Effects Of Qishen Yiqi Pills Pretreatment On Cardiac Function Of Patients Undergoing Valve Replacement

Background and ObjectiveThe current research on cardiac valve replacement operation under cardiopulmonarybypass in patients with myocardial protection in many, but mostly concentrated incardioplegia solution and various additives, this research aims to explore the moderntraditional Chinese medicine preparation of Qishen Yiqi Pills effects of preconditioning inpatients undergoing cardiac valve replacement operation under cardiopulmonary bypasscardiac function.Methods120patients were randomly divided into control group (group A) and Qishen group (Bgroup),60in each group. The preoperative control group routine cardiac, diuretic therapy,application of Qishenyiqi placebo,0.5g each time,3times a day, half hour after meals,continue until the end of the study; Shenqi group on the basis of conventional therapy,application of Qishenyiqi drop pills,0.5g each time,3times a day, half hour after meals,continue until the end of the study. Two groups of patients before anesthesia （T0）and12hafter opening aorta (T1) and24h (T2) were detected by serum myocardial blood damagemarkers of cardiac troponin I (nTnI) and creatine phosphokinase isoenzyme (CK-MB). After1weeks,6weeks in two groups were measured in patients with right ventricular ejectionfraction (RVEF), right ventricular stroke volume (RVSV), right ventricular end diastolicvolume (RVEDV) and right ventricular end systolic volume (RVESV). And record theascending aorta blocking time, cardiopulmonary bypass time, aortic opening time, automaticRebeating situation, the incidence of arrhythmia and myocardial ischemia reperfusion injuryafter extracorporeal circulation, stop after the dosage of dopamine, postoperative care unit(ICU) residence time.Results1．Two groups of patients with cardiopulmonary bypass time, aortic clamping time,auxiliary cycle time had no significant difference (P>0.05). Qishen group the incidence of arrhythmia was lower than the control group, were all paroxysmal atrial fibrillation,comparison between the two groups was statistically no significant difference (P>0.05).2．The average amount of extracorporeal circulation after the cessation of dopamine in Agroup compared with B group differences(P<0.05). Differences between the two groups afteraorta open heart Rebeating situation significantly (P<0.05). Significant difference in the ICUtime of A group and B group (P<0.05). The two time period cTnI and CK-MB concentrationin blood extraction test comparison, there are significant differences (P<0.05).3. Two groups of patients after cardiac valve replacement heart function at six weeks, theright of first week and showed right ventricular end diastolic volume (RVEDV) afteroperation in the two groups, right ventricular stroke volume (RVSV), right ventricular endsystolic volume (RVESV)were decreased significantly, and the right ventricular ejectionfraction (RVEF) increased significantly, but Qishen group postoperative right ventricularstroke volume (RVSV), right ventricular end systolic volume (RVESV), right ventricular enddiastolic volume (RVEDV)decreased significantly lower than the control group, thedifference was statistically significant (P<0.05), and ejection fraction (RVEF) of Qishengroup increased significantly higher than that in control group, the difference was statisticallysignificant (P<0.05).ConclusionRheumatic patients with valvular heart disease before the routine treatment plusQishenyiqi pills, on cardiac function in patients with right improvement after operation,enhance the anti hypoxia ability of myocardial cells, reduce the CPB induced myocardialischemia reperfusion injury, promote the postoperative rehabilitation has an important role,has opened up a new way in the treatment of heart failure for valve replacement after theoperation, is worth the clinical promotion.