Yang Xin's Tablets In The Treatment Of Coronary Heart Disease With Chronic Heart Failure Qdbs Of Clinical Research

Heart failure is caused by any reasons which bring aboutmyocardial damage and change the structure and function of theheart,as a result lead to the function of ventricle pumping bloodreducing which brings about a complex clinical syndrome. Heartfailure is the final stage of every heart disease. The incidence,morbidity rate, mortality and mayhem rate of heart failure is veryhigh. The money expended on it is very large. It hazards seriously.Now it is becoming a difficult problem of sanitation and healthall of world. The study on it is think much of by the world. Atpresent, it is found out by epidemiological investigation thatcoronary heart disease is the first pathogenic factor of HF.What remolding of myocardium is the reason of generation anddevelopment of heart failure is being recognized thoroughly afterthe middle period of 1990'.people have a cognizance that the moldof nerve and endocrine takes important function on the generationand development of HF, blockading factors which forward myocardialremolding, preventing and backing the restructure of ventricle isthe most efficient path of treating HF and decreasing themortality rate of HF, and that is the target of exploiting new drug.Treating HF with antagonist of never and endocrine such as:angiotensin converting enzyme inhibitor(ACEI), beta blocker(βB),aldosterone antagonist (ALDA),angiotensin receptor blocker(ARB)has decreased mortality and mayhem rate of HF successfully and haspostponed the development of HF.However the high mortality and progressively feature of HF cuesthat the ideal medication of today can't shut off it'spathological mechanism. Some toxic and side effects of westernmedicine limit it application in clinical.Prevention and cure HF with Traditional Chinese Medicine iscenturies-old history and has particular curative effect, doctorsthrough the ages have accumulated a great deal of preciousexperience particularly on improving symptom, enhancing quality oflife, preventing recurrence of this disease. It has shown forth well curative effect. Modern studies on Chinese traditionalmedicine manifest that Chinese medicine and set prescription havemulti-target effect of pharmacological action. They have wellcurative effect on preventing nerve and endocrine excessivelyactivated and holding back remolding of ventricle. But for thelack of supporting by strict contrast clinical experiment Chinesepatent medicines those can take the place of west medicinechanging the prognosis of HF is very few. Exploiting low priceChinese patent medicine treating coronary heart disease chronicheart failure and changing its prognosis with multi syntheticcurative effects is very important in satisfying increasing needof patients need with CHDHF. And it is also important in relievingthe reality of relative inadequate of medical economical resources.Many doctors recognize that deficiency of Qi and blood stasisis frequently found in heart failure, especially in early stage ofHF. Correspondingly invigorating Qi and warming Yang, promotingblood circulation to dispel blood stasis is often used in treatingpatients who suffer from HF. YangXinShiPian is an efficientmedicine treating CHD angina pectoris in clinic practice. It hassuch functions as strengthening the body resistance, invigoratingQi and warming Yang, promoting blood circulation to dispel bloodstasis which accord with the pathogenesis of HF.To disclose the clinical influnce and the prognostic influenceof YangXinShiPian on patients with Qi deficiency blood stagnationsyndrome and chronic heart failure caused by coronary heartdisease,we studied this thesis adopting stratified random, multicenter,positive medicine parallel contrast clinical researchmethod, using the patients who visit cardio and vessel section ofDongZhiMen hospital which affiliated Beijing TCM university,andGuangAnMen hospital which affiliated China TCM Academy and BeijingTCM hospital which affiliated Capital Medicine university ,contrasting with LOTINSIN and BETALOC as the positive medicine.We inspired 77 patients who suffered from CHF caused by CHDbelong to qi deficiency and blood stasis syndrome. They wererandomly divided into 2 groups. One was test group with 39patients. The other was control group with 38 patients. Betweentwo groups there was no significant difference in age, sex, courseof diseases and severity degree before therapy. After 4 weeks treatment, clinical curative effects show: there is no remarkabledifference in following aspects as general curative effect of TCMSyndromes, cardiac function curative effect (NYHA gradingstandards), 6-minute-walk trail general curative effect, thestopping and decreasing rate of DIGOXIN, the stopping anddecreasing rate of HYDRODIURIL after statistics analysis(p>0.05).But making a comparison between 2 groups in general integral ofTCM Syndromes, there is remarkable difference after statisticsanalysis (P<0.05). The test group is better than the contrastgroup. In the contrast of main TCM symptom, we can see that Thetest group is better than the contrast group after 7 daystreatment in the following aspects: palpitation, short breath,chest stuffiness. But there is no remarkable difference after 14,21, 28 days treatment (P>0.05), however there is aggravatingpatients in the contrast group; on the contrary, none, in testgroup. There is statistical difference after 28 days treatmentbetween the two groups in the following aspects: asthenia,sweating, darkish complexion and picture of tongue (P<0.05). Thetest group is better than the contrast group. There is nostatistical difference after 28 days treatment between the twogroups in pulse condition(P>0.05). The two groups can decrease theraising level of blood serum BNP all. There is no statisticaldifference after 28 days treatment between the twogroups(P>0.05).The contrast group is better than the test group indecreasing heart rate and blood pressure, however the test groupcan decrease systolic pressure too. There is no statisticaldifference by contrast their echocardiogram index (LVEF, FS, Epeak, A peak, E/A) before and after therapy (P>0.05), althoughLVEF, FS, E peak and E/A of the two groups manifest increasingtrend, A peak of the two groups manifest decreasing trend. Inadverse reaction aspect, 1 patient of the test group appearssickness and abdominal distention. 1 patient of the test groupappears slight dry mouth, these can't affect on their continuingtaking medicine. We can't find severe adverse reactions; In thecontrast group, 1 patient appears acutely dry cough after takingmedicine 1 week and he quit this clinical trail, 2 patients appearsickness and fatigue and disappear after reducing the dose ofLOTINSIN, 2 patients appear sinus bradycardia and slight dizziness and disappear after reducing the dose of BETALOC.The above findings demonstrate: using YangXinShiPian treatingpatients who suffer from CHDCHF belong to Qi deficiency and bloodstasis syndrome is as curative as using west medicine combinationof BETALOC and LOTINSIN on the aspect of heart functionimprovement. The improvement of single TCM symptom such as fatigue,sweating, darkish complexion and tongue picture YangXinShiPian issuperiority. it has no the side effect of aggravating the symptomof HF. Few adverse reaction, can be well tolerated. It candecrease the raising level of serum BNP in patient who suffer fromHF. Maybe, it is a good medicine on improving the prognosis ofpatients who suffer from HF. It is worth studying more. This studyalso demonstrates that it is an efficient therapeutic methods ofstrengthening the body resistance, invigorating Qi and warmingYang, promoting blood circulation to dispel blood stasis.