| CHF is the final results on a variety of chronic cardiovascular diseases. It is very common and critical diseases harming to human health. Because of higher mutilation rate and poorer prognosis, it has become the main cause of the death and workless in patients with cardiovascular diseases. According to the survey of Epidemiology and Prevalence rate in Chinese adult population, which a total of 15 518 adults (ages from 35 to 74) were surveyed; the prevalence of CHF was 0.9 % for the general population and is becoming an important component of the public health problem in China. The mortality of the patients with CHF is related to the cardiac function (NYHA degree) and the clinical symptoms.①It has been established that the mortality in 5 years is 20% of the patients with cardiovascular diseases of cardiac function I.②the mortality in 2.5 years is 25% in patients with cardiac functionⅡorⅢ.③the mortality in 1 year is as high as 50% in patients with cardiac function IV. Improving the quality of life, prolonging life and preventing the progress of the clinical syndrome is the treatment aim of heart failure and must take long-term comprehensive measures such as the treatment of original disease and incentives, regulation of neurohumoral factors and improvement of ventricular function. The final aim is to improve exercise tolerance and quality of life, to prevent and delay the development of left ventricular enlargement, to correct hemodynamic abnormalities, alleviate the symptoms and decrease mortality and hospital admission rate. Nowadays, the strategy to deal with CHF has been radically changed from short-term haemodynamic and pharmacological way (such as Diuretics,Positive inotropic drugs and Vasodilator drugs) to long-term improvement of neurohormonal dysfunction and the remodelling of the ventricle. But improving the symptoms,reducing the cardiac load and pulmonary congestion is still a very important elements in the treatment of CHF. Nitrate drugs can expansion the peripheral venous,pulmonary artery and coronary artery directly on vascular smooth muscle. Therefore it is considered effective vasodilative drugs in the treatment of CHF. The active ingredients of Ixeris sonchifolia Hance injection which consisted of adenosine,flavonoids and isoflavones has been used in patients with ischemic cardiovascular and cerebrovascular disease. Adenosine, one of the active ingredients of the Ixeris sonchifolia hance injection, has shown a clear role not only in expanding coronary artery and peripheral vascular but also in improving myocardial and pulmonary blood supply. Inhibit the generation of oxygen free radicals and cellular calcium overload, Reduce oxygen free radicals and calcium overload- induced cardiomyocyte apoptosis, to reduce the decline of the number of myocardial cells. Adenosine also has the pharmacological effects such as promoting the generation of new capillary,restraining the proliferation and transfer of vascular smooth muscle cells,inhibiting the generation of extracellular matrix and the myocardial fibrosis, which may play a role in improving left ventricular remodeling. So far, clinical studies show that the Ixeris sonchifolia hance injection can significantly improve the dyspnea and heart function in patients with chronic pulmonary heart disease, and it also can improve the hemorrheology and microcirculation status of the patients with chronic pulmonary heart disease.Objective In this study we observe the curative effect of Ixeris sonchifolia Hance injection in the treatment of chronic heart failure by comparing with Isosorbide mononitrate injection.Methods 62 patients from the in-patient and the out-patient were randomly divided into curative group and conventional group. The conventional treatment of CHF were gived in both groups, including bed rest,low-salt diet and some drugs such as diuretics,ACEI or ARB drugs,digitalis and so on. 40ml of Ixeris sonchifolia Hance injection which was dissolved in 250ml of 5% glucose or xylitol or 25mg of isosorbide mononitrate injection which was dissolved in 250ml of 5% glucose or xylitol, were respectively gived in curative group or conventional group, once a day for ten or fourteen days. Clinical symptoms such as chest distress,shortness of breath,dyspnea and edema of both lower extremities were observed and the cardiac function of all patients in pre- and post-treatment was evaluated, according to the NYHA classification. Left ventricular ejection fraction,left ventricular end-diastolic diameter and mitral regurgitation were measured in pre- and post-treatmen by the Color Doppler ultrasonography.Result Compared pre-treatment with post-treatment in LVEF of both groups, there were significant differences (p<0.01). The LVEF of Ixeris sonchifolia Hance injection group was from 28.73±9.72% to 37.35±10.81% and Isosorbide mononitrate injection group was from 28.32±8.87 % to 35.06±10.09%. But no significant difference between groups(P>0.05). LVEDD of Ixeris sonchifolia Hance injection group was not obvious in both groups (p>0.05). Decreased from 64.42±8.13 (mm) to 64.00±7.70 (mm) (p>0.05), And Isosorbide mononitrate injection group decreased from 67.06±8.42 (mm) to 66.32±8.27 (mm) (p>0.05). There is a marked improvement in Ixeris sonchifolia Hance injection group, the mitral regurgitation decreased from 9.00±4.37(cm2)to 5.56±3.88(cm2) (P<0.01), But in conventional group the MR decreased from8.98±5.60(cm2)to 7.68±6.71(cm2)(P>0.05). And there was difference between two groups (P<0.05).Conclusion First, Both Ixeris sonchifolia Hance injection and Isosorbide mononitrate injection are effective in the treatment of chronic heart failure. There are obviously improvement on clinical symptoms and cardiac function classification. Second, LVEF of two groups was markedly improved from pre-treatment to post-treatment, but there was no difference between groups. However, the mitral regurgitation was obviously improved in Ixeris sonchifolia Hance injection group. Third, as Ixeris sonchifolia Hance injection, it is mitigative and fewer adverse reactions.Thus, it can be used as a substitude for Isosorbide mononitrate injection, when its side effects or contraindication is not underwent by patient.
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