| Objective:This study selected Yiqi Wenyang traditional Chinese medicine Huangqi(Radix Astragali,黄芪)、Fuzi(Radix Aconiti Lateralis Praeparata,附子)、Tinglizi(Semen Lepidii,葶苈子)mixture for effective compatibility combined with the pathological mechanism of heart failure,through animal experiments and clinical studies,to explore the mechanism of action and therapeutic effect on heart failure.Animal experiment is to study the changes of myocardial mitochondrial subgroup respiratory chain complex IV activity in heart failure before and after the intervention of Yiqi Wenyang TCM,to explore the role of mitochondrial energy metabolism changes in heart damage,so as to deeply dig in the therapeutic mechanism of Yiqi Wenyang TCM on myocardial mitochondrial damage in terms of biological function;Clinical research is to observe the clinical effect of Yiqi Wenyang TCM on elderly patients with chronic heart failure,thus exploring its advantages in the clinical treatment of heart failure,and opening up a new direction for clinical and scientific research in the future.Methods:1.Cardiac function assessment and BNP determination were performed on heart failure model rats established by adriamycin hydrochloride:60 male clean SD rats aged about 8 weeks,weighing about 250 g,were randomly divided into 6 groups,a blank group(BG),a heart failure model group(MOD),a trimetazidine group(TMZ),an astragaloside IV(AS-IV)group,a Yiqi Wenyang traditional chinese medicine mixture high dose(TCM-H)and a low group(TCM-L),with 10 rats in each group.In addition to the blank group,the remaining groups of rats were given intraperitoneally injection with adriamycin hydrochloride(10 mg/kg)to establish a model.Four weeks after the model was established,the cardiac function indexes of rats were determined by cardiac ultrasonography under anesthesia,and plasma brain natriuretic peptide(BNP)levels were detected by blood samples.2.Correlation analysis of mitochondrial energy metabolism on heart failure model rats:Six weeks later,myocardial tissue samples were isolated and collected after the rat was anesthetized with intraperitoneal injection of 3% sodium pentobarbital solution.After the extraction of mitochondria,colorimetric method was used to detect rats enzyme activity of respiratory chain complex Ⅳon mitochondrial membrane.3.A total of 60 elderly patients with chronic heart failure were selected from Affiliated Hospital of Shandong University of Traditional Chinese Medicine and Shandong Provincial Hospital from May 2019 to November 2020 as the research objects.The patients were divided into control group and experimental group by random number table method.The two groups were given the same basic treatment measures,such as heart strengthening,diuresis and vasodilation.Meanwhile the experimental group was given Yiqi Wenyang mixture as adjuvant therapy.Left ventricular ejection fraction(LVEF%),N-terminal brain natriuretic peptide(NT-pro BNP),NYHA,6min walking distance,and clinical effect were compared between the two groups before and after treatment.Results:1.After successful modeling,compared with blank group,BNP in model group,astragaloside IV group,trimetazidine group,TCM-H group and TCM-L group were all significantly increased,and the model group was the highest 829.90±5.516pg/ml,better than the blank group(P<0.01).Compared with the blank group,cardiac function in the other groups decreased,and the model group reduced to a great extent(P<0.01).Model group was in lowest activity in mitochondrial respiratory chain complex Ⅳ,low dose group was in the highest enzyme activity,traditional Chinese medicine high dose group and astragaloside IV group,western medicine group enzyme activity compared with model group were all improved.2.Through the observation of 60 elderly patients with chronic heart failure,the comparison between the two groups before and after treatment showed Yiqi Wenyang traditional Chinese Medicine had a good effect for the elderly patients with chronic heart failure in clinical treatment of TCM syndrome score,6min walking test,LVEF,NYHA and NT-pro BNP.After treatment,the increase of TCM syndrome score and LVEF mean value in the treatment group was better than that in the control group(P<0.05),and the TCM syndrome score in the treatment group was higher than that in the control group in terms of effective rate and total effective rate,the inefficiency was lower than that in the control group,and the improvement effect in the treatment group was more significant than that in the control group in terms of the 6min walking test distance(P<0.05).As for the therapeutic effect of NYHA heart function,the significant efficiency,effective rate and total effective rate of the treatment group were higher than those of the control group,while the inefficiency was lower than that of the control group.Therefore,the therapeutic effect of NYHA heart function of the treatment group was better than that of the control group.The decreasing trend of NT-pro BNP in the treatment group was significantly higher than that in the control group(P<0.05).Conclusions: Yiqi Wenyang traditional Chinese Medicine can effectively improve the mitochondrial respiratory chain complexes Ⅳ enzyme activity,strengthen the function of mitochondria,improve cell energy supply,delay the onset of heart failure development;In clinical practice,Yiqi Wenyang traditional Chinese Medicine has obvious clinical effect on elderly patients with chronic heart failure.It has obvious improvement in TCM syndrome score,6min walk test,LVEF,cardiac function improvement,NT-pro BNP,which can effectively delay the process of heart failure,improve symptoms,and improve the quality of life of patients. |
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