室射血分数（LVEF）指标，以客观反映心脏结构及功能变化

[8]

。

4.2.4．六分钟步行试验(6 minute walking test, 6MWT)

治疗前后,在平直走廊中进行6MWT,事先告诉患者试验方法及注意事项，用手表计时，严格按照Vera Bitter方法进行，测量患者6min内步行总距离

[9]

。

4.2.5．生活质量评分

参照明尼苏达心力衰竭生活质量量表（MLHFQ）对患者治疗前后生活质量评分，得出的分数越高代表生活质量越好，对比两组患者生活质量改善情况

[10]

。

4.2.6．不良反应

观察并记录两组患者治疗过程中出现的不良反应，如胃肠不适、头晕、失眠、皮疹等，统计不良反应发生率。统计学方法采用SPSS 26.0软件，计量资料以（x±s）表示、用t检验，计数数据以（%）表示、用χ2检验， P＜0.05为差异有统计学意义

[11]

。

5．疗效标准显效

证候积分下降＞80%，心功能改善2级以上，6MWD增加距离大于50米。有效：证候积分下降30%~80%，心功能改善1级以上，6MWD增加距离50米内。无效：证候积分下降小于30%，心功能改善＜1级，6MWD无变化或下降

[12]

。

6．治疗结果

两组治疗前后中医证候的积分比较见表1：

表1 两组中医证候积分疗效的比较单位：例(%)。

组别	例数	显效	有效	无效	总有效
治疗组	41	20(48.78)	15(36.58)	6(14.63)	35(85.37)
对照组	40	16(40.00)	10(25.00)	14(35.00)	26(65.00)

两组治疗前后的心功能分级指标比较见表2

表2 两组中医心功能的分级疗效比较单位：例(%)。

组别	例数	显效	有效	无效	总有效
治疗组	41	21(40.00)	16(47.50)	4(12.50)	37(87.50)
对照组	40	16(40.00)	11(27.50)	13(32.50)	27(67.50)

表3 两组治疗前后的心功能相关指标比较单位：例。

组别	例数	LVEF（%）				心功能分级（NYHA）
组别	例数	治疗前	治疗后	t	p	治疗前	治疗后	t	p
治疗组	41	43.20±6.82	47.49±4.18*	3.626	＜0.001	3.54±0.55	2.90±0.37*	6.086	＜0.001
对照组	40	42.23±5.02	44.88±6.07*	2.130	0.036	3.48±0.55	3.10±0.38*	3.533	＜0.001
t		0.749	2.252			0.501	2.360
p		0.456	0.028			0.618	0.021

组别	例数	6MWD（m）				NT-proBNP(pg/mL)
组别	例数	治疗前	治疗后	t	p	治疗前	治疗后	t	p
治疗组	41	270.61±59.45	337.39±65.14*	4.849	＜0.001	16433.27±14499.01	5905.66±3827.84*	4.495	＜0.001
对照组	40	273.25 ±57.69	304.98±60.59*	2.398	0.019	15067.60±10055.51	11067.53.±6898.61*	2.075	0.041
t		0.203	2.320			0.491 4.177
p		0.840	0.023			0.624 ＜0.001

注：与本组治疗前比较，*p＜0.05。

7．结论

强心汤浓煎剂通过温阳益气、活血利水、宣肺通络的复合作用机制，且浓煎剂型可以减少心衰患者入水量

[13]

，利于达到出入水量负平衡，显著改善阳虚水泛型心水病患者心功能及水肿症状

[14]

，构建“温阳益气+活血利水+宣肺通络”的复合治法，打破了单一治法（如单纯温阳、单纯利水）治疗心衰的局限，实现了病机与治法的精准对应，提升了中医治疗的针对性和有效性且组方兼顾攻补平衡，尤其适用于高龄、兼夹血瘀证患者，此类人群多存在正气亏虚、瘀水互结的复杂病机，常规治疗易出现疗效不佳或不良反应，本研究证实强心汤浓煎剂兼顾攻补的特点可有效适配此类人群的病机特点，填补了高龄、血瘀兼夹型心衰中西医结合治疗的研究空白，为中西医结合治疗心衰提供新路径

[15]

。当然，本研究同样存在样本量与研究周期局限，作用机制研究不够深入等不足，未来继续扩大样本量，延长研究周期，深入开展作用机制研究，结合现代分子生物学技术，从细胞、分子层面深入探讨强心汤浓煎剂的作用靶点和调控机制，重点研究方剂对心肌细胞凋亡、炎症反应、氧化应激、心功能相关信号通路的影响，可进一步完善本研究成果，推动强心汤浓煎剂的临床推广和产业化转化，为中西医结合治疗心力衰竭提供更坚实的理论支撑和临床证据，助力中医心系疾病治疗的创新发展，最终惠及更多心衰患者。

基金项目

邵阳市科技计划项目经费资助（项目编号：2023ZD0159）。

References

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He, Y. (2026). Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction. Science Discovery, 14(3), 54-58. https://doi.org/10.11648/j.sd.20261403.11

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He, Y. Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction. Sci. Discov. 2026, 14(3), 54-58. doi: 10.11648/j.sd.20261403.11

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AMA Style

He Y. Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction. Sci Discov. 2026;14(3):54-58. doi: 10.11648/j.sd.20261403.11

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@article{10.11648/j.sd.20261403.11,
  author = {Yongqiang He},
  title = {Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction},
  journal = {Science Discovery},
  volume = {14},
  number = {3},
  pages = {54-58},
  doi = {10.11648/j.sd.20261403.11},
  url = {https://doi.org/10.11648/j.sd.20261403.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sd.20261403.11},
  abstract = {Objective: To evaluate the clinical efficacy and safety of Qiangxin concentrated decoction combined with conventional western medicine in the treatment of patients with heart water disease (syndrome of yang deficiency and water flooding). Methods: A total of 81 patients from April 2024 to June 2025 were enrolled and randomly divided into the experimental group (treated with Qiangxin concentrated decoction+conventional treatment) and the control group (treated with conventional treatment). The treatment course lasted for 2 weeks. The TCM syndrome scores, cardiac function indicators (left ventricular ejection fraction [LVEF], brain natriuretic peptide [BNP]), degree of edema and safety indicators were observed. Results: The total effective rate in the experimental group was 85.37%, which was significantly higher than that in the control group (60.00%) (PConclusion: Qiangxin concentrated decoction can effectively improve the cardiac function and edema symptoms of patients with heart water disease of the syndrome of yang deficiency and water flooding, and has good safety.},
 year = {2026}
}

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TY  - JOUR
T1  - Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction
AU  - Yongqiang He
Y1  - 2026/05/15
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N1  - https://doi.org/10.11648/j.sd.20261403.11
DO  - 10.11648/j.sd.20261403.11
T2  - Science Discovery
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JO  - Science Discovery
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EP  - 58
PB  - Science Publishing Group
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UR  - https://doi.org/10.11648/j.sd.20261403.11
AB  - Objective: To evaluate the clinical efficacy and safety of Qiangxin concentrated decoction combined with conventional western medicine in the treatment of patients with heart water disease (syndrome of yang deficiency and water flooding). Methods: A total of 81 patients from April 2024 to June 2025 were enrolled and randomly divided into the experimental group (treated with Qiangxin concentrated decoction+conventional treatment) and the control group (treated with conventional treatment). The treatment course lasted for 2 weeks. The TCM syndrome scores, cardiac function indicators (left ventricular ejection fraction [LVEF], brain natriuretic peptide [BNP]), degree of edema and safety indicators were observed. Results: The total effective rate in the experimental group was 85.37%, which was significantly higher than that in the control group (60.00%) (PConclusion: Qiangxin concentrated decoction can effectively improve the cardiac function and edema symptoms of patients with heart water disease of the syndrome of yang deficiency and water flooding, and has good safety.
VL  - 14
IS  - 3
ER  -

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Author Information

Yongqiang He

Cardiology Department, Shaoyang Hospital of TCM, Shaoyang, China

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http://orcid.org/0009-0000-9880-9606

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Table 1

表1 两组中医证候积分疗效的比较单位：例(%)。
Table 2

表2 两组中医心功能的分级疗效比较单位：例(%)。
Table 3

表3 两组治疗前后的心功能相关指标比较单位：例。

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APA Style

He, Y. (2026). Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction. Science Discovery, 14(3), 54-58. https://doi.org/10.11648/j.sd.20261403.11

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ACS Style

He, Y. Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction. Sci. Discov. 2026, 14(3), 54-58. doi: 10.11648/j.sd.20261403.11

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AMA Style

He Y. Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction. Sci Discov. 2026;14(3):54-58. doi: 10.11648/j.sd.20261403.11

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@article{10.11648/j.sd.20261403.11,
  author = {Yongqiang He},
  title = {Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction},
  journal = {Science Discovery},
  volume = {14},
  number = {3},
  pages = {54-58},
  doi = {10.11648/j.sd.20261403.11},
  url = {https://doi.org/10.11648/j.sd.20261403.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sd.20261403.11},
  abstract = {Objective: To evaluate the clinical efficacy and safety of Qiangxin concentrated decoction combined with conventional western medicine in the treatment of patients with heart water disease (syndrome of yang deficiency and water flooding). Methods: A total of 81 patients from April 2024 to June 2025 were enrolled and randomly divided into the experimental group (treated with Qiangxin concentrated decoction+conventional treatment) and the control group (treated with conventional treatment). The treatment course lasted for 2 weeks. The TCM syndrome scores, cardiac function indicators (left ventricular ejection fraction [LVEF], brain natriuretic peptide [BNP]), degree of edema and safety indicators were observed. Results: The total effective rate in the experimental group was 85.37%, which was significantly higher than that in the control group (60.00%) (PConclusion: Qiangxin concentrated decoction can effectively improve the cardiac function and edema symptoms of patients with heart water disease of the syndrome of yang deficiency and water flooding, and has good safety.},
 year = {2026}
}

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TY  - JOUR
T1  - Effective Observation on Treating Heart Water of the Syndrome of Yang Deficiency and Water Flooding with the Qiangxin Concentrated Decoction
AU  - Yongqiang He
Y1  - 2026/05/15
PY  - 2026
N1  - https://doi.org/10.11648/j.sd.20261403.11
DO  - 10.11648/j.sd.20261403.11
T2  - Science Discovery
JF  - Science Discovery
JO  - Science Discovery
SP  - 54
EP  - 58
PB  - Science Publishing Group
SN  - 2331-0650
UR  - https://doi.org/10.11648/j.sd.20261403.11
AB  - Objective: To evaluate the clinical efficacy and safety of Qiangxin concentrated decoction combined with conventional western medicine in the treatment of patients with heart water disease (syndrome of yang deficiency and water flooding). Methods: A total of 81 patients from April 2024 to June 2025 were enrolled and randomly divided into the experimental group (treated with Qiangxin concentrated decoction+conventional treatment) and the control group (treated with conventional treatment). The treatment course lasted for 2 weeks. The TCM syndrome scores, cardiac function indicators (left ventricular ejection fraction [LVEF], brain natriuretic peptide [BNP]), degree of edema and safety indicators were observed. Results: The total effective rate in the experimental group was 85.37%, which was significantly higher than that in the control group (60.00%) (PConclusion: Qiangxin concentrated decoction can effectively improve the cardiac function and edema symptoms of patients with heart water disease of the syndrome of yang deficiency and water flooding, and has good safety.
VL  - 14
IS  - 3
ER  -

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