| Background:Congestive Heart Failure(CHF) is a commonly encountered heart disease with high morbidity and mortality rates. The prognosis of it is worse than the most cancers. So study of CHF is the emphasis of cardiac disease. Numerous researches have shown that Traditional Chinese Medicine(TCM) has certain curative effect on CHF. Professor Yan Dexin, who is a renowned doctor nationally, considers that yang deficiency and blood stagnation are the basic caruse of CHF; accordingly, its therapy should be yang-warming and blood-flow stimulation. In this study, Professor Yah used Xinshuai No. 1, an alternated form of the Mahuangfuzixixin decoction and Xinshuai No. 2, an alternated form of the Xuefuzhuyu decoction, as a cure for the CHF patients, and had satisfactory effect.Objective:To study the method of yang-wanrming and blood-flow stimulation in the treatment of CHF, and to provide a practical and valuable approach for curative effects. Further more, investigate the action mechanism of Xinshuai No. 1 and Xinshuai No. 2, evaluate the effect and safety of Xinshuai No. 1.Methods:1. Experimental Study:Take 50 SD rats as the experimental objects. We coarctation of abdmomial aorta to fade in congestive heart falilure rat model. To continue manufacture yang deficiency and blood stagnation rat model. And they were divided into 5 groups randomly: feigned operation team,CHF of yang deficiency team,CHF of blood stagnation team,CHF of yang deficiency+Xinshuai No. 1 team,CHF of blood stagnation＋Xinshuai No. 2 team. We lavage Xinshuai No. 1 and Xinshuai No. 2 separately to CHF of yang deficiency+Xinshuai No. 1 team and CHF of blood stagnation＋Xinshuai No. 2 team. NO medications were given to feigned operation team,CHF of yang deficiency team and CHF of blood stagnation team. After 4 weeks, contrast each group of heart colored ultrasonic wave, hemodynamics, LVMI, pathomorphism, serum AngⅡ, BNP, CRP, TNF-α, IL-1, IL-61evel.2. Clinical Observation:A total of 30 qualified patients were randomly divided into treatment and controlled groups using a table of randomized numbers. The treatment group was prescribed mainstream therapy and Xinshuai No. 1, while the controlled group was simply given the former. After 2 weeks, we observed patients' serum TNF-αand IL-6, heart function, integral of heart failure, TCM Syndromes, and their quality of life. We also observed the number of days of hospitalization, and rountinely checked for side effects.Results:1. Experimental Study:(1)Xinshuai No. 1 and No. 2 can reduce LVSD, PWD, IVSS significantly, enhance EF, FS. Inhibition the left ventricle reconstitution, elevate EF.(2)Two drugs can can remarkably reduce LVEDP, and remarkably elevate LVSP,±dp/dtmax, they may improve the the left ventricle complaisance, enhance the cardiac output and improve hemodynamics.(3) Two drugs can remarkably reduce SAP, DAP and MAP, explain they affect to the peripheral blood vessel, reduces the blood pressure.(4) Two drugs can reduce serum AngⅡ, BNP, TNF-α, CRP, IL-1, IL-6 level.(5) Two drugs can improve myocardium super ultrastructure and pathology performance.2. Clinical Observation:(1)Comparing the two groups, there was no significant difference in age, sex, course of illness, degree of severity, and also no significant difference in their quality of life before therapy (P＞0.05).(2)As for integral of heart failure and TCM syndromes, there was no significant difference in inefficiency and aggravation rate, but the total effective rate(effective rate+significantly effective rate) of the TCM syndromes integral and the effective rate of heart failure syndromes integral between the two groups after therapy (P＜0.05).(3)There was no significant different in serum TNF-αand IL-6 level between two groups before therapy (P＞0.05), but significant changes were observed after therapy (P＜0.05). The treatment group's serum TNF-αand IL-6 level decreased more than the controlled group (P＜0.01).(4)No obvious or serious side effects were observed in the test drug.Conclusion:1. The method of yang-warming and blood-flow stimulation have certain effect in treating CHF. It is worthwhile to perform further studies and hopefully brings into a broader spectrum in clinical use.2. Xinshuai No. 1 and No. 2 not only improve heart function and hemodynamics, but also inhibitory the release of neuroendocrine and inflammatory factors, moreover improve myocardium super ultrastructure and pathology performance.3. Xinshuai No. 1 increases the overall curative effect of CHF. No obvious or serious side effects were observed in it.
|
PDF Full Text Request