| ObjectivesBased on the achievements of years of clinical and experimental studies about Xinshuai Mixture, the purposes of this research were to evaluate the effects of Xinshuai Mixture on the metabolites and the quality of life in patients with heart failure induced by coronary heart disease, to reveal the effects of Xinshuai Mixture on the micro material of organism, to analyze their characteristics of metabolism spectrumin, and to discover and explain the advantage of Xinshuai Mixture.Methods59patients with heart failure induced by coronary heart disease were enrolled from September2011to December2013in Beijing Hospital of Traditional Chinese Medicine (TCM). They were randomly divided into two groups, the treatment group (29cases, besides routine therapy of western medicine they were treated with Xinshuai Mixture) and control group (30cases, treated with the routine therapy of Western medicine). The course of treatment was14days. Before and after the treatment, TCM syndrome integral, left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVED), the level of NT-proBNP and the score of the Chronic Heart Failure Quality of Life Scale of Integrated Chinese and Western Medicine were tested. After the treatment, tested the metabolites of every group. The serum samples were analysed by using a ’H-NMR-based metabonomic strategy, in order to the evaluate the efficacy of TCM therapy via metabonomic methods. The normal control group had11participants who were randomly choosed from September2011to December2013in Physical Examination Center of Beijing Hospital of Traditional Chinese Medicine.Result1. After treatment, the total rate of cardiac function effect of the treatment group was89.66%The TCM symptoms integral of the two groups was significantly improved after treatment (P<0.05). After treatment, the symptoms and physical signs of the treatment group were lower than the control group. The difference was statistically significant (P<0.05).2. LVEF of the two groups’after treatment was increased (P<0.05). After14days’therapy the treatment group’s LVEF was higher than the control group’ s. The difference was significant (P<0.05). The two groups’LVED was improved after treatment. After14days’treatment, the treatment group improved more significantly compared with those before treatment (P<0.05). The control group’ s LVED also improved than that before treatment. But the difference was not significant (P>0.05).3. Before treatment, both group of the patients’NT-proBNP increased significantly. After14days of treatment, NT-proBNP were significantly decreased of the two groups (P<0.05). Compared with the control group, NT-proBNP of the treatment group was significantly lower after treatment (P<0.05).4. After treatment both group of patients’life quality total score and score in every fields were improved. The score of the physiological function field, energy field, social function field, mental health field, medical support field and the total score were significantly improved after therapy in the treatment group (P<0.05). The score of the physiological function field, mental health field, medical support field and the total score were significantly improved after therapy in the control group (P<0.05). After treatment the score of the physiological function field and mental health field in the treatment group was higher than that in the control group (P<0.05).5. After treatment, the serum samples of the two groups of patients and healthy volunteers were analysed by using a’H-NMR based metabonomics strategy, including carrpurcell meiboom gill (CPMG) test and longitudininaleddy delay (LED) test. The checkout of the CPMG test included small molecule metabolites in serum, such as sugars, amino acids and organic acid. The checkout of the LED test mainly contained the signal of lipoprotein and fatty acid.The orthogonal signal correction of partial least square method (OSC-PLS) analysis of serum’H-NMR spectra CPMG test revealed the patients of the treatment group could be significantly distinguished from the control group. And was closed to the healthy. The test showed that the content of lipoprotein, lactic acid and alanine of the treatment group and the healthy were higher than the control group. The content of trimethylamine oxide, Sugars and glycine of the treatment group and the healthy were lower than the control group.The OSC-PLS analysis of serum’H-NMR spectra LED test showed, the metabol i tes content of the treatment group and the healthy group was very close. But the control group’s was obviously different. Chemical shifts of LDL/VLDL of0.86ppm concentration:the treatment group was lower than the healthy group, and was lowest than the control group. Chemical shifts of VLDL of0.90ppm concentration: the treatment group was higher than the healthy group, and was much higher than the control group. Chemical shifts of LDL/VLDL of1.26ppm concentration:the health group was higher than the treatment group, and was much higher than the control group. Chemical shifts of VLDL of1.30ppm,1.34ppm concentration:the treatment group was higher than the healthy group, and was much higher than the control group. Chemical shifts of Lipid (CH2-CH2CO) of1.58ppm concentration: the treatment group was higher than the healthy group, and was much higher than the control group. Chemical shifts of Lipid (CH2CO) of2.22ppm concentration: the treatment group was higher than the healthy group, and was much higher than the control group. Chemical shifts of PUFA (-C=C-CH2-C=C-) of2.74ppm concentration:the treatment group was higher than the healthy group, and was much higher than the control group. Chemical shift of UFA (=CH) of5.3ppm,5.34ppm concentration:the treatment group was higher than the healthy group, and was much higher than the control group.ConclusionXinshuai mixture can effectively improve the clinical symptoms of coronary heart disease in patients with heart failure, reduce brain natriuretic peptide level in patients, improve cardiac function and the quality of life in patients with heart failure after treatment. Metabolite of the patients using Xinshuai mixture were closer to the healthy. No obvious adverse reaction was found in clinical application. |
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