| Objective: To observe influence of rhizoma coptidis lipid-lowering agent in the treatment of clinical efficacy,TCM syndrome integral, Minnesota score,lipid levels,inflammatory factors related to, exercise tolerance, NT-pro BNP of those suffering from chronic heart failure, and to explore its possible mechanisms in the treatment of chronic heart failure.Method: We choosed 90 patients conforming to the standard from cardiology of combining traditional Chinese and western medicine hospital in wuhan city, among them,40 had ischemic heart disease,7 had dilated heart disease,10 had valvular heart disease,15 had hypertensive heart disease,10 had heart disease due to lung,8 had hypertrophic cardiomyopathy.And then we choosed 30 patients randomly as control group(standard western medicine),the rest 60 patients as traditional chinese medicine combined with western medicine group(rhizoma coptidis lipid-lowering agent+standard western medicine),among them 27 patients belonged to phlegm retention rssistance pulmonary syndrome of chronic heart failure,we called it traditional chinese medicine combined with western medicine group A,the rest 33 patients belonged to not phlegm retention resistance pulmo- nary syndrome,we called it traditional chinese medicine combined with western medicine group B.According to the routine management guide of the treatment of chronic heart failure is angiotensin converting enzyme inhibitor/angiotens in receptor blockers,beta blockers,aldosterone receptor antagonist,diuretics,the medicine of diuretic,expansion tube and stronging heart assisted.The treatment of traditional chinese medicine combined with western medicine group was on the basis of conventional western medicine therapy plus rhizoma coptidis lipid-lowering agent,drink 50 ml every moring and eveing,the period of treatment of three groups were all 12 weeks. Those persons suffering from high blood pressure and high blood glucose of three groups still continued to buck and hypoglycemic therapy.To see the clinical effect,TCM syndrome interal change,the Minnesota score,lipid level changes(TC、TG、LDL-C、HDL-C),the level of change of inflammatory factor(Hs-CRP,IL-6,TNF-α),the walking distance in 6minutes,NT-pro BNP before and after the cure of chronic heart failure and adverse reaction in the period of curing eparately and the Minnesota score of three groups after cure.Finally,we studied data for statistical analysis.Results:(1)The curative effect of persons having chronic heart failure in the treatment group A was better than the control group and the treatment group B after treatment,it had statistically difference(p<0.05);The curative effect of the treatment group B was better than the control group,but it had no statistically difference(p>0.05);(2)TCM syndrome score of three groups after medication were lower than before medicion,the intra-group comparison had statistically difference(p<0.05);The drop of treatment group A was lower than control group and treatment group B,it had statistically difference(p<0.05);(3)After treatment,the Minnesota score of thr- ee groups all went down,the intra-group comparison had statistically difference(p<0.05);Group A was lower than control group and treatment group B,it had statistically difference(p<0.05); the Minnesota score of treatment group B was lower than control group,it had no statistically difference(p>0.05);(4)After medicine,lipid index such as TC、LDL-C of three groups all decreased,and HDL-C all increased,the intra-group comparison had statistically difference(p<0.05),but TG after treatment of three groups compared with before treatment had no statistically difference(p>0.05);The down of TC、HDL-C and the up of HDL-C of treatment group A was better than control group and treatment group B,it had statistically difference(p<0.05);(5)After medicine,the level of Hs-CRP、IL-6、TNF-α of three groups all decreased than before medicine,the intra-group comparison had statistically difference(p<0.05);The above indices of treatment group A was lower than control group and treatment group B,it had statistically difference(p<0.05);(6)After treatment,the walking distance in 6 minutes of three groups were all longer,the intra-group comparison had statistically difference(p<0.05);The distance of treatment group A was much longer than control group and treatment group B,it had statistically difference(p<0.05);(7)After treatment, NT-pro BNP of three groups all decreased,the intra-group comparison had statistically difference(p <0.05),but the comparison among three groups had no statistically difference(p>0.05);(8)2 patiens of treatment group A and 1 patient of treatment group B had mild nausea,but did not vomit during the first week,but it disappeared after one week;in the control group,one patient had dry cough after three days,it gradually eased in one week when it was changed by angiotens in receptor blockers;the safety indicators did not have big difference before and after the treatment(p>0.05).Conclusion: Rhizoma coptidis lipid-lowering agent had definite curative effect for the patients suffering from chronic heart failure, and curative effect of the patient whose TCM syndrome was phlegm retention resistance pulmonary syndrome was better than the patient whose TCM syndrome was not phlegm retention resistance pulmonary syndrome,but for the latter,the effect of traditional chinese medicine combined with western medicine was the same with western medcine only.Treatment of chronic heart failure also had security, its effect perhaps by lipid regulation,inhibiting inflammatory reaction mechanism to implement, but it still needs us to explore the specific mechanism further. |
PDF Full Text Request