ObjectiveTo evaluate the impact of yang-reinforcing and blood-activating therapy on the long-term prognosis for patients with dilated cardiomyopathy （DCM） of yang deficiency and blood stasis syndrome. MethodsA retrospective cohort study was conducted involving 371 DCM patients with yang deficiency and blood stasis syndrome. The yang-reinforcing and blood-activating therapy was defined as the exposure factor. Patients were categorized into exposure group （186 cases） and non-exposure group （185 cases） according to whether they received yang-reinforcing and blood-activating therapy combined with conventional western medicine for 6 months or longer. The follow-up period was set at 48 months， and the Kaplan-Meier survival analysis was used to assess the cumulative incidence of major adverse cardiovascular events （MACE） in both groups. Cox regression analysis was used to explore the impact of yang-reinforcing and blood-activating therapy on the risk of MACE， and subgroup analysis was performed. Changes in traditional Chinese medicine （TCM） syndrome score， left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular end-diastolic diameter （LVEDD）， and Minnesota Living with Heart Failure Questionnaire （MLHFQ） score were compared between groups at the time of first combined use of yang-reinforcing and blood-activating therapy （before treatment） and 1 year after receiving the therapy （after treatment）. ResultsMACE occurred in 31 cases （16.67%） in the exposure group and 47 cases （25.41%） in the non-exposure group. The cumulative incidence of MACE in the exposure group was significantly lower than that in the non-exposure group ［HR=0.559， 95%CI（0.361，0.895）， P=0.014］. Cox regression analysis showed that yang-reinforcing and blood-activating therapy was an independent factor for reducing the risk of MACE in DCM patients ［HR=0.623， 95%CI（0.396，0.980）， P=0.041］， and consistent results were observed in different subgroups. Compared with pre-treatment， the exposure group showed decreased TCM syndrome score and MLHFQ score， reduced LVEDD， and increased LVEF and LVFS after treatment （P＜0.05）； in the non-exposure group， TCM syndrome score decreased， LVEF and LVFS increased， and LVEDD reduced after treatment （P＜0.05）. After treatment， the exposure group had higher LVEF and LVFS， smaller LVEDD， and lower TCM syndrome score and MLHFQ score compared with the non-exposure group （P＜0.05）. ConclusionCombining yang-reinforcing and blood-activating therapy with conventional western medicine can reduce the risk of MACE in DCM patients with yang deficiency and blood stasis syndrome， meanwhile improving their clinical symptoms， cardiac function， and quality of life.

Dilated cardiomyopathy(DCM)is a common disease leading to heart failure,arrhythmia,and sudden death.The etiology of DCM is complex and diverse,and the mechanisms have not been fully elucidated.Conventional interventions have a limited ability to improve the prognosis of patients,who have a 10-year survival rate of less than 25％.This study aimed to summarize the construction and characteristics of a DCM animal model and evaluate the clinical compatibility of the model with traditional Chinese and Western medicines.Analysis was based on domestic and overseas research into DCM animal models,Western clinical diagnostic criteria,and traditional Chinese medicine syndrome differentiation.The DCM modeling method mainly involved gene editing,drug induction,immune induction,viral infection,and rapid pacing induction.Experimental animals included muroids,zebrafish,Drosophila,and pigs,of which mice and rats were most commonly used.Gene editing was the most commonly used method for modelling DCM,followed by doxorubicin-induction.In the literature,the experimental animals,drugs,single or cumulative doses,administration method,and modeling period used varied among studies involving DCM animal models.The level of clinical anastomosis according to traditional Chinese and Western medicines varied considerably,being generally lower in traditional Chinese medicine than Western medicine in the same model.In addition,the modeling standards for DCM animal models were mostly based on Western medicine theories.The differentiation of syndrome models and information collection for the four diagnoses have not been standardized and unified.In the future,stable and homogeneous animal models of high clinical consistency combining both disease and syndrome need to be established to provide a basis for DCM mechanism research and drug development.

Dilated cardiomyopathy(DCM)is a common disease leading to heart failure,arrhythmia,and sudden death.The etiology of DCM is complex and diverse,and the mechanisms have not been fully elucidated.Conventional interventions have a limited ability to improve the prognosis of patients,who have a 10-year survival rate of less than 25％.This study aimed to summarize the construction and characteristics of a DCM animal model and evaluate the clinical compatibility of the model with traditional Chinese and Western medicines.Analysis was based on domestic and overseas research into DCM animal models,Western clinical diagnostic criteria,and traditional Chinese medicine syndrome differentiation.The DCM modeling method mainly involved gene editing,drug induction,immune induction,viral infection,and rapid pacing induction.Experimental animals included muroids,zebrafish,Drosophila,and pigs,of which mice and rats were most commonly used.Gene editing was the most commonly used method for modelling DCM,followed by doxorubicin-induction.In the literature,the experimental animals,drugs,single or cumulative doses,administration method,and modeling period used varied among studies involving DCM animal models.The level of clinical anastomosis according to traditional Chinese and Western medicines varied considerably,being generally lower in traditional Chinese medicine than Western medicine in the same model.In addition,the modeling standards for DCM animal models were mostly based on Western medicine theories.The differentiation of syndrome models and information collection for the four diagnoses have not been standardized and unified.In the future,stable and homogeneous animal models of high clinical consistency combining both disease and syndrome need to be established to provide a basis for DCM mechanism research and drug development.