| Dilated cardiomyopathy is a common type of cardiomyopathy, is a kind of left ventricular expansion accompanied by decreased systolic function cardiomyopathy characterized.Without the name of "DCM" in ancient books of traditional Chinese medicine, according to clinical mainly belongs to "obstruction" of traditional Chinese medicine "palpitation" "gasping syndrome" "drink" and "edema" category.DCM results in the decrease of left ventricular systolic function, progressive heart failure and ventricular arrhythmia and room on sex, abnormal conduction system, thromboembolism, and sudden death, is the third cause of heart failure.All patients with dilated cardiomyopathy from all over the world.Because of the increase in knowledge discovery the incidence, morbidity and mortality of the disease has increased trend, and a high incidence of tropical and subtropical regions, individual regions the disease of heart first.Is little information about the disease incidence and prevalence, therefore the true incidence and prevalence is unknown.On the basis of pathology of DCM, with the continuous progress of progressive congestive heart failure, cardiac function is declining, the whole body each system will be affected, and western medicine, there is no special prevention and cure, treatment principle is congestive heart failure and various kinds of arrhythmia and prevention of pulmonary and systemic embolism, extend the life of the patients. In the process of western medicine in the treatment of DCM can produce all kinds of adverse reactions, such as ACEI and ARB often worsening renal function, spironolactone can result in hyperkalemia. That limits the western medicine for the treatment of heart failure.At present, the domestic have been some reports of traditional Chinese medicine treatment of dilated cardiomyopathy, such as using the evergreen, ginseng, aconite, radix astragali, etc have strong heart effect of traditional Chinese medicine for the treatment of dilated cardiomyopathy, most have achieved satisfactory results. For DCM the limitations of modern medical treatment, can be appropriate to join the traditional medicine, combine them organically, in order to better improve the clinical symptoms, improve the quality of survival, even in reverse, it is very valuable research direction.This experiment adopts the method of combination of syndrome differentiation and disease, according to the theory of TCM syndrome differentiation and treatment, on the basis of the standardized treatment of western medicine, with "yiqi, explored, invigorate the circulation, water" for the principle, from Chinese traditional medicine prescription to justify heart kidney deficiency, blood stasis patients with water stops for the combination of Chinese and western medicine treatment, in order to investigate the clinical curative effect for the treatment of the disease.Objective:Temperatures were observed on the basis of standardized treatment of western medicine for reasons Yang invigorate the circulation of the water treatment of dilated cardiomyopathy heart kidney deficiency, blood stasis water stops the patient’s clinical curative effect.Methods:This experiment adopts the principle of random, strictly abide by the diagnosis and inclusion criteria and were shijiazhuang great wall heart hospitalized patients with combined Chinese and western medicine hospital, a total of 120 cases.All accord with dilated cardiomyopathy, heart failure, diagnostic criteria, condition accord with NYHA heart function classification Ⅱ- level of DCM patients.Conform to the requirements of the 120 patients Ⅲwere randomly divided into 2 groups. Treatment group(60 cases, the male 47 cases, 13 cases of female;Aged 21 to 62 years old, average 43.51 ±11.23 years old; Course of most elderly people 16 years, minimum 1 year,24 cases of cardiac function grade cardiac Ⅱ function, level 36 cases;Control group 60 Ⅲcases, 43 cases of male, female 17 cases; Age age 24-66(44.73 ±13.96 years);Course of most elderly people 15 years, minimum 1 year, cardiac function level 26 cases, cardiac function grade 34 cases.General daⅡ Ⅲ ta to compare the two groups no significant difference(P> 0.05), comparable.All into the group of patients according to the condition to give rest, limit water and sodium intake. Standardization of the control group given conventional western medicine treatment, namely, dilate blood vessels, diuresis, cardiac, improve the treatment such as ventricular remodeling, given in the control group given cefuroxime Sammy, spironolactone, without perindopril captopril and metoprolol, digoxin, according to the different degree of patients take into consideration the adjustment of individual treatment; Based on the same standardized treatment, the treatment group to add with the yi Yang invigorate the circulation of the water temperature,Prescription: radix astragali 30 g dangshen 30 g atractylodes poria cocos 10 g, 10 g of semen lepidii 30 g epimedium 15 g cassia twig 10 g angelica semen plantaginis 15 g, 10 g leonurus 30 g.A dose of the decoction 300 ml, two in the morning and evening.Is one period of treatment groups were observed treatment 4 weeks. Between groups in treatment were measured before and after the blood, urine, stool routine, liver function and renal function, plasma brain natriuretic peptide(BNP), walking distance, the application of color doppler ultrasound to determine left ventricular ejection fraction(LVEF), cardiac output(CO), early diastolic filling velocity(E), late diastolic filling velocity(A), left ventricular diastolic early and late maximum blood flow ratio(E/A), etc.Results:1 after treatment, the treatment group of 60 cases of patients, 39 cases were markedly effective, effective in 16 cases, 5 cases failed, the total effective rate 91.66%, control group of 60 cases of patients, 30 cases were markedly effective, effective 20 cases, 10 cases of invalid, total effective rate 83.33%, two groups in terms of total treatment, treatment group was significantly higher than the control group.2 Walking distance before and after the treatment the two groups are obviously improved, and the treatment group compared with the control group increased more obviously, statistically difference.3 Through comparison between groups to compare the EF, A value have bigger difference(P< 0.01 or P< 0.05), and CO, between E and E/A no significant difference(P> 0.05).4 Two groups of patients before and after the treatment of the comparison of plasma BNP levels were statistically significant(P< 0.05), the comparison between the group after treatment was statistically difference(P< 0.05).5 The experimental group, 2 cases of mild diarrhea during treatment, symptomatic treatment after improving. Comparison before and after the treatment group and control group patients’ blood, urine, stool routine, liver and kidney function were not abnormal changes.Conclusion:From yi Yang invigorate the circulation of the water temperature side and regular western medicine to control the clinical symptoms of heart failure patients, improve heart function, make the shrink, expand the heart can be more effective in reducing the BNP, improve the 6 minutes walking distance of patients, improve the quality of life have certain effect, no significant side effects, and combine traditional Chinese and western medicine treatment curative effect is superior to pure western medicine treatment. |
PDF Full Text Request