| Objective: To observe the clinical effect of Guizhi Yangxin capsule in treatment ofchronic congestive heart failure, and explore its mechanism of treatment on chronic heartfailure, the thesis provides objective basis for traditional Chinese medicine in the treatment ofthis disease.Methods: Randomly divided69chronic heart failure patients who were matchedinclusive criteria into treatment group35cases and control group34cases. The two grouppatients had no significant difference in sex, age, weight and duration of illness, disease orother general information. The patients in control group were given the foundmental treatmentrecommended by The Chinese medical association cardiovascular branch of the guide ofdiagnosis and treatment of chronic heart failure in2007, while treatment group was given thesame medicine combined with Guizhi Yangxin capsule, three capsules each time, three timesa day. After four weeks，two groups were observed before and after treatment in patients withsymptomatic integral, NYHA cardiac function grading, BNP, ultrasonic Heartbeat graphincluding LVEDD, LVESD and LVEF，heart rhythm variability including SDNN, SDANN,RMSSD and PNN50indexes, and security indicators including blood, urine, liver function,kidney function, thus the clinical efficacy can be judged.Results:(1) Comparison of the main syndrome score: the total effectiveness of thetreatment group was80.00%, while that of control group was66.67%. The difference of theeffectiveness between the two groups by rank sum test was statistically significant (P<0.05);The total symptom score of the treatment group was better than the control group. And theindividual symptom scores were also respectively compared between the treatment group andthe control group in the aspects of heart palpitations, shortness of breath, fatigue, chesttightness, edema, oliguria and other symptoms which had significant differences (P<0.05),while there were no significant difference in dyspnea and pulmonary rales (P>0.05).(2) Comparison of heart function improvement: the total effectiveness of treatment groupwas63.33%, while that of control group was53.33%. There was significant differencebetween two groups (P>0.05).(3) Comparison ofBNP levels improvement: BNP levels decreased after treatment in thetwo groups. There were significant differences in the groups (P<0.05); there were nosignificant difference between the two groups (P>0.05).(4) Comparison of ultrasonic heartbeat graph improvement: LVESD, LVEDD decreasedafter treatment in the groups, and there were no significant differences in the groups (P>0.05), and no statistically significant differences between the two groups (P>0.05). After treatment,LVEF had increased trend (P<0.05), and no statistically significant differences between thetwo groups (P>0.05).(5) Comparison of HRV: SDNN, SDANN, RMSSD and PNN50has an increasingtendency, but the improvement of them was no significant difference (P<0.05). Comparedtwo groups: the improvement of SDNN and SDANN of treatment group were moresignificant than those of control group (P<0.05); but the improvement of RMSSD and PNN50of two groups were not different (P>0.05).Conclusions：Guizhi Yangxin capsule can improve the symptoms of patients with heartfailure by Nourishing Qi and activate blood circulation, strengthening Yang-qi, decrease thelevel of BNP and increase left ventricular ejection fraction, thereby improving cardiacfunction. Guizhi Yangxin capsule can improve autonomic nervous function in patients withheart failure by level of yin and Yang. But the specific mechanism needs further experimentalstudy to verify. |
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