| Objective:To study the effect of TCM treatment on CHF patients'syndrome, quality of life,heart function, the nerve-endocrine-cell factors,the reduction of drugs, as well as the rate of clinical events,in order to have a preliminary discussion about the efficacy and action mechanism of TCM on patients with chronic heart failure.Methods:The study was a randomized control trail.All inpatients were people who suffered from CHF in cardiovascular center of Xiyuan hospital affiliated to China Academy of Chinese Medicine Sciences. All patients were randomized into two groups: western medicine treatment group (control group) and TCM comprehensive interventi-on group(experiment group),all of them received the therapy of conventional western medicine.Patients of experiment group received the therapy of Chinese medicine,besid-es western medicine.We observed the clinical symptoms,the signs,quality of life,heart function,the result of echocardiogram, brain natriuretic peptide,angiotensin-Ⅱ,aldos-terone,Iinterleukin-1,Iinterleukin-6,tumor necrosis factor-alpha and the reduction of drugs before and after the therapy.After they left the hospital,we followed them for six months to compare the incidence rate of clinical events.Results:1. There were 60 patients in the research,37 patiens in experiment group,23 patients in control group.There were 22 men and 15 women in experiment group,and the avera-ge age of them was 73.14±7.53.There were 11 men and 12 women in control group,and the average age of them was 75.13±8.39.One patient of experiment group was lost to follow-up,no patient was dropped,no patient was knockouted.There was no significant difference between patients of two groups on sex,age,previous medical history, the dise-ases combined and so on.2. The effects on heart function:After 2 weeks'therapy,the heart function of patients in two groups was much better than before,and the difference was significant(P< 0.05),but there was no significant difference on the variation of heart function between two groups(P>0.05).The total effective rate of patients'heart function in experiment group was 91.89%,and that was 95.65% in control group.The difference was not signifi-cant between two groups(P>0.05).3. The effects on syndrome:After 2 weeks'therapy,the scores of all patients' syndrome were significantly smaller than before,and compared with the scores before therapy, the differences were significant for two groups(P<0.05).There was significant difference between the scores of two groups after therapy(P<0.05).The total effective rate of patients'syndrome scores in experiment group was 100%,and that was 95.65% in control group,the difference being not significant(P>0.05).4. The effects on quality of life:After 2 weeks'therapy, all patients'scores of qual-ity of life were smaller than before,the differences of two groups being significant(P< 0.05).But there was no significant difference on the scores between two groups after therapy(P>0.05).The total effective rate of patients in two groups was 100%,the differ-ence being no significant(P>0.05).5. The effects on the echocardiography result:After two weeks'therapy, there was no significant difference on the size of left atrium,left ventricle,right ventricle or EF values, compared with themselves before therapy(P>0.05).6. The effects on nerve-endocrine-cell factors:After 2 weeks'treatment,the level of BNP,Ald,IL-1,IL-6 in experiment group was lower than before,and the differences were significant(P<0.05), the TNF-a level of patients in experiment group was lower than that before therapy,but the difference was not significant(P>0.05).The level of AngⅡ, IL-1,IL-6 in control group was lower than before,the difference being significant(P< 0.05).There was no significant difference of all factors between two groups after the therapy(P>0.05).7. The effects on the reduction of drugs:the reduction of vasodilator of patients in experiment group was better than that of patients in control group,and the difference was significant(P<0.05),but the difference on the reduction of diuretics or positive inotropic drugs between two groups was not significant(P>0.05).8. The effectts on short-term clinical efficacy:the efficacy of experiment group on syndome was better than that of control group,and the difference between them was significant(P<0.05).9. The effects on the rate of clinical events:The rate of clinical events is no significant difference between two groups in 6 months after discharged from the hospi-tal(P> 0.05). Half of patients in two groups might have no clinical events in 6 months after discharged from the hospital.Conclusions:1. The therapy of TCM can better the syndrome of patients with CHF. 2. The therapy of TCM has increased the reduction rate of vasodilator drugs,and the reduction of experiment group is better than that of control group,it means that the effect of TCM on CHF may be related to the dilation of blood vessels, and the reduction of heart stress.3. The therapy of TCM has no significant effect on CHF patients'heart functi-on,quality of life, the echocardiography result,nerve-endocrine-cell factors or the rate of clinical events in 6 months after discharged from hospital. |
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