Clinical Observation On The Therapeutic Effects Of Treating Phlegm-blood Stasis Syndrome Type Of Chronic Congestive Heart Failure By Yi-Xin Decoction

Objective:Observation on changes pre and post treatment in the clinical manifestations,traditional Chinese medical syndrome(TCM syndrome),NYHA cardiac functional grading and markers reflecting cardiac function such as 6 minutes walking test(6MWT),plasma levels of B-type natriuretic peptides(BNP),and left ventricular ejection fraction(LVEF) of patients with phlegm-blood stasis syndrome type of chronic congestive heart failure(CHF) treated by Yi-Xin Decoction,so as to evaluate its clinical curative effects.Methods:60 patients with phlegm-blood stasis syndrome type of CHF chosen to this study were divided into the Yi-Xin Decoction therapy group(The treatment group) and the regular western therapy group(the control group) by a random,controlled and single blind method.The control group was given hydrochlorothiazide 12.5-25mg qd or bid,antisterone 20mg qd,enalapril 5-10mg bid or losartan 50-100mg qd,betaloc 12.5-25mg qd or bid,digoxin 0.125-0.25mg qd;and the Yi-Xin Decoction was added into the treatment group based on medicines of the control group.The treatment duration was two weeks.To observe changes of symptoms and physical signs,traditional Chinese medical syndrome,NYHA cardiac functional grading,6MWT,BNP and LVEF before and after treatment,and the therapeutic effects were going to be evaluated after the therapeutic period of the treatment was over.Results:1.Comparison of the curative effects of TCM syndrome,heart function and 6MWT before and after treatment between two groups:The total effective rates of the treatment group were 90.00%,86.67%and 83.33% respectively,and the control group were 83.33%,76.67%and 73.33% respectively.The treatment group was superoir to the control group (P＜0.05).2.Comparison of the heart function before and after treatment 4.17±1.56 and 6.10±1.90,there were significant difference between two groups(P＜0.05).3.Comparison of the levels of BNP before and after treatment: The levels of BNP of the two groups were obviously decreased compared with themselves(P＜0.05),and there were also significant difference between two groups(P＜0.05).4.Comparison of the levels of LVEF before and after treatment:The levels of LVEF of the two groups were not significantly reduced in comparison with themselves(P＞0.05),though the levels of LVEF of the two groups manifested increasing trend separately.5.One patient in the treatment group appeared nausea and another patient in the treatment group appeared bitter-mouth,these undesirable effects didn' t affect on their continuing taking medicine.In the control group,two patients appeared light dry cough and this untoward effect disappeared after changed enalapril into losartan;one patient appeared sinus bradycardia,and this unwanted reaction disappeared after the dose of betaloc was reduced.Conclusions:The General clinical curative effect of the Yi-Xin Decoction therapy group was superior to the regular western therapy group for treating phlegm-blood stasis syndrome type of CHF.It was a safe and effective drug in improving heart function,TCM syndrome,6MWT and the level of BNP of patients with phlegm-blood stasis syndrome type of CHF.Hence,it was well worth to clinical studying further.