Heart failure is the final battleground of cardiovascular diseases and the leading cause of hospitalization for patients over 65 years old. The five-year survival rate is lower than that of many cancers, and the readmission rate is as high as 47%. Although the diagnosis and treatment level of heart failure has improved in China, the mortality rate of cardiovascular diseases remains high, and the clinical outcomes of patients are not optimistic. Traditional Chinese medicine has a long history in the treatment of heart failure. Most scholars believe that the disease location of heart failure lies in the heart and is closely related to the lungs, spleen, kidneys, and liver. The basic pathogenesis involves qi (yang) deficiency, blood stasis, and water retention.

The team led by Professor Fu Deyu from the Cardiology Department of Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine adheres to the "harmonizing and balancing" philosophy in treating heart failure, follows the theory of "circulation of qi," and advocates regulating qi movement for treatment. Drawing inspiration from Zhang Xichun’s series of prescriptions for raising sinking qi, they utilize the ascending and descending properties of Chinese herbal medicine to regulate qi movement and unblock the "sovereign organ" (the heart), achieving significant clinical efficacy. Supported by the Shanghai Traditional Chinese Medicine Cardiology Specialty Project and the Shanghai University of Traditional Chinese Medicine Budget Project, the clinical efficacy and mechanisms of prescriptions such as Shengxian Tang (Decoction for Raising Sinking Qi), Huiyang Shengxian Tang (Decoction for Reviving Yang and Raising Sinking Qi), Shengxian Lishui Fang (Formula for Raising Sinking Qi and Promoting Diuresis), and Yixin Fang (Formula for Nourishing the Heart) have been validated (which can significantly improve patients' clinical efficacy [11-12]). A series of standardized formulas, including Shengxian Lishui Fang and Yixin Fang, have been developed to address "collapsed thoracic qi" accompanied by water retention and blood stasis, with proven efficacy. The team is also conducting in-depth research and analysis on the TCM syndrome elements and metabolomics of heart failure patients.

In clinical practice, the team has optimized and proposed a strategy of treating heart failure by focusing on the triple energizer (San Jiao) and implementing full-course intervention for chronic heart failure. Based on the "Triple Energizer - Qi Transformation" theory, Professor Fu Deyu’s team summarized and proposed the following approaches: for the upper energizer (Shang Jiao), symptoms such as cough, expectoration, wheezing, and palpitations are treated with modified Tingli Dazao Xiefei Tang (Descurainiae and Jujubae Decoction for Draining the Lungs) or Fuling Xingren Gancao Tang (Poria, Almond, and Licorice Decoction); for the middle energizer (Zhong Jiao), symptoms such as poor appetite, nausea, and epigastric fullness are treated with modified Wuling San (Five-Ingredient Powder with Poria) or Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction); for the lower energizer (Xia Jiao), symptoms such as lower limb edema, body heaviness, and difficulty in urination and defecation are treated with modified Zhenwu Tang (True Warrior Decoction) or Shenqi Wan (Kidney Qi Pill). Depending on the patient’s condition, combined treatment of the upper and middle energizers (heart and lungs) or the middle and lower energizers (spleen and kidneys) can be applied, or the triple energizer (lungs, spleen, and kidneys) can be regulated comprehensively. For clinically stable heart failure patients over the long term, herbal paste (Gao Fang) can be selected for conditioning to tonify deficiency and treat diseases, combined with the Tranquil Liver-Regulating and Breath-Regulating Exercise derived from the deer play of the Five-Animal Exercises to regulate qi movement.

In summary, the integrated treatment of traditional Chinese and Western medicine can effectively improve the clinical symptoms of heart failure patients and reduce their readmission rates. The combination of traditional Chinese and Western medicine in the prevention and treatment of heart failure can complement each other’s strengths, significantly enhancing the therapeutic outcomes for patients.