| Objective Clinical observation of compound preparation of traditional Chinese medicine Qiliqiangxin capsule in improving the cardiorenal syndrome in patients with clinical symptoms,heart and kidney function,to further explore its mechanism play a role in renal protection,this provides a theoretical basis for the treatment of cardiac and renal syndrome with integrated traditional Chinese and Western medicine.Methods Clinical research section: Collection meets the inclusion criteria 73 patients with cardio renal syndrome.The patients were randomly divided into the treatment group(37 cases)and the control group(36 cases),the treatment group was treated with oral Qiliqiangxin capsule,4 pills 3 times a day and western medicine treatment,the control group only received routine western medicine treatment.Through 12 weeks,observed the curative effect of TCM symptoms before and after treatment,measured the change of the main symptoms of TCM were improved,the biochemical indexes of left ventricular ejection fraction(LVEF),Type B brain natriuretic peptide(BNP),Serum creatinine(Scr),cystatin C(Cys C).Animal experiment section: The healthy male SD rats were selected as experimental animals,a rat heart and kidney syndrome(CRS)model was established by ligation of the anterior descendingcoronary artery in rats,12 SD rats successfully operated were randomly divided into 4 groups,3 rats in each group,respectively:group A: 2 weeks model group;B group: 2 weeks medicine group(Qiliqiangxin capsule drug group);group C: 4 weeks model group;D group: 4 weeks medicine group(Qiliqiangxin capsule drug group).The A group was given normal saline with the same volume of drug group gavage for 14 days;B group were given Qiliqiangxin drug solution by intragastric gavage treatment,dose of 4g/kg/d,to made the day before,from the 15 day after operation were measured;C group received saline with the same volume of intragastric administration of the drug group 28 days;group D were given Qiliqiangxin drug solution by intragastric gavage dose,4g/kg/d,to draw the day before,from the 29 day after operation were measured.The changes and differences of angiotensin II(AngII),interleukin-6(IL-6)and creatinine(CRE)in serum of 4 groups of rats under different intervention were observed.Results Clinical research section:(1)The curative effect comparison of two groups of TCM symptoms:13 cases were markedly effective in the control group,19 cases were effective,the total effective rate was 88.89%;the treatment group was markedly effective in 20 cases,effective in 16 cases,the total effective rate was 97.30%.The total effective rate of the treatment group was obviously better than that of the control group(P < 0.05).(2)The main symptoms: the main symptoms of traditional Chinese medicine score was statistically significant in two groups before and after treatment than before treatment(P<0.05)after the treatment,the main symptoms of traditional Chinese medicine were significantly lower than before treatment,that treatment group twohad improved effect on clinical symptoms.The symptoms of fatigue,Yaoxisuanruan,aversion to cold,nausea and vomiting,pale complexion,anorexia improved,the treatment group than the control group(P<0.05).It has the same curative effect on symptoms,chest tightness,shortness of breath and edema(P>0.05).(3)Compared with before treatment,the control group,the treatment increased LVEF were different after 12 weeks group(* P <0.05,**P<0.01),BNP,Scr,Cys and C decreased(*P <0.05,**P<0.01);compared with the control group,the treatment group to improve the function of heart and kidney index more obviously(P<0.05).Animal experimental research section:B group and A group compared with B group rats serum AngII,IL-6,CRE,A and the content of AngII,IL-6 group,which has significant difference(P<0.05),CRE was not statistically significant(P>0.05),B group of rats serum AngII,IL-6 were significantly lower than group A,CRE two in serum group had no significant difference.C group and A group compared with A group,the contents of AngII,IL-6 and CRE in serum of group C and group C were significantly different from those of group A(P<0.05),and the contents of AngII,IL-6 and CRE in serum of group C were significantly higher than those in group A.D group and B group compared with D group rats serum AngII,the content of IL-6 and B group,with significant difference(P<0.05),CRE was not statistically significant(P>0.05),D group of rats serum AngII,IL-6 were significantly higher than that of B group,serum CRE two groups had no significant difference.D group and C group: D group rats serum C content and IL-6,AngII group compared with significant difference(P<0.05),CRE was notstatistically significant(P>0.05),D group of rats serum AngII,IL-6 content was significantly lower than C group,serum CRE two groups had no significant difference.Conclusion According to the research results,as well as awareness of the cardiorenal syndrome pathogenesis,and review the previous studies on Qiliqiangxin capsule,the statistical data analysis the following conclusions:(1)Qiliqiangxin capsule combined with conventional western medicine therapy compared with conventional western medicine therapy,can improve heart and kidney more obvious clinical symptoms,protect the heart and kidney function.(2)By ligating the anterior descending branch of coronary artery in rats,the CRS model of acute myocardial infarction in rats was established,which is an ideal experimental animal model.(3)By AngII,IL-6 and CRE level changes in rat serum animal experiment shows that Qiliqiangxin capsule can inhibit AngII reduced cytokine production of IL-6,reduce kidney damage,play a protective role in the mechanism of kidney.(4)Combination of traditional Chinese and Western medicine treatment of CRS can play a greater clinical advantage,so that patients benefit further,with good clinical prospects. |
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