Astragalus acupoint injection at PC6 significantly improves cardiac function and reduces RAAS activity in chronic heart failure.
Background
Chronic heart failure (CHF) remains a major global health burden, characterized by high morbidity and mortality despite advances in conventional therapies. A significant subset of CHF patients presents with qi-deficiency and blood-stasis syndrome according to Traditional Chinese Medicine (TCM) diagnostics, indicating a potential gap in Western medical approaches. The renin-angiotensin-aldosterone system (RAAS) plays a critical role in CHF progression, and its overactivation contributes to cardiac remodeling and dysfunction. While Astragalus has been widely used in TCM for cardiovascular support, its specific efficacy via acupoint injection and impact on RAAS in CHF patients with this particular TCM syndrome has not been definitively established.
Study Design
A randomized, double-blind, placebo-controlled, parallel-group trial was conducted with 200 patients diagnosed with chronic heart failure and qi-deficiency and blood-stasis syndrome. Patients were randomized 1:1 to receive either conventional standard therapy plus Astragalus injection at the Neiguan (PC6) acupoint, or conventional standard therapy plus placebo. Primary endpoints included changes in TCM syndrome scores, B-type natriuretic peptide (BNP) levels, left ventricular ejection fraction (LVEF), Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, 6-min walk distance (6MWD), New York Heart Association (NYHA) functional class, and plasma RAAS markers (plasma renin, angiotensin II, aldosterone). Safety and 3-month major adverse cardiac events (MACE) were also monitored.
Results
The study included 200 patients, with 100 in each group. Baseline characteristics were comparable (p > 0.05) between groups, except for LVEF stratification. Post-treatment, the Astragalus group showed significant improvements compared to placebo. > The experimental group exhibited significantly reductions in TCM syndrome scores, BNP, MLHFQ scores, NYHA functional class, plasma renin (PRA), angiotensin II (Ang II) and aldosterone (ALD) (p < 0.05), as well as significantly greater increases in LVEF and 6MWD (p < 0.05). There was no significant difference in readmission rates between the two groups (p > 0.05). Importantly, no adverse events were observed in either treatment arm, indicating a favorable safety profile.
Key Findings
- Acupoint injection of Astragalus at PC6 significantly reduced TCM syndrome scores (p < 0.05).
- Plasma
BNPlevels were significantly reduced in the Astragalus group (p < 0.05). - Left ventricular ejection fraction (
LVEF) significantly increased in the Astragalus group (p < 0.05). - The Astragalus group showed significant reductions in
PRA,Ang II, andALD(p < 0.05). - No adverse events were observed in either the Astragalus or placebo group.
Why It Matters
Integrating acupoint injection with Astragalus into conventional therapy could offer a novel, safe, and effective adjunctive treatment for chronic heart failure, particularly for patients presenting with qi-deficiency and blood-stasis syndrome. This approach not only improves objective cardiac function markers like LVEF and functional capacity (6MWD) but also modulates the detrimental RAAS pathway, a key driver of CHF progression. The absence of adverse events suggests a high tolerability, making this a promising complementary strategy for improving quality of life and clinical outcomes in CHF patients. While 3-month MACE showed no difference, the significant improvements in multiple surrogate endpoints warrant further investigation into long-term benefits and broader applicability beyond the specific TCM syndrome.
astragalus
chronic-heart-failure
chf
acupoint-injection
tcm
raas