Clinical Study On Preventing And Treating Heart Failure Using Theory Of "Reinforcing Yang From Yin"

Objective:Chronic heart failure(CHF)is a set of clinic syndromes resulting in ventricular filling or impaired ejection function caused by changes of cardiac structure and functions.In recent years,with the development of social aging,the incidence of chronic heart failure keeps rising.The quality of life of heart failure patients decreases.Hospitalization rate increases with high mortality.Therefore,reducing the recurrence of heart failure,improving the quality of life of patients,and reducing mortality are the key problems needed to be paid attention to at present.Western Medicine has changed from therapeutic modalities from improving hemodynamics with cardiac,diuresis,vasodilator into neuroendocrine therapy.Angiotensin converting enzyme inhibitor,angiotensin II receptor antagonist,beta blockers and aldosterone antagonist are used to block RASS system and sympathetic nervous system,in order to improve the long-term prognosis of chronic heart failure.But there are still some limitations.In Chinese Medicine,deficiency of heart qi and heart yang is the basic differentiation pattern with blood stasis,water stop and phlegm.Promoting Qi and warming Yang and activating blood and promoting diuresis are the basic treatment methods.Although clinical symptoms of heart failure can be improved in short-term,warming yang blindly will rob the true yin,and hurt both yin and Yang in the end.Traditional Chinese medicine treatment of chronic heart failure often ignored the side of yin deficiency.However,heart failure is a kind of comprehensive disease,benefiting yin in long-term treatment of chronic heart failure process can not be ignored.This research collected treating data of heart failure patients of yin and yang deficiency and heart blood vessel stasis patterns based on the TCM reinforcing yang from yin theory and the modern medicine eastern Medicines requirement on the pleurosis treatment for CHF to discuss the feasibility of the TCM Yiyinzhuyang(nourishing yin to invigorate yang)method and further develop TCM treating therapies of CHF.Method:60 cases of CHF patients of yin and yang deficiency pattern according with the TCM diagnostic standards are evenly randomized into treatment group of TCM tonifying yin and yang and controlled group of western medicine standardized treatment.Both groups received the standard pharmacological therapies,including diuretic,angiotensin-converting enzyme inhibitors,beta blockers mineralocorticoid receptor antagonists and digoxin.In addition to the standard treatment,nourishing yin to invigorate yang formulas are applied single-blindly to the treatment group.Courses of treatment were both 28 days.By comparing the clinic effect of heart function,TCM diagnostic scale,heart failure scale,hemodynamic assessment,6 minute walk test,serum NT-proBNP and Minnesota Living with Heart Failure Questionnaire of the two groups before and after the trial,improvement of nourishing yin to invigorate yang method on patients' hearts can be observed.Conclusion:Combine standardized treatment against CHF with TCM tonifying yin and yang formula can further improve patients' heart function,lower NYHA classes of heart failure conditions and grade of TCM diagnostic scale and heart failure scale,improve left ventricular ejection percentage and patients' 6 minute walk distance,lower serum NT-proBNP and improve patients' living standard.Therefore,based on the Traditional Chinese Medicine "reinforcing yang from yin" theory,attention should be paid to Yin and yang deficiency for the long-term benefit of heart failure.Using tonifying Yin and Yang method to treat heart vessel blood stasis syndrome can treat both root causes and symptoms and improve the prognosis of heart failure.It can be used to repair the heart and reverse myocardial remodeling and correction of cardiac exhaustion,in order to improve the quality of life of patients,reduce heart failure readmission rate,reduce mortality.Compared with pure western medicine treatment,it has diverse advantages of multiple ways,multiple targets,less adverse reactions,enriching the TCM treatment of chronic heart failure with distinctive characteristics of the times.