Clinical Study Of Yang-warming Blood-quickening Phlegm-dispersing On The Treatment Of Gerontal Cardiac Failure

1. ObjectiveTo observe the clinical therapeutic effects of yang-warming blood-quickening phlegm-dispersing therapy on elderly heart failure patients through clinical study, and observe its influence and clinical effect on the acute physiology and chronic health evaluation Ⅱ(APACHE-Ⅱ score), Chinese medicine symptom integral,endothelin-1(ET-1),plasma nitric oxide(NO),oxygenation index(OI),brain natriuretic peptide(BNP),lactic acid(LAC), hypersensitive C reactive protein(hs-CRP).We want to explore the possible mechanisms of yang-warming blood-quickening phlegm-dispersing therapy on elderly heart failure with yang deficiency and blood stasis phlegm obstruction so it can provide objective basis for integrative medicine treatment of elderly heart failure.2.MethodsWe choose 72 patients diagnosed as elderly heart failure with yang deficiency and blood stasis phlegm obstruction in ICU in our hospital from January 2013 to November 2014,which were randomly divided into two groups, the control group with 36 patients, the treatment group with 36 patients. The control group received Conventional Western medicine treatment(diuretics,expansion of blood vessels,phlegm-dispersing, limiting intake of sodium and water,antibiotics, inspiring oxygen, stabilizing internal environment, nutritional support, using ventilator when patients need assisting with breathing, the routine use of inotropic agents, treatment of the primary disease, etc.), the treatment group received yang-warming blood-quickening phlegm-dispersing therapy(Shen Fu injection + Sodium Tanshinon Ⅱ Asilate injection + Kechuanping granules)on the basis of Conventional Western medicine treatment,taking 7 days as one course of treatment. Before and after seven days treatment, Patients were observed aboutchanges on APACHE-Ⅱ score, Chinese medicine symptom integral,ET-1, NO, OI,BNP, LAC, hs-CRP and comparing clinical prognosis of the two groups.3.Results3.1 The level of APACHE-Ⅱ score and Chinese medicine symptom integral in the treatment group decreased significantly after treatment, compared with the control group they were statistically significant(P <0.05).3.2 The level of ET-1 and BNP in the treatment group decreased significantly after treatment,while the level of NO increased remarkably after treatment, compared with the control group they were statistically significant(P <0.05).3.3 The level of LAC in the treatment group decreased significantly after treatment,while the level of OI increased remarkably after treatment, compared with the control group they were statistically significant(P <0.05).3.4 In terms of Inflammatory response indicators, The level of hs-CRP in the treatment group decreased significantly after treatment, compared with the control group it was statistically significant(P <0.05).3.5 In terms of prognostic outcome, treatment group was significantly better than the control group, the two groups have a significant difference(P <0.05).4.ConclusionYang-warming blood-quickening phlegm-dispersing therapy on elderly heart failure with yang deficiency and blood stasis phlegm obstruction has obvious clinical effect,can reduce the level of acute physiology and chronic health evaluationⅡand TCM syndrome score and improve the body. Yang-warming blood-quickening phlegm-dispersing therapy achieved the purpose of treating disease and improving the patient’s prognosis and outcome maybe through inhibiting cytokine, regulating theneuronendocrine system, improving tissue perfusion, improving systemic oxygenation and oxygen supply. This study, no obvious adverse drug reactions, provides objective indicators and basis for integrative medicine treatment of elderly heart failure as well as reflects the the characteristic of Chinese medicine.