The Shenfu The Qi Cardiac Soup With Ultrafiltration Treatment Of Heart Yang Heart Failure Clinical Study

Congestive heart failure (referred to as heart failure), in Chinese medicine are palpitations, Zheng Chong(怔忡),Chest Pain, edema and other areas of clinical common diseases and frequently-occurring disease. It means that the amount of venous return in a case, cardiac output is insufficient to maintain tissue metabolism in need of a pathological statebecause of the systolic and/ or diastolic dysfunction, is more common in severe clinical syndrome, is a variety of end-stage heart disease clinical manifestations. Pathogenesis of congestive heart failure is complicated, which is based on virtual reality as both evil and more by clinical analysis, No evidence alone is virtual or standard independent exist. At present, drug therapy remains the main treatment for heart failure, and natriuretic row is the most important and basic heart failure treatment. Shuinazhuliu(水钠潴留),blood volume increases and high venous pressure is the basic characteristics of heart failure. Treat diuretics is the cornerstone of the heart failure treatment. The treatment of heart failure in all combinations, diuretics are the basic and most important components. However, there are many defects,like diuretic resistance, electrolyte imbalance, hypotension, activation of the neuroendocrine system and so on,which can further aggravate the heart failure.With the development of medical engineering technology,Kramer and other German doctors reported the first use of continuous arteriovenous hemofiltration (CAVH) treatment of saving acute renal failure in 1977, which marks a new birth of blood purification therapy-a continuous renal replacement therapy (CR-RT). with the continuous development of blood filtration technology, ultrafiltration was used in the treatment of congestive heart failure, compared with diuretics, there are great advantages, such as strong diuretic effect, neglect the impact of renal function, correct the electrolyte imbalance, avoid causing sympathetic and RAS activation, remove some harmful inflammatory cytokines, But it also brought new problems, such as expensive and difficult to operate, after ultrafiltration weak, weak urination symptoms. In the ultrafiltration treatment of heart failure, based on Chinese medicine with analysis from the pathogenesis of heart failure that Qi(气)and yang(阳), promoting blood circulation when the heart failure is the main rule, supported by Shenfu(参附汤)Decoction of Traditional Chinese Traditional Medicine treatment of heart failure, heart failure integrative medicine complement each other, the unique effect, hoping to achieve better clinical efficacy.Objective:To overcome the deficiencies of ultrafiltration,and play the advantages of Chinese medicine and improve the quality of life, the method of combining Chinese and Western Medicine should be taken to avoid Shenfu Injection(参附注射液)which is used on patient without any differential, by contrast with Decoction ShenFu(参附汤)which is implementation of individualized treatment for patients, the clinical syndrome, treatment of heart bad air yang(阳)deficiency patients, caused by water solution on the stopping the double lower extremity edema, ascites, clinical symptoms of wheezing not supine, collaborative ultrafiltration treatment of heart failure, After ultrafiltration while reducing the side effects, improve fatigue, shortness of breath, weak urination and other symptoms, Chinese medicine in order to better play the role of the clinical treatment of heart failure.Methods:A randomized control study. Cases from January 2008-February 2010 Xiyuan Hospital of China Academy of Traditional Chinese Medicine Cardiovascular Center, hospital wards and intensive care unit patients with heart failure. Selected 41 patients randomized,40 patients were finally completed, including 20 cases in control group, experimental group of 20 patients in the control group were simply blood ultrafiltration treatment, experimental group with reference to the blood ultrafiltration Qi strongly attached to treating, Total treatment 4 times, observe a month of treatment, body weight, cardiac function, serum potassium, BNP changes in incidence of hypotension, and symptoms improve.Results:1. On the incidence of hypokalemia:traditional Chinese medicine combined with blood ultrafiltration group compared with the pure blood ultrafiltration P> 0.05, no significant difference between the two groups.2. On the BNP's impact:the two groups before treatment were significantly lower than the test group were significantly better than the control group, the BNP had no significant difference compared with the control group difference (P> 0.05).3. On body weight:two groups had significantly lower body weight after treatment, no significant difference between the two groups.4. On cardiac function:experimental group in improving heart function than the control group, the difference was significant (P<0.05).5. On the incidence of hypotension:low blood pressure test group was significantly lower than the control group were 40% and 75%.6. The impact on the associated symptoms:the experimental group decrease in symptom score, the significantly higher, with significant difference (P<0.05); and respiratory difficulties, heart palpitations, cold, fatigue and other symptoms improvement effect significant. Conclusion:1. Shenfuyiqiqiangxin Decoction(参附益气强心汤)decrease of blood ultrafiltration failure incidence of hypokalemia, the experimental group rate was 75% in the control group rate was 85%.2. Shenfuyiqiqiangxin Decoction(参附益气强心汤)of blood ultrafiltration in patients with BNP and decreased body weight compared with the control group, no significant advantage.3. Shenfuyiqiqiangxin Decoction(参附益气强心汤)can significantly improve cardiac function in patients with heart failure. It found that the test group can significantly expand coronary artery, to strengthen myocardial contraction, increase cardiac output, reduce myocardial oxygen consumption, improving the role of cardiac pump function, which can improve cardiac function.4. Study found that the test group and control group, experimental group significantly reduced the incidence of hypotension, low blood pressure control rate was 75%, the experimental group and 40% rate of hypotension.5. Study found that the experimental group to improve the breathing difficulties (wheezing, sitting position), ascites, leg edema, palpitations, insomnia, cold, fatigue and other symptoms have a significant effect, significantly better than the control group.