Clinical Observation on Yiqi Fumai Lyophilized Injection for Treating Elderly Patients with Qi and Yin Deficiency Syndrome of Atrial Fibrillation

Abstract

Objective: To explore the effects of Yiqi Fumai Lyophilized injection on the levels of inflammatory factors (CRP, IL-6, TNF-?)
and oxidative stress markers (MDA, SOD, HCY) in elderly patients with Qi and Yin deficiency syndrome of atrial fibrillation. Methods: According to the inclusion and exclusion criteria, elderly patients with Qi and Yin deficiency syndrome of atrial fibrillation were randomly
assigned to the control group and observation group using the random number table method. Both groups received the rivaroxaban tablets
for anticoagulation and the metoprolol succinate extended-release tablets for ventricular rate control. The observation group received, in
addition, Yiqi Fumai lyophilized injections for 14 days, followed by a 28-day observation period and a 2-month follow-up. After treatment,
we observed the clinical efficacy rates of both groups based on predefined criteria, compared changes in plasma inflammatory factors and
oxidative stress markers, and measured left atrial diameter (LAD), left ventricular ejection fraction (LVEF), and E/A ratio indices using
echocardiography. We also recorded adverse reactions, as well as recoverydefined as symptom resolution and functional improvement
and recurrence of atrial fibrillation after the intervention. Results: After intervention, the overall efficacy rate regarding TCM syndromes
and electrocardiogram findings in the observation group was significantly higher than that in the control group (P all < 0.01). The levels of
three inflammatory factorsTNF-?, CRP, and IL-6were significantly lower in the observation group compared with the control group (P
all < 0.01). Moreover, these inflammatory factors decreased significantly in the observation group after intervention compared with baseline (P all < 0.01). Regarding oxidative stress markersMDA, SOD, and HCYthe observation group showed significantly lower HCY
and MDA levels and higher SOD levels than the control group (P all < 0.01). Additionally, the observation group exhibited a significant
decrease in HCY and MDA levels and a significant increase in SOD levels after intervention compared with baseline (P all < 0.01). Both
groups experienced a significant decrease in LAD and a significant increase in LVEF after intervention (both P < 0.01). Furthermore, the
observation group had significantly lower LAD and higher LVEF than the control group (P < 0.01). The control group's E/A index showed
no significant change (P > 0.01), whereas the observation group's E/A index improved significantly compared with baseline (P < 0.01) and
was better than that of the control group (P < 0.01). There was no significant difference in adverse reactions between the two groups (P >
0.01). Finally, no significant differences were found in the recurrence rate or the rate of return to sinus rhythm between the groups after
intervention (both P > 0.01). Conclusion: Yiqi Fumai Lyophilized Injection administered to elderly patients with qi and yin deficiency
syndrome associated with atrial fibrillation can effectively reduce the levels of inflammatory mediators and improve oxidative stress markers. This promotes the clinical efficacy in treating atrial fibrillation. Its mechanism involves multi-target regulation, including inhibition of
inflammatory responses and alleviation of oxidative stress-induced damage, thereby delaying atrial structural remodeling and improving
cardiac function indicators. Although there is no statistical difference in cardioversion and recurrence rates, the drug does not cause many
adverse reactions. This demonstrates its safety and reliability in elderly patients.