The Clinical Study Of Impact On The Sympathetic Nervous System In The Heart Failure Patients With Xin-yang Deficiency Syndrome By Wenyang Decoction

ObjectiveThis study gived full play to the adoption of characteristics of Chinese medicine.On the basic of Western medicine conventional treatment of heart failure,applied the classic Chinese medicine prescription wenyang decoction of the well-known professor De-Xin Yan.To observe the effect of wenyang decoction in the treatment of the heart failure patients with Xin-yang deficiency Syndrome,and the impact on the sympathetic nervous system of the syndrome.Then to explore the possible mechanism of this decoction,and to provide an objective modernization basis for the mechanism of the old experience prescription of Chinese medicine,and layed a solid foundationts for the industrial development of the wenyang decoction.MethodsThis study used the way of prospective randomized controlled clinical trial.The 80 heart failure patients with Xin-yang deficiency Syndrome were selected from the Guangdong Provincial TCM Hospital Heart Center outpatient,inpatient and observation room in accordance with strict inclusion criteria.And then they were randomly divided into treatment group and control group,40 cases of each group.The treatment group was treated by the wenyang decoction and standardizational western medicine(diuretics,ACEI,β-blockers and digitalis-type) while the control group was only treated by standardizational western medicine (diuretics,ACEI,β-blockers and digitalis-type),both 1-month course of treatment.To observe the changes of cardiac function,cardiac-related indicators(heart rate,myocardial oxygen consumption,cardiothoracic ratio,left ventricular ejection fraction),endocrine indicators of sympathetic nervous system NE(norepinephrine),other related indicators of neuroendocrine(IL-18,NT-proBNP),the number of re-hospitalization and safety indicators of creatinine(Cr),alanine aminotransferase(ALT) before and after treatment in the two groups patients.Results1.The treatment group was significantly different than the pre-treatment in the left ventricular ejection fraction(LVEF),cardiothoracic ratio,heart rate,myocardial oxygen consumption(P<0.01),and between the two groups,the treatment group was significantly better than the control group after treatment(P<0.01);2.The treatment group was significantly different than the pre-treatment in the 6min walk test(P<0.01),and between the two groups,the treatment group was significantly better than the control group after treatment(P<0.01);3.The treatment group was significantly different than the pre-treatment in the classification of cardiac function and the number of re-hospitalization(P<0.01),and between the two groups,the treatment group was significantly better than the control group after treatment(P<0.01);4.The treatment group were significantly improved than the pre-treatment in the NE,IL-18,NT-proBNP(P<0.01);and the treatment group were significantly lower than the control group in the NE,IL-18 after the treatment(P<0.01);NT-proBNP levels after treatment between the two groups were also significantly different(P<0.05);5.The two groups before and after the treatment in the Cr,ALT were no significantly different(P>0.05);the two groups after treatment in the Cr,ALT were also no significantly different(P>0.05).Conclusion1.Wenyang decoction can reduce the activity of sympathetic nervous system in the heart failure patients with Xin-yang deficiency Syndrome, and can reduce the release of norepinephrine from peripheral sympathetic.Meanwhile it can reduce the secretion of inflammatory cytokines IL-18 so as to reduce the inhibition of myocardial contraction,reduce cardiac remodeling and myocardial apoptosis,then improve heart failure symptoms.2.Wenyang decoction can slow down the heart rate in the heart failure patients with Xin-yang deficiency Syndrome and reduce myocardial oxygen consumption,lower heart ratio.left ventricular ejection fraction can be increased at the same time.and it can improve the patients' cardiac function.3.Wenyang decoction can reduce the number of re-hospitalization of the heart failure patients with Xin-yang deficiency Syndrome.and it is safe,no significant damage to liver and kidney functions,it is worth to promote the use of clinic furtherly.