| The chronic congestive heart failure(CHF) is defined as the heart is unable to pump blood at a rate commensurate with the requirements of the metabolizing tissues or can do so only at an elevated filling pressure. Although usually caused by a slowly developing intrinsic deficit in myocardial contraction, a similar clinical syndrome is present in some patients with heart failure caused by conditions in which the normal heart is suddenly presented with a load that exceeds its capacity(e.g., fluid overload, acute myocardial infarction, acute valvular dysfunction) or in which ventricular filling is impaired. CHF is common and often recurrent condition with a poor prognosis. The 5-year-survival rate is about 40~60%, and 10-year is 10~30%. According to the development of the mechanism of heart failure: in 1950s, the hypothesis that hemodynamics changes when heart failure occurs; in 1990s, the hypothesis that neuroendocrine disorder when heart failure exists; and, now, the level of the molecule and the cellule changes when heart failure occurs and develops, the therapy has been changing--- from the short term releasing the symptoms therapy to long term repairing the neuroendocrine dysfunction. Addition to the level of treating hypertension, coronary heart disease, et al is improved; the incidence of CHF is higher. And the present therapy has some complications, side effects and the tolerance of drugs. For example, taking the diuretic for a long term can cause electrolytes disorder, especially hyponatremia and kaliopenia. There are some researches demonstrating that hyponatremia is the independence forecasting factor of rehospitalization and mortality increasing. We know that the kaliopenia can cause the sudden death due to heart failure. For other examples, ACEI can induce to cough, then patients withdraw; patients can't tolerance the hypotension which caused by nitrate, ACEI/ARB,βreceptor blocker, diuretic, et al; digitaloid drugs, nitroprusside sodium, et al are easy to induce intoxation; the statins can damage muscle, liver, kidney, et al. All above factors and others restrict the therapy of CHF. Nevertheless, the traditional Chinese medicine obviates these to some extent. For the example of Qiliqiangxin capsule, it has the cardiotonic role, the role of diuresis and dilating vessels, and it can reserve the serum Na+. So as while as it play the above roles, it can lessen the drug side effect (e.g. electrolytes disorder).Objective: To evaluate the clinical effects of Qiliqiangxin capsule in chronic congestive heart failure (CHF).Methods: A total of 64 CHF patients were randomly enrolled in this study; and out of this number, 51.6% (33) received Qiliqiangxin capsule orally (therapy group) for more than two weeks while 48.4% (31) didn't receive the drug (control group). All the 64 CHF patients received the same treatment according to the CHF therapy guideline. In the therapy group the patients took Qiliqiangxin capsule (4#, tid, p.o.) from the first day after they came to the hospital. During the treatment, body weight, urine output, sweat secretion and 6 min walking distance were observed in the two groups. The dosage of cedilanid and furosemide for the first week and second week in the two groups was analyzed. And electrolytes(including Na+, K+) on the second day, the eighth day, and the fifteenth day after patients came to the hospital between 2 groups were analyzed. During the treatment, the side-effect and compliance were observed.Results: The basement data including age, sex, the types of the disease, the course of the disease and the degree of cardiac insufficiency are no significant differences between the two groups statistically(P >0.05). When they came to the hospital, there is no significant differences about the general conditions between the two groups patients statistically(P >0.05). The general conditions include body weight, urine output, sweat secretion and 6min walking distance. One week later, in both groups, sweat secretion was better than before, but the therapy group was better than the control group(P <0.05); the urine output was more than that before (P <0.05), and there is no significant difference between two groups(P >0.05); body weight became less, and there is a significant difference statistically(P <0.05), but there is no significant difference between two groups(P >0.05); 6 minutes walking distance was better than before, but there is no significant difference between two group(sP >0.05). Two weeks later, in both groups, sweat secretion and the urine output were more than that before; body weight became less; 6 minutes walking distance was better than before. All these differences are significant differences statistically(P <0.05). And there are significant differences about sweat secretion,urine output and 6 minutes walking distance between two groups statistically(P <0.05); about body weight between two groups there is no significant difference statistically(P >0.05). There are no significant differences about the dosage of lanatoside C and furosemide in the first and second week between two groups statistically(P >0.05). There are no significant differences about the levels of serum Na+ and K+ on the second day after patients came to the hospital between the two groups statistically(P >0.05). On the eighth day, the level of serum Na+ is lower than before, there is a significant difference(P <0.05 )in both groups. There are no significant differences about the levels of serum Na+ between the two groups statistically(P >0.05). And the level of serum K+ has no significant difference in and between the two group(sP >0.05). On the fifteenth day, there is almost no change about the level of serum Na+ of the therapy group compared with that in the end of the first week(P >0.05); on the contrary, there is a significant difference about the level of serum Na+ of the control group statistically(P <0.05). And there is a significant difference about the level of serum Na+ between two groups statistically(P <0.05). And the level of serum K+ still has no significant difference in and between the two group statistically(P >0.05). During the period of using the capsule, the 33 patients have not any uncomfortable complain about this drug and nobody stop using this capsule.Conclusion: The effect of Qiliqiangxin capsule about releasing hyperidrosis is conspicuous. It can play the role in a short time. There is no obvious effect on body weight. The short-term effects of Qiliqiangxin capsule about improving urine output and 6 minutes walking distance are not significant, but it palys this role during the second week gradually. Qiliqiangxin capsule can't reduce the dosage of cedilanid and furosemide. Qiliqiangxin capsule has the effect of keeping the level of serum Na+ to some extent. During the observation, the tolerance of this capsule is good, and there is no side effect observed. |
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