A Randomized Controlled Trial Of Astragalus Injection In The Treatment Of Patients With Acute Decompensated Chronic Heart Failure And Qi-deficiency

The first part-documentation studyThis paper provides an overview of the following aspects:1 The current Situation of medication in heart failure.2 Serum Protein Markers correlated to heart failure:BNP,hsCRP,cTnI,MMP-9.3 Another heart function index -TEI index.4 The study progress about Astragalus injection used in heart failure.The second part-experiment studyOBJECTIVES1 To observe the clinical efficacy of Astragalus injection in treating acute decompensated chronic heart failure(DCHF).2 To discuss the influence of Astragalus injection to the Serum Protein Markers correlated to heart failure and the correlation of the Serum Protein Markers and DCHF.3 To observe the influence of Astragalus injection to the traditional Chinese Medicine(TCM) symptoms and syndromes of DCHF patients with Qi Deficiency.METHODS118 cases with DCHF and Qi Deficiency were randomly assigned to receive conventional therapy(control group)or conventional therapy plus Astragalus injection(treatment group).After 7 days observations,The therapeutic efficacy and adverse reactions were compared between the two groups.RESULTS1 There were significant differences between 2 groups in LVEF(P=.003), dyspnea situation(P=.002),cardiac function grade improvement(P=0.044) and Tel index(P=0.035) In treatment group showed better improvement than in control group.2 About the improvement of TCM symptoms,There were significant differences between 2 groups in cardiopalmus(P=.003).In treatment group showed better improvement than in control group.3 There were significant differences between 2 groups in cTnI(P=.041).In treatment group showed better improvement than in control group.That means Astragalus injection afect myocardium of patients with heart failure protectively.So Astragalus injection can help relief damnification of myocardium cells in patients with heart failure.4 Results of regression analysis show that MMP-9 is corelated with classification of heart function(P=.001) and BNP (P=.026).That means MMP-9 is corelated with heart failure.After medication, MMP-9 in patients with heart failure declined(P＜0.01),which means the degree of ventricular remodeling could be improved by medication.5 the different characteristic of Qi Deficiency syndrome,Qi-Yin Deficiency Syndrome,Qi-Yang Deficiency Syndrome in DCHF patients include the following aspects:dilated cardiomyopathy patients always have Qi-Yang Deficiency Syndrome.ln the three syndromes,the degree of heart failure is most serous in Qi-Yang Deficiency Syndrome.6 After medication,Qi Deficiency syndrome and Qi-Yang Deficiency Syndrome changed,some subjects with Qi Deficiency Syndrome turned to with Qi-Yin Deficiency Syndrome,some subjects with Qi-Yang Deficiency Syndrome turned to with Qi Deficiency Syndrome,There were no significant differences between 2 groups in changes of Syndrome(P＞0.5).7 There was no adverse Event and adverse reactions to drug happened.Conclusions1 In this examination,we compared Astragalus injection with 5%glucose injection in the efect to DCHF,the result showed that Astragalus injection can effectively improve heart function in DCHF patients.2 In the examination,we compared Astragalus injection with 5%glucose injection in the security,the result was no Adverse Event happened,which showes that Astragalus injection has good security.3 MMP-9 is corelated with heart failure.MMP-9 in in patients with heart failure declined after medication,which means the degree of ventricular remodeling could be improved by medication.4 except for dyspnea,Astragalus injection also can help improve other symptom of DCHF such as cardiopalmus.5 In Qi Deficiency Syndrome,Qi-Yin Deficiency Syndrome and Qi-Yang Deficiency Syndrome.dilated cardiomyopathy patients always have Qi-Yang Deficiency Syndrome.In the three syndromes,the degree of heart failure is most serous in Qi-Yang Deficiency Syndrome.6 After medication,Yang Deficiency Syndrome may be improved even completly remissed and turned to Qi Deficiency Syndrome;After medication,Yin may be injured in DCHF patients.