The Efficacy Of Shenmai Injection Combined With Atorvastatin On Coronary Heart Disease Patients With Chronic Heart Failure

Coronary heart disease, CHD, mainly due to coronary atherosclerotic lesions incoronary artery and lead to stenosis, occlusion, effect on coronary flow, Causemyocardial ischemia and hypoxia in heart disease, chronic heart failure of coronary heartdisease is the most common manifestation.。Clinical research identified, inflammation plays a very important role in the startof a variety of cardiovascular disease, progression and clinical events occurred. Statins ascarboxymethyl coenzyme A reductase inhibitors, has blood lipid regulation, can also belowered angiotensin receptor expression, reduce endothelin synthesis, inhibition ofNF-κB activity, reduce endothelial adhesion molecules expression, increasing NOsynthesis, to reduce the generation of oxidative stress in the material, to inhibit thecomplement complex-mediated endothelial injury, played the anti-inflammatory and toimprove vascular endothelial function. Thus delaying the process of coronary heartdisease with chronic heart failure and reversal of ventricular remodeling, protect andimprove the patient’s heart function.chronic heart failure of coronary heart disease has been one of the hot Chinesemedicine research. Chronic heart failure of coronary heart disease belongs to theChinese" palpitation, chest pain, dyspnea card ". Shenmai injection is the injection madefrom a traditional Chinese medicine ancient prescription "Shengmaisan " with modernscience and technology. Shenmai injection can effectively improve cardiac function,improve patients’ quality of life and reducing the severity of cardiac events. However, Shenmai injection of clinical efficacy and safety of coronary heart disease with chronicheart failure is controversial, besides, there are few reports about the treatment ofcoronary heart disease with chronic heart failure with atorvastatin.ObjectiveObserve the relationship of the changes and the onset of coronary heart diseasepatients with chronic heart failure of hs-CRP, TNF-a levels, To evaluate the effect and thesecurity of Shenmai Injection Combined with Atorvastatin on CHD Patients withChronic Heart Failure.Data and methodsA total of120patients with Chronic Heart Failure of CHD treated in our hospitalfrom June,2011to December，2011were divided randomly into A、B、C three groups，Group A received conventional treatment including diuretics, aspirin, B-blockers,angiotensin-converting enzyme inhibitors,and soon，B group treated with atorvastatin40mg besides conventional therapy. C group in the B group based on treatment withShenmai Injection.The Cardiac function，6-minute walking test，Clinical signs andsymptoms score (Lee) and Chinese determine and echocardiographic indice wereevaluated before therapy,after2-week therapy.And the levels of high-sensitivityC-reactive protein(hs-CRP),tumor necrosis factor–a （TNF-a）,brain natriureticpeptide(BNP) and Incidence of adverse reactions were observed.Results(1) Before treatment，three groups patients6min walk test, biochemical testing of theindicators and cardiac color Doppler ultrasound indicators was no significantdifference (P>0.05).(2) compared with before treatment, after treatment in eachgroup6min walk test walk distance was significantly prolonged (P <0.05), biologicaland chemical detection and other indicators of observation decreased significantly (P<0.05), LVEF, LVESD were LVEDD improvement is not significantly (P>0.05); B,C treatment in both groups after the6min walk test distance walked extension thangroup A more significant (P <0.05), biochemical detection and observation of indicators decreased compared with group A more obvious (P <0.05); comparedwith group B, group C after treatment,there are no significant changed in the level ofbiochemical detection and observation of indicators (P>0.05),6min walk testdistance walked was significantly prolonged (P <0.05).(3) after treatment B and C ’scardiac function to improve, the total efficiency was significantly higher than groupA (P <0.05); Group C of the clinical signs and symptoms score (Lee), the totalefficiency is higher than A, B (P <0.05); B and C of Chinese determine observed, thetotal were significantly higher than group A (P <0.05),group C is higher than groupB (P <0.05). the Incidence of adverse reactions, three groups during the treatmentof patients with no significant difference (P>0.05).ConclusionCoronary heart disease with chronic heart failure patients with elevated levels ofhs-CRP, TNF-a, and declined as the condition improved, suggesting that inflammationmay play an important influence on the development of coronary heart disease withchronic heart failure. Shenmai injection combined with atorvastatin on coronary heartdisease in patients with chronic heart failure have a good therapeutic effect, safety,worthyof promotion and application.