| Objective To investigate therapy regularity of traditional Chinese medicine (TCM) on chronic heart failure from the perspective of spleen and stomach in order to improve the clinical efficacy on chronic heart failure and provide new feasible idea and method for TCM treatment on chronic heart failure, by learning after professor Shao rongshi at clinical practice, collecting and systematically organizing typical cases and clinical experience referring to professor Shao’s clinical experience and prescription, consulting related literature data and systematically organizing the academic idea and clinical research of professor Shao on chronic heart failure.Methods 1. The author learned after professor Shao rongshi at clinical practice and collected typical cases by the way, then summarized professor Shao’s academic idea on treatment of chronic heart failure from the perspective of spleen and stomach.2. A total of 60 patients with heart-spleen yang deficiency were observed and randomly divided into two groups:control group (conventional western medicine treatment) and treatment group (add traditional Chinese medicine for three months on basis of conventional western medicine treatment). TCM symptom score, NYHA classification of cardiac function, six-minute walk test, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS), superoxide dismutase (SOD), malondialdehyde (MDA) and n-terminal pro-brain natriuretic peptide (NT-ProBNP) were detected and statistically analyzed.Results 1. Professor Shao rongshi diagnosed and treated chronic heart failure by combining syndrome differentiation and disease differentiation. His theory sounded reasonable and his prescription proved suitable. The clinical efficacy was significant.2. Symptoms including palpitation, short of breath, lassitude, asthma when active, intolerance to cold, cold hands and feet, edema, abdominal distension, cough and oliguria between pre and post treatment in each group and between two groups after treatment were compared and the differences were all statistically significant (P<0.05). Whereas for spontaneous perspiration and night sweat, the differences between pre and post treatment in both groups were statistically significant (P<0.05) but the differences between two groups after treatment were not statistically significant (P>0.05). 3. Total effective rate of treatment group was 93.3%, that of control group was 80%, and the difference was statistically significant (P<0.05).4. The differences of NYHA classification of cardiac function between pre and post treatment in two groups were remarkably statistically significant (P<0.01) and the difference of NYHA classification of cardiac function between two groups after treatment was also statistically significant (P<0.05).5. The differences of six-minute walk test between pre and post treatment in both groups were statistically significant (P<0.05) but the difference of that between two groups after treatment was not statistically significant (P>0.05).6. The differences of EF and FS in ultrasonic cardiogram between pre and post treatment in both groups were statistically significant (P<0.05) and the difference of FS between two groups after treatment was statistically significant (P<0.05) but the difference of EF between two groups after treatment was not statistically significant (P>0.05).7. The differences of SOD, MDA and NT-ProBNP between pre and post treatment in both groups and between two groups after treatment were all statistically significant (P<0.05).8. All patients were reexamined including electrocardiogram and hepatic and renal function after treatment and the results were all normal.Conclusion As for diagnosis and treatment of chronic heart failure, professor Shao rongshi makes a point from spleen and stomach, focuses on heart and spleen as location of disease, gives consideration to both tongue and pulse, treats patients with methods of supplementing qi and consolidating the constitution, resolving phlegm and regulating collateral in combination and protecting yin, and clinical efficacy is significant as a result. In TCM treatment group, symptom of heart failure can be significantly improved in patients with chronic heart failure of yang deficiency; both treatment group and control group show remarkable and similar efficacy in NYHA classification of cardiac function, six-minute walk test and cardiac ultrasound; efficacy in treatment group is significantly superior to that in control group in testing indexes of oxidative stress and neuroendocrine factors regulation. TCM therapy can increase SOD content and decrease MDA and NT-ProBNP contents and significantly improve cardiac function of patients with chronic heart failure. |
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