| 1.Objectives:Theoreticl research:To summary and analyze the theory of professor Zhou Yi Xuan’s academic opinion, clinical experience of internal medicine. Especially academic thinking, the pattern of clinical thought, clinical idea of diagnosis and treatment, drug laws, dialectical characteristics of heart failure. The contents of Traditional Chinese Medicine in treatment of chronic heart failure will been enriched.Clinical research:Clinical studies using randomized controlled study of the method, observe the effect of the method of Wenyang Huoxue Lishui in chronic heart failure. We evaluated before and after treatment of patients with caidiac function of NYHA, "Zhenghou "of Traditional Chinese Medicine, the parameters of the heart (LVEF, LADD, LVEDD, SV),6 minutes walking test, Minnesota living with heart failure questionnaire, the level of plasma BNP. Reveal mechanism of the method of Wenyang Huoxue Lishui on the treatment of chronic heart failure. For TCM clinical theory basis was provided for the prevention and treatment of chronic heart failure. To inherit and carry forward the special advantage of traditional Chinese medicine, this study explore new train of thought of the old academic experience of inheritance of TCM, the new model, promote the development of the cause of Chinese medicine will have important significance.LMethods:Theoreticl research:Sorting and summary of TCM scholars about the literature research of chronic heart failure, the teacher published academic papers, works and related published books; To collect the medical record, essays, manuscript of Pro.Zhou Yi Xuan, record with learning experience of the teacher; etiology and pathogenesis of chronic heart failure, the understanding of the pathogenesis regularity; Rule of chronic heart failure characteristics, diagnosis and treatment, the cure characteristics, drug characteristics, so as to inherit and summarizes the teacher academic thinking of diagnosis and treatment of CHF.Clinical research:60 patients of CHF were randomly divided into research group (30 cases) and control group (30 cases). Two groups of patients in age, sex, etiology, duration and NYHA heart function comparable. The control group was treated by conventional therapy and the trial group were added with WenYangHuoXueLiShui’s herb on the basis of conventional therapy for total four weeks.To observe the change of clinical symptoms and signs, NYHA heart function classification, the parameters of the heart (LVEF, LADD, LVEDD, SV),6 minutes walking motion experiment, Minnesota living with heart failure questionnaire, the level of plasma BNP and safety indicators in both groups before and after the treatment, we evaluate clinical curative effect.3.Results:3.1Theoreticl research:Pro.Zhou Yi Xuan attached importance to Qi and blood in treatment, that it is extremely important to guide clinical if not a eight class. Qi is the first for all diseases and blood is root. And then put forward the qi and blood is a medical disease differentiation syndrome differentiation. Clinical importance to the body’s "Yin ping yang mi", think to adjust the balance of "Yin and Yang" of the viscera is the key of treatment; Emphasis on spleen and stomach damage for all ills, attaches great importance to regulate spleen and stomach; Clinical medicine to promote "the medicine well chosen, in the party", compatibility and light spirit, use a medicine, the clever use of medicine.By gathering in the Pro.Zhou Yi Xuan expert outpatient service clinical medical record of 210 cases of patients with chronic heart failure analysis, application of data mining technology are studied. A total of 31 species of traditional Chinese medicines using frequency is more than 15%. 31 kinds of drug classified analysis to this, the result mainly contains "yiqi","wenyang","yangyin","huoxue","lishui","jianpi","liqi "drugs. The drug compatibility of application are reflected the academic thought of chronic heart failure of Pro.Zhou Yi Xuan.Pro. Zhou Yi Xuan think the name of CHF available corresponding disease of TCM "heart failure disease". These "Xu", "Yu", "Shui" are the three syndromes of CHF. The causes of CHF include natural endowment, the responsibility of high weak, will accordingly, combined with the experience invaded, eating disorders, modern and etiology of work etc. The basic pathogenesis is the Yin and Yang qi of heart failure, viscera function disorder, heart displaced, effort is not luck, "blood is adverse water", may perform poorly, and phlegm turbidity and blood stasis, drinking water stop, blocking the heart arteries and veins, fixing the heart Yang suppression and disease. In general, that is "Xu", "Yu", "Shui" at the head of the TCM pathogenesis of heart failure. In mind, the disease is closely related with lung, spleen, liver and other viscera, late and kidney. Early is given priority to with heart qi deficiency, and gradually developed into the qi and Yin deficiency, leading to Yin and Yang all deficiency, end up wu Yin wu Yang, Yin and Yang from run-off. The pathological nature always belong to the virtual to real, the deficiency of qi and blood, Yin and Yang deficiency, as well as blood stasis, phlegm turbidity, water to drink, and qi stagnation. Pro. Zhou Yi Xuan clinical follow the principle of "follow the ancient, and not doctrine of ancient ", on the basis of traditional viewpoints, combined with the change of the card machine, treatment proposed the "installment differentiation" academic ideas, flexible evidence-based medicine. For early heart failure, heart qi deficiency is given priority to, use tonic mood; The intermediate stage, qi deficiency and blood stasis, qi and Yin deficiency, theYiQiHuoXue, YiQiYangYin; In the late stage, Yang deficiency of heart and kidney, and blood stasis, phlegm turbidity, water to drink, the Wen Yang Yi Qi, removing the heart kidney is given priority to, with blood stasis, phlegm and water unclogged arteries.3.2Clinical research:3.2.1.The influence of NYHA cardiac function in patients with CHF after using the method of Wen YangHuoXueLiShui.Results show that the two groups after treatment NYHA heart function classification were significantly improved, and the treatment group than the control group improved significantly, the difference is statistically significant (P< 0.05).3.2.2. Overall curative effect comparison of Zhenghou of TCM about two groups of patients before and after treatment of the method of Wen YangHuoXueLiShui.The results showed that the total effective rate of the treatment group was 96.7%, the total effective rate of the control group was 73.3%. Two groups of curative effect of TCM syndrome before and after treatment the overall situation more difference (P< 0.05), the treatment group in the clinical syndromes of TCM overall efficacy is better than that in control group.3.2.3. The comparison of two groups of patients before and after treatment of TCM integral value of Zhenghou.Before the treatment, two groups of TCM integral value of Zhenghou was no significant difference (P> 0.05). In the two groups after treatment of TCM integral value of Zhenghou itself controls are falling, with significant difference statistically significant (P< 0.01); Comparison between groups:the treatment group is better than that of control group, the difference statistically significant (P< 0.05). The results showed that the treatment group in improving the TCM syndrome study better than the control group.3.2.4.The comparison of two groups before and after treatment in patients with doppler ultrasound of the heart.The results show that the two groups after treatment LVEF, SV were significantly higher than before treatment (P< 0.01), the two groups after treatment LADD, LVEDD indicators was reduced, the difference has the remarkable significance (P< 0.01). Compared with the control group and treatment group in improving LVEF, SV is obvious (P< 0.05), but in reducing LADD, LVEDD indicators, comparing the two groups have no difference (P> 0.05).3.2.5. The comparison of two groups before and after treatment in patients with the levels of plasma BNP.The results showed that the treatment group and control group before treatment there was no statistically significant difference of the levels of BNP (P> 0.05); The levels of BNP in the two groups after treatment was decreased, the differences are significant statistical significance (P< 0.01); Treatment group of the levels of BNP to reduce the more obvious, the difference was statistically significant (P< 0.05).3.2.6.The comparison of two groups before and after treatment in patients with 6 minutes walk test (6 MWT).The results showed that the 6 MWT difference between the two groups before treatment had no statistical significance (P> 0.05); Comparing the two groups after treatment, the treatment group and control group after treatment 6-MWT was increased, the significant statistical significance (P< 0.01); Treatment group 6-MWT was significantly increased, the difference was statistically significant (P< 0.05).3.2.7. The comparison of two groups before and after treatment in patients with Minnesota heart failure table (MLHFQ).The results show that the two groups of patients before treatment integral value of Minnesota heart failure table (MLHFQ) comparison, there was no statistically significant difference (P> 0.05); In the two groups after treatment was decreased, the integral value has significant difference statistically significant (P< 0.01); Treatment group integral value change is more significant, the difference is statistically significant (P< 0.05).4.Conclusion:Prof. Zhou Yi Xuan think the name of CHF available corresponding disease of TCM "heart failure disease". These "Xu", "Yu", "Shui" are the head of the TCM pathogenesis of heart failure. Pro. Zhou clinical follow the principle of "follow the ancient, and not doctrine of ancient ", on the basis of traditional viewpoints, combined with the change of the card machine, treatment proposed the "installment differentiation" academic ideas. Heart failure early heart qi deficiency is given priority to, use tonic mood; Mid-qi deficiency and blood stasis, qi and Yin deficiency, the yiqi huoxue, qi and nourishing Yin; Late heart kidney Yang deficiency, and blood stasis,, phlegm turbidity, water to drink, the WenYangYi air, removing the heart kidney is given priority to, with blood stasis, phlegm and water unclogged arteries. Especially for refractory heart failure from renal syndrome differentiation, heart kidney pathogenesis, the clinical curative effect is distinct.The clinical study explored the method of WenYangHuoXueLiShui to chronic heart failure in the heart of the kidney Yang deficiency and blood stasis syndrome curative effect is distinct, water can not only improve the patients’ clinical symptoms, NYHA heart function classification, TCM syndrome integral value,the parameters of heart function of cardiac doppler ultrasound, the levels of plasma BNP, but also can improve the patient’s 6 minutes walking distance, improve exercise tolerance, improve the patient’s quality of life. Explored the method of WenYangHuoXueLiShui can increase myocardial contraction in patients with CHF, improve the heart function, clinical effect is remarkable. |
