What question did this study set out to answer?

This research aims to evaluate the effectiveness and safety of astragalus injection at the Neiguan acupoint for treating chronic heart failure with qi-deficiency and blood-stasis syndrome.

June 1, 2026Open Access

Effect and safety of Neiguan acupoint injection with astragalus injection for chronic heart failure with qi-deficiency and blood-stasis syndrome: a randomized controlled trial

Key Points

This research aims to evaluate the effectiveness and safety of astragalus injection at the Neiguan acupoint for treating chronic heart failure with qi-deficiency and blood-stasis syndrome.
Conducted a randomized, double-blind, placebo-controlled trial involving 200 patients with chronic heart failure.
Participants were assigned to receive either astragalus injection at Neiguan plus standard therapy or placebo plus standard therapy.
Assessment measures included TCM syndrome scores, BNP levels, LVEF, MLHFQ scores, 6-min walk distance, and plasma renin levels before and after treatment.
The experimental group saw significant reductions in TCM syndrome scores, BNP, MLHFQ scores, NYHA class, PRA, Ang II, and ALD, with p<0.05 for all.
Improvements in LVEF and 6MWD were also significantly greater in the experimental group, with p<0.05.
No adverse events were reported, and there was no difference in readmission rates between groups (p>0.05).

Abstract

Objective To investigate the effect and safety of astragalus injection at Neiguan (PC6) for chronic heart failure (CHF; HF) with qi-deficiency and blood-stasis syndrome, and its effect on the renin-angiotensin-aldosterone system (RAAS). Methods A randomized, double-blind, placebo-controlled, parallel-group trial was conducted. Patients with CHF presenting with qi-deficiency and blood-stasis syndrome were randomly assigned in a 1:1 ratio to either the experimental group or control group using a random number table. The experimental group received conventional standard therapy plus astragalus injection at PC6, whereas the control group received conventional standard therapy plus placebo. Traditional Chinese Medicine (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, plasma renin (PRA), angiotensin II (Ang II), aldosterone (ALD), were compared between groups at baseline and post-treatment. 3-month major adverse cardiac events (MACE), including all-cause mortality and HF-related readmission. Adverse events and safety indicators were also monitored. Results A total of 200 patients were included in the final analysis, 100 in each group. Baseline characteristics were not significantly different between the two groups ( p 0.05), except for the grouped distribution of patients stratified by LVEF level. Compared with the control group after treatment, the experimental group exhibited significantly reductions in TCM syndrome scores, BNP, MLHFQ scores, NYHA functional class, PRA, Ang II and ALD ( p 0.05), as well as significantly greater increases in LVEF and 6MWD ( p 0.05). There was no significant difference in readmission between the two groups ( p 0.05). No adverse events were observed in either group. Conclusion Acupoint injection at PC6 with astragalus injection combined with conventional standard therapy can effectively improve cardiac function, exercise tolerance and quality of life in patients with CHF with qi-deficiency and blood-stasis syndrome. It is a safe and effective adjuvant treatment for CHF. Clinical trial registration Registration number: ITMCTR2026000404. https://itmctr.ccebtcm.org.cn/mgt/project/user/user-project-view/1be0197d-9db9-434d-a2d1-fa4e5bccbc44

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