The Curative Effect Observation Of Jian Xin Decoction Treating Chronic Heart Failure And The Effect Of TNF-α,IL-6 And Hs-CRP On Inflammatory Factors

Objective:To observe Jian Xin decoction treatment in patients who belong to Qi deficiency and Blood stasis type of chronic heart failure by clinical trials, Meanwhile to observe the influence of the serum levels of inflammatory cytokines TNF-α、IL- 6、hs-CRP in patients with heart failure. Method:Randomly dividing 33 people of the 65 patients who belong to Qi deficiency and Blood stasis into a contrast group and the last 32 people were divided into a treatment group. According to the Chinese guidelines for the diagnosis and treatment of heart failure 2014, standardized treatment was carried out for patients in both groups. The treatment group was given Jian Xin decoction in addition to the above treatment. All the patients were treated for 4 weeks. Observing the changes of serum Interleukin-6、 serum BNP、serum Tumor necrosis factor-α、serum High-sensitivity C-reactive protein levels as well as the cardiac function、Left ventricular ejection fraction(LVEF)、TCM syndrome score、Lee’ s scoring of heart failure、Minnesota Living with Heart Failure Questionnaire score、Six minute walk distance before and after the therapy in the two groups. Result:1.Clinical efficacy: Contrast of heart function:The total effective rate of heart function of the treatment group was 87.5%, the control group is 66.7%, and the results between both groups have significant statistical difference(P<0.05); Comparison of left ventricular ejection fraction: The LVEF of the two groups was significantly improved after treatment, there were statistically significant differences between before and after treatment,but there was no significant difference between the two groups after treatment. Comparison of TCM syndrome score、Lee’ s scoring of heart failure、Minnesota Living with Heart Failure Questionnaire score: After treatment, the scores of the two groups were significantly decreased, and compared with thoses before treatment, there were significant differences(P<0.01). The TCM syndrome score and Lee’ s scoring of heart failure of patients in the treatment group were lower than those in the control group(P<0.05),and the Minnesota Living with Heart Failure Questionnaire score of the treatment group were significant lower than the control group(P<0.01). Contrast of the six minute walk distances: Walking distance between the two groups after treatment were significantly longer than treatment before(P<0.01), and the treatment group was more obvious on the lengthened distance(P<0.01).2. Biochemical targets: The levels of plasma Tumor necrosis factor-α、plasma Interleukin-6、plasma High-sensitivity C-reactive protein and serum BNP were all being reduced compared with the treatment before in the two groups(P<0.01).The decline serum levels of Interleukin-6、High-sensitivity C-reactive protein of treatment group were better than those in the control group(P<0.05),and decline serum levels of BNP、Tumor necrosis factor-αof treatment group were significantly better than the contrast group. Conclusions:The Jian Xin decoction combined with conventional western medicine in the treatment of heart failure has good clinical efficacy, and its mechanism of action may be related to inhibiting the expression of inflammatory factors such as Interleukin-6、High-sensitivity C-reactive protein、Tumor necrosis factor-α,et al.