The Study Of Treatment Of Chronic Heart Failure By Supplementing Qi And Nourishing Yin In Clinical And Experimental

Chronic Heart Failure (CHF) is a frequent, complicated and severe clinical syndrome. The total prognosis of CHF is very bad. It is a global medical problem to decrease the incidence, prevalence, disability rate and mortality of CHF. Traditional Chinese Medicine (TCM) have been fighting with diseases that have relation with CHF since the ancient year, and the treatment outcome of TCM is definite. The basic therapies of CHF which have been extensively approved are Reinforcing Qi, Warming Yang, Activating Blood and Diuresis-Removing. The aim of this thesis is to explore the therapeutic mechanism of supplementing qi and nourishing yin therapies with the method of serum modulin of heart cell and find the compatible regularity of this therapies through evaluating each role of it objectively, and we reviewed the clinical practice of this therapies in order to support our conclusion.In the clinical study, 260 cases (from 1,2004 to 12,2006) that had been confirmed to be CHF were from the guangzhou college of TCM the main purpose is to see different way especially the supplementing qi and nourishing yin and to see their result. The results are as the following: Qi Deficiency, yin asthenia, Blood Stasis, Water Retention, Yang Deficiency, especially the Qi Deficiency yin asthenia and Blood Stasis are the most frequent symptom complex according to syndrome differentiation of TCM; Yang Deficiency is more frequent in severe cases; The frequent syndrome differ classification in turn are Qi Deficiency and Qi and yin Deficiency Blood Stasis; Qi Deficiency, Blood Stasis and Water Retention; Yang and Qi Deficiency, Blood Stasis and Water Retention; Yang and Qi Deficiency, Blood Stasis. The front two syndrome are frequent in light cases and the rest are frequent in severe cases. The treatment of combination of Reinforcing Qi, supplementing qi and nourishing yin have a definite clinical effect.The experimental study was carried out with the method of orthogonal test. The experiment of rat' were divide into five and give different medicine as the following: Perindopril yangxinfang(method of supplementing qi and nourishing yin)with normal metrology and its high metrology. As the plan give different medicine to each team after the model of CHF ready, at the end to measure the Phospholamban and Sarcoendoplasmic reticulum Ca~2+-ATPase of each team. The results were compared with that of the blank serum. Results: The high of supplementing qi and nourishing yin groups has obvious effect to the CHF of rats', The expression of Phospholamban in cureteam rise obvious, especially the team that given supplementing qi and nourishing yin, these effect has statistical significant difference compared with that of the blank serum; the different of Sarcoendoplasmic reticulum Ca~2+-ATPase of each team has no effect has statistical significant difference Reinforcing supplementing qi and nourishing yin possible has beneficial result to the CHF patients by adjusting the modulin of the heart.Through clinica beneficial review and experimental study, we can get some conclusions as the following: The basic symptom complexes of CHF are Heart Qi Deficiency, Heart Yin and Yang Deficiency, Blood Stasis, Water Retention. The basic syndromes of CHF are various combination of light or severe basic symptom complexes. The development of the syndromes is: Heart Qi Deficiency→Heart Yin or Yang Deficiency→Heart Qi Deficiency, Blood Stasis and Water Retention→the severe symptom of Heart Heart QiYang and QiYin Deficiency. The role treatment of CHF is combination of Reinforcing Qi, supplementing qi and nourishing yin and huoxueiishui, Its treatment efficacy is definite and the five basic therapy should be applied simultaneously and flexibly. One of the mechanism of the supplementing qi and nourishing yin therapy to CHF is adjusting the modulin of the heart.