| Objective:Use the traditional Chinese medicine(TCM) yiqi huoxue method to treat pre-clinical heart failure(HF) based on coronary atherosclerotic heart disease(CHD), observe the improvement situations on patients’clinical symptoms, quality of life, neuroendocrine, myocardial reconstruction and other related aspects. Explore the relationship of pre-clinical heart failure symptoms of TCM and western medicine index, and provide clinical evidence to establish a effective measures of HF based on CHD’s prevention and treatment with TCM characteristic. Most importantly, to learn combining traditional Chinese and western medicine treatment principle with the purpose "early intervention, prevention first" in the long-term treatment whether be possible to really delay the development of HF based on CHD.Methods:Our research used randomized controlled trials. During the period of Feb. 2014 to Jul.2015, took the patient with cardiovascular disease from DongZhimen Hospital outpatient and ward as the research scope, according to the diagnosis of coronary heart disease, chronic heart failure diagnosis standard, development phase standard heart failure, cardiac function classification standard, the standard of syndromes of traditional Chinese medicine and TCM symptom classifying quantization standard into the object of research. This study, a total of 53 cases of samples in advance for a one-year clinical treatment and periodic follow-up survey. Research object were randomly divided into Chinese medicine treatment group and western medicine control group, and were treated by relevant intervention:traditional Chinese medicine treatment group used GuoWeiqin Professor’s "yiqi huoxue decoction", or used Chinese Patent Medicines YiXinshu capsule and (or) XueShuan XinMaining pill, and used conventional western medicine treatment at the same time; The western medicine control group only gave western medicine routine treatment. Used "The clinical observation table of pre-clinical HF based on CHD" to recorded symptoms observation and test results when into the group and later periods of treatment. Established database, from the general data, onset of the disease, TCM symptom assessment, related inspection, and the quality of living survey to took the comparison test statistics. Analysised and researched object’s improvement situations on clinical symptoms, quality of life, neuroendocrine and heart function, then explored the relevance of pre-clinical HF based on CHD’s symptoms of TCM and western medicine index.Results:1. The symptom scores and curative effect of traditional Chinese medicine:(1) Symptom scores:The treatment group and control group in the team to score were 48.519±13.60 points and 45.462±8.00 points, there was no statistically significant difference (P=0.3221>0.05).6 months after treatment, the treatment group symptom scores fell by 28.074±11.20 points, the control group symptom scores fell by 18.577±5.59 points, two groups of the decline of score differences, statistically significant difference (P=0.0003<0.05); 1 year after treatment, the treatment group symptom scores fell by 40.88±14.32 points, the control group symptom scores fell by 27.36±6.42 points, two groups of the decline of score differences, statistically significant difference (P=0.0001<0.05).(2) The curative effect evaluation:According to Nimodipine method make curative effect evaluations are:6 months after treatment, treatment group total effectiveness 100%, which show the efficiency of 11.11%, effective rate was 88.89%, control group total effective rate 92.31%, which show the efficiency of 0%, effective rate was 92.31%, the curative effect is similar between the two groups have statistical significance (P=0.0283<0.05); 1 year after treatment, two groups were was 100%, total effective rate in treatment group efficiency 92%, effective rate was 8%, the control efficiency of 4%, effective rate was 96%, the curative effect is similar between the two groups have statistical significance (P<0.0001<0.05).2. The quality of living survey score changes:In the beginning, the treatment group and control group was not significant between each part (P>0.1).6 months after treatment, the treatment group and control group in body pain (BP), general health (GH), energy (VT) (SF), social function, mental health (MH) and health (HT) aspects’score had statistically significant differences (P<0.05); 1 year after treatment, based on the differences in 6 months after treatment, two groups in physiological function (PF) appeared differences, which had statistically significant(P=0.015<0.05).3. Heart function improvement:(1)6 minutes walk test(6MWT):In the beginning, the treatment group and control group there was no statistically significant difference of 6MWT results (P=0.1532>0.05).6 months and 1 year after treatment, two groups’6MWT results are differences, statistically significant difference (P value were 0.0186,0.0025,<0.05).(2) The BNP:In the beginning, the BNP index difference between two groups had no statistical significance (P=0.7305>0.05).6 months and 1 year after treatment, two groups of BNP test results’differences had statistically significant difference (P value were 0.0101, 0.0006,<0.05).(3) Ejection fraction:In the beginning, the ejection fraction value difference between two groups had no statistical significance (P=0.058>0.05).6 months and 1 year after treatment, there were two groups of ejection fraction results differences, statistically significant difference (P value were 0.0031, 0.00001,<0.05).4. The relevance between symptoms of TCM and western medicine detection index:(1) Palpitations, insomnia symptoms and and heart rate:Uesd statistical data in the periods of beginning, after treatment for 6 months and 1 year after treatment. Statistical results suggested that heart palpitations, insomnia symptom scores and heart rate had no correlation (P values were 0.071,0.091,0.177, all>0.05).(2) Weak symptom and 6MWT:Two groups in the periods of beginning and 1 year after treatment, weak sympotom scores and 6MWT result had no correlation (P values were 0.351, 0.164,>0.05),6 months after treatment stage, statistical results suggested that weak sympotom scores and 6MWT result had linear correlated (P=0.0120.05, r<0.4).(3) The shortness of breath symptom and the BNP:Two groups in the periods of beginning and 6 months after treatment, the shortness of breath symptom and the BNP result had no correlation(P values were 0.126,0.321,>0.05),1 year after treatment stage, statistical results suggested that the shortness of breath symptom and the BNP result result had a significant linear correlation (P<0.0001<0.05,0.4< r0.7).(4) Blood stasis symptoms and the degree of blood clots:No matter blood stasis symptom on lips and tongue or on skin, there was no correlation between blood stasis symptoms and the degree of blood clots(P values were 0.307,0.669,>0.05).(5) Chest stufly, chest pain symptoms and the degree of blood clots:Chest stufly, chest pain symptoms and the degree of blood clots had a significant linear correlation (P=0.001<0.05, 0.4<r<0.7).Conclusion:1. The treatment group and control group in clinical treatment, patients with Qi deficiency blood stasis of TCM symptoms were improved, but the improvement of the symptom scores of treatment group was better than control group. The result show that long-term application of traditional Chinese medicine YiQi HuoXue method with the clinical routine treatment in pre-clinical CHD based on CHD can be obvious and deficiency of blood stasis in the continuous improvement of clinical symptoms.2. In the long-term treatment, the treatment group in physiology, body pain, general health, energy, social function, mental health, health changes improved better than that in control group, and the degree increases along with the increase of the course. That long-term use of traditional Chinese medicine YiQi HuoXue method in pre-clinical HF based on CHD is better than pure western medicine routine treatment can improve the patient’s quality of life.3. The two groups of patients’heart function in 6MWT showed with the extension of the course has a certain reduce trend, but significantly less than the control group, the treatment group decreased cardiac function in the treatment of late that there is a certain difference, difference increased with the extension of treatment time. BNP result and ejection fraction, and the results of treatment group was obviously superior to the control group. That shows that Chinese medicine YiQi HuoXue method with conventional western medicine therapy can effectively slow the onset of heart failure patients with coronary heart disease before cardiac insufficiency.4. The symptoms of TCM and western medicine pathological index, such as chest pain symptoms and the degree of blood clots, shortness of breath symptoms and plasma BNP levels, and weak symptoms and 6MWT, have a certain correlation. The symptoms associated with index of research or can be, as a sensitive diagnosis point of HF disease early detection. At the same time to facilitate clinical more targeted to combine traditional Chinese and western medicine treatment, and in improving the clinical symptoms of physiological function at the same time corresponding improvement of western medicine.5. Combining traditional Chinese and western medicine treatment principle with the purpose "early intervention, prevention first" in the long-term treatment is possible to really delay the development of HF based on CHD. |
PDF Full Text Request