Clinical Observation Of Wenyang Decoction On Heart Failure Combine With Atrial Fibrillation Patients With Yang Deficiency

ObjectivesTo systematical evaluate the therapeutic efficacy of Wenyang Decoction on Heart Failure combine with Atrial Fibrillation patients with Yang Deficiency Syndrome, and the impact on the sympathetic nervous system(SNS) and renin-angiotensin-aldosterone system(RAAS) of the syndrome. Then to provide an objective modernization basis for the mechanism of the old experience prescription of Chinese medicine.MethodsThis study used the way of prospective randomized controlled clinical trial. The 70 heart failure patients combine with atrial fibrillation with Yang deficiency Syndrome were selected from the Guangdong Provincial TCM Hospital Heart Center outpatient and inpatient department. And then they were selected strict randomly and divided into treatment group and control group,35 cases of each group. The treatment group was treated by the wenyang decoction and standardizational western medicine while the control group was only treated by standard western medicine, both 1-month course of treatment. To observe the changes of cardiac function, cardiac-related indicators (heart rate,6-minute walk test,left ventricular ejection fraction),related endocrine indicators(NE,Angâ…¡,BNP),the integration of TCM Syndromes and safety indicators of creatinine (Cr),alanine aminotransferase (ALT) before and after treatment in the two groups patients.Result1.The treatment group was significantly different than the pre-treatment in the 6-minute walk test, cardiac function and LVEF (P<0.01), and between the two groups, the treatment group was significantly better than the control group after treatment(P<0.05); 2. The two groups'Resting heart rate and Post-exercise Heart rate were significantly slow down after treatment(P<0.01), and between the two groups, the efficiency of the Resting heart rate control has no different (P>0.05), but the efficiency of the Post-exercise Heart rate control of treatment group was significantly better than the control group after treatment(P<0.01);3. The efficiency of the integration of TCM Syndromes between the two groups, the treatment group was significantly better than the control group after treatment (P<0.05);4. The treatment group were significantly improved than the pre-treatment in the NE,Angâ…¡,BNP (P<0.01);and the treatment group were significantly lower than the control group in the NE,Angâ…¡,BNP after the treatment (P<0.01);5. The two groups have no significantly difference before and after the treatment in the Cr and ALT, the two groups were also no significantly different after treatment in the Cr and ALT (P>0.05).Conclusion1. Wenyang decoction can reduce the activity of SNS and RAAS in the heart failure combine with atrial fibrillation patients with Yang Deficiency Syndrome and can reduce the release of NE and Angâ…¡,BNP. Meanwhile it can reduce cardiac remodeling and myocardial apoptosis,then improve heart failure and atrial fibrillation symptoms.2. Wenyang decoction can slow down the heart rate in the heart failure combine with Atrial Fibrillation patients with Yang Deficiency Syndrome and reduce myocardial oxygen consumption, LVEF can be increased at the same time, and it can improve the patients'cardiac function.and it is safe, no significant damage to liver and kidney functions, it is worth to promote the use of clinic furtherly.