| Objective:1.Observe the incidence of depression in different syndrome types of chronic heart failure(CHF).2.Observe the clinical curative effect and security of traditional Chinese medicine on chronic heart failure(CHF)with depression.Methods:The first part:Collect184cases patients with chronic heart failure(NYHA class Ⅱ-Ⅳ) from the affiliated hospital of chengdu university of TCM.Gather the general information (age, gender, pathogeny and cause) and hospitalization condition.Finally, analyze related factors by Statistical methods.The second part:Absorb70hospitalized patients with chronic heart failure(CHF) combined with depression, according to1:1comparison principle, randomly divided into observation group (35cases) and control group (35cases).Observation group Yangxin anshen decoction+foundation treatment of heart failure; The control group: wu ling capsule+foundation treatment of heart failure.Observe before and after treatment curative effect after4weeks treatment grade the results, use SPSS19.0statistical software for statistical analysis (P<0.05for clinical significance)Results:The first part:(1) One hundred and eighty four patients with heart failure were included in this study, in which71cases(38.59%)had depression.(2) In patients with heart failure, there has correlation between cardiac function classification and incidence of depression:the higher the cardiac function rating is, the higher of Depression self rating scale(SDS)score (36.86±13.21VS43.12±14.79VS55.43±15.11,P<0.01), it was agreed that patients with higher cardiac function classification has higher depression level than the lower one.(3) In four groups of TCM syndrome type of chronic heart failure, the prevalence of depression, depression self rating scale (SDS) score and cardiac function rate in Yang deficiency-water flooding type were higher than the rest of the three groups(Qi deficiency-blood stasis, phlegm retention aggregates lung, qi and Yin deficiency).The above three indicators of Yang deficiency-water flooding have significant difference (P<0.05) between the remaining three groups. The second part:(1)Total curative effect of heart failure:the total effective rate of intervention group was90.9%, control group was64.7%, the observation group is better than control group (P<0.05);Syndromes curative effec of TCM:the total effective rate of intervention group was82.8%, control group was53.9%, the observation group is better than control group (P<0.05).(2) The intervention group was better than control group on improving the symptoms of TCM and cardiac function,(P<0.05);Intervention group is better than control group on Lee’s ratings, BNP and hs-CRP(P<0.01).(3) Depression effect:The total effective rate of intervention group was75.8%, control group was79.4%, there is no difference on total effective rate between two groups (P>0.05);SDS scale integral:In intervention group, there is significant difference between the beginning of treatment and the end (P<0.01).In control group,there is significant difference too (P<0.01). There is no significant difference between the two groups at the end of treatment (P>0.05),we can conclude that the treatment effect between two groups are the same.(4) There was no obvious adverse reaction occurred during the medication between two groups.Conclusion:The first part:(1)In patients with heart failure, the higher the cardiac function rating is, the higher of the depression level.(2) In four groups of TCM syndrome type of chronic heart failure, the prevalence of depression and depression level in heart kidney Yang deficiency-wet water flooding(Yang deficiency-water flooding) type were higher than the rest of the three groups.The second part:(1) TCM intervention therapy can not only alleviate the typical symptoms of heart failure, and also improve other systemic symptom such as deep sigh, insomnia, sweating,significantly reduce depression score, improve depression, reduce the influence of depression on heart failure.(2) TCM intervention therapy can lower hs-CRP level in the blood, hs-CRP is a good biological indicators of inflammation.Chronic heart failure and depression are associated with inflammation, Chinese medicine treatment can not only improve the symptoms of chronic heart failure with depression, but also restrain inflammatory response,presumably one of its mechanisms is restraining the inflammatory response.(3) Treating traditional Chinese medicine with syndrome differentiation can improve cardiac function,clinical symptoms and depression of patients with heart failure merge depression, and improve the life quality of patients. The overall efficacy of intervention group was better than control group, reflects the treatment advantage of TCM. |
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