Effect Of Shenfu Injection On Patients With Acute Decompensated Heart Failure

BackgroundsHeart failure is a clinical syndrome characterized by typical symptoms(e.g.breathlessness,ankle swelling and fatigue)that may accompanied by signs(e.g.elevated jugular venous pressure,pulmonary crackles and peripheral edema)caused by a structural and/or functional cardiac abnormality,resulting in a reduced cardiac output and/or elevated intracardiac pressure at rest or during stress.It is the end and severe stage of various cardiac disease,which has high incident and is one of the most important cardiovascular diseases.Heart failure is classified according to different criterias.Taking time,speed and severity into account,it can be divided into chronic heart failure and acute heart failure.Symptoms and signs gradually appear in chronic heart failure patients on the basis of chronic heart diseases.If the symptoms and signs don not advance,heart failure is considered to be stable.Otherwise decompensated heart failure develops.And acute heart failure is known as the decompensated heart failure happens in short time.Another form of acute heart failure is a new heart failure caused by acute heart disease.Both of the two forms are belong to acute decompensated heart failure(ADHF).For patients with ADHF,conventional western medicine therapy is not very effective,and the mortality is still high.It is imperativeto seek new approach to improve the plight of ADHF.In recent years,the related study is endless,numbers of new drugs and new programs continually apply to clinic patients,including CRT,ICD,and so on.But because of high cost,or other reasons,these new drugs or technology did not target the satisfactory goals.So,we intend to find a different way to solve the problem.Tradition Chinese medicine have been used to treat variety diseases thousands of years ago.For heart failure,Chinese medicine aims to active the blood circulation,drain off water,and warm yang.The ancient prescription "Shenfu Decoction ",mainly composed of red ginseng and black aconite,can solid qi and have been used to treat HF as early as thousands of years ago.Shenfu injection originated from Shenfu decoction,which is refined by modern technology,and may have an unexpected effect on ADHF.Therefore,this study Is designed to observe the clinical effect of Shenfu Injection on patients with ADHF.ObjectiveThe study aims to observe the efficacy and safety of Shenfu injection on patients with ADHF and investigate the mechanism.MethodsA prospective randomized and controlled study was carried out from October2014 to August 2015.100 patients with ADHF were randomly divided into control group and Shenfu group,with 50 patients in each group.All patients received the conventional treatment,and the Shenfu group also received Shenfu injection(100 ml5% glucose injection + 80 ml Shenfu injection)for 10-14 days.Before and after treatment,we detect the plasma level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)?cardiac Troponin T(c-TNT)?interleukin-6(IL-6)?interleukin-8(IL-8)?interleukin-10(IL-10)?tumor necrosis factor-?(TNF-?)and record the left ventricular ejection fraction(LVEF)?left ventricular end diastolic volume(LVEDV)?fraction shortening(FS)of all patients.Besides,we evaluate the improvement of New York Heart Association(NYHA)classification and observe the 6-minute walk distance(6-MWD)after treatment.We also observe the side-effects of Shenfuinjection.Results1 After treatment,the NYHA classification and the 6-MWD had a better improvement in Shenfu group(P=0.027,0.043);2 The Shenfu group has a more significant change about the observation indexes: the decreased indexes including NT-proBNP?c-TNT?IL-6?IL-8?TNF-??LVEDV(P=0.047,0.039,0.010,0.011,0.023,0.046);and the increased indexes including IL-10?FS?LVEF(P=0.020,0.038,0.021);3 Shenfu injection has some side-effects,such as rash,headache.ConclusionShenfu injection can improve the cardiac function of patients with ADHF.The mechanism may be that Shenfu injection can decrease the proinflammatory factors(IL-6 ? IL-8 ? TNF-?)and increase the anti-inflammatory factors(IL-10).Besides,Shenfu injection can cause some side-effects.