Intervention Of Nuanxin Capsule On Plasma Of RAAS In Patients With Chronic Heart Failure

Objective:This study was performed to observe the impact of the traditional Chinese herbmedicine Nuanxin Capsule on RAAS(PRA AngII, ALD) in patients with chronicheart failure(CHF).Method:1.40 Patients with CHF from the inpatient department were randomly dividedinto two groups, each 20: the matched control group which was treated withwestern basic medicine and the treatment group which was treated with NuanxinCapsule(3#, tid) as well as western basic medicine The treatment time was bothtwo weeks.2.Making measurements of blood plasma RAAS(PRA, AngII, ALD) level beforeand after the treatment.3. Making ultrasonic examination on the patients' heart before curingin order to explore the relativity between each index of RAAS and the LVEF(%).4. Making measurements of BNP in the blood before curing in order to explore the correlation between each index of RAAS and BNP.5. Assessing the grade of CHF according to NYHA before and after curing to observing the relativity of it and each index of RAAS.6. Use laboratory checks, such as the blood-routine,urine-routine, stool-routine and hepatorenal function as safety index to make sure whether the Nuanxin Capsule had any side-effects or toxicity.Result:1.The comparisons between the plasma level of RAAS within different gradesof NYHA each other :1.1 Before curing:among different grades of NYHA-Class, there is no sifnificant statistic difference(P>0. 05). Making the Pearson related analysis, every component of RAAS had a positive correlation with NYHA-Class;the related coefficient r is individually 0.175, 0.237, 0.271, but three all P>0. 05.1.2 After curing:araong different grades of NYHA-Class, there is also no sifnificant statistic difference(P > 0.05). Making the Pearson related analysis, every component of RAAS had a positive correlation with NYHA-Class;the related coefficient r is individually 0.221, 0.200, 0.154, but three all P > 0. 05.Result hint:Each index of RAAS level at different heart function ratingshave no obvious difference, may exist negative related trend.2.All patients were divided into two groups according to LVEF. BetweenLVEF < 45% and LVEF ^ 45%, there is sifnificant statistic difference(P <0. 05), explaining the activation degree of RAAS in the group with anormal EFis higher than that in normal group.3.Making the Pearson related analysis, each index of RAAS had a nagtivecorrelation with LVEF;the related coefficient r is individually-0. 581,-0.561,-0.453, three all not only P < 0. 05 but also P < 0. 01, explaining thelower EF value, the higher the activation degree of RAAS.4.Making the Pearson related analysis, each index of RAAS had a positivecorrelation with blood level of BNP;the related coefficient r isindividually 0. 653, 0. 627, 0.689, three all not only P<0. 05 but alsoP<0.01, explaining when heart doesn't work, the activations of differentneuroendocrine factors have consistency.5. Compared with before curing, both groups have sifnificant statistic difference (P<0. 01) in the content of RAAS after curing;explaining each index of RAAS level after curing obviously descendes than that before curing.6. Compared with the matched control group, There is significant statistic difference(P < 0.01) in the declining percentage of Angll in treatment group, while there's no statistic difference(P >0. 05)in that of PRA and ALD;hinting the declining degree of Angll in the treatment group is better than that in the matched control.7.Safety monitoring: every laboratory checks seems to have the same result after curing as before curing, fe haven't yet discovered depravation, hintingConclusion:1. In patients with chronic heart failure, the blood level of PRA^ Angll and ALD can monitor the activation of the RAAS of the neuroendocrine system. Each index of RAAS had a nagtive correlation with LVEF, that is to say:The lower EF value, the higher the activation degree of RAAS. The activations of different neuroendocrine factors have consistency, for example, the RAAS and the BNP. Though thus, the activation of the RAAS doesn't reflect the different grades of NYHA-Class. During treatment of CHF, we may chose the level of RAAS to monitor the disease change and evaluate curative effect.2. Nuanxin Capsule has an accurate curative effect on the patients with CHF in the clinical practice, without side-effects and toxicity. The mechanism of Nuanxin Capsule could be that it suppresses the activation of the RAAS neuroendocrine systerm, especially that it declines the plasma level of Angll.