The Study Of Detoxicating And Activating Blood Method On Chronic Heart Failure Inflammatory State

Chronic heart failure (CHF) is a complex syndrome, defined as a variety of cardiovascular diseases due to long-term overloading, myocardial damage and contractile force weakened making ventricular dysfunction (decompensated). CHF Is the end stage of many heart disease and mortality is extremely high. The study of heart failure (HF) development mechanism has been the focus of the global cardiovascular disease prevention. For a century, the HF theory developed from heart and kidney doctrine, the hemodynamic theory, neuroendocrine hormones doctrine to the modern theory of ventricular remodeling. Modern molecular biology holds that HF pathology and physiological mechanisms involved in the activation of two aspects:ventricular remodeling and neuroendocrine cytokine system. Ventricular remodeling is due to a series of complex molecular and cellular mechanisms of myocardial cell structure, function and phenotypic changes, including cardiomyocyte apoptosis, cardiac hypertrophy, the embryonic gene expression and myocardial extracellular matrix quantity and composition changes. Sustained excessive activation of the neuroendocrine cell factor system is the important reason of ventricular remodeling and worsening HF. The study confirmed that inflammatory factors and HF have a close relationship:on the one hand, the development of CHF, along with TNF-alpha, a significant increase of the concentration of IL-1, IL-6and other proinflammatory cytokines; the other hand, a variety of factorsinduced increase in the concentration of these inflammatory factors can significantly increase the degree of HF, and can even induce HF. Thus, the occurrence and development of HF is a progressive process. In this process, always with neuroendocrine activation. This excessive activation also increased, while the low ventricular function from compensatory myocardial damage, and aggravate HF deterioration. At the same time, a variety of cytokines in the circulation and tissue levels also increased, together, these factors and neuroendocrine activation can damage the activity of myocardial cells and stimulate myocardial fibrosis, to promote cardiac remodeling.The pathogenesis of HF is very complex, with the in-depth understanding of HF mechanism, the treatment decision making also produced corresponding change. The blocking of neuroendocrine, cytokine system activation and myocardial remodeling between the vicious spiral treatment of CHF view has attracted many scholars'attention, although the regulation of neuroendocrine factors in the treatment of ischemic HF drugs are constantly being developed and evaluated, but further by inhibiting neuroendocrine or other body systems to improve mortality may also very far away, there is no precise method can be used for CHF interventions of chronic inflammatory state.Traditional Chinese medicine for treatment of chronic inflammation in long-term clinical practice has good clinical curative effect of traditional Chinese medicine, anti-inflammatory pharmacologic research has shifted from" overall-organ-cell" level to develop at the molecular, genetic level of traditional Chinese medicine mechanism, gradually showing relates to traditional Chinese medicine breed more, research range wider, research level higher than in the past situation. In recent years, with further elaboration of the pathogenesis of CHF, especially the emphasis on chronic inflammatory response in the CHF occurred role in the development, as well as anti-inflammatory treatment for improving the CHF clinical symptoms and the prognosis is important to help, many scholars began to re-recognize Chinese medicine treatment of CHF can be used not only the method ofæ°”and blood circulation, dieresis, can also intervene in chronic inflammatory response in CHF, in particular, the current Western medicine is no good way in this regard. And Chinese traditional medicine hairy holly has heat clearing and detoxicating and promoting blood circulation pulse-beating. Modern pharmacological research founds that it has anti-inflammatory and multiple cardiovascular pharmacological effects of ginseng tonic, with vitality, quench thirst, sedative and other effects, modern pharmacological studies have shown its active components on cardiovascular system diseases have far-reaching significance.In recent years Chinese medicine pathogenesis of heart failure tend to be consistent, i.e. heart failure for this standard is false card, virtual as Qi, Yang long, involving the heart Yang, involving the spleen, lung, kidney, as by Qi to Yang, condition gradually worsened; Standard for water resistance, phlegm, blood stasis; specimens of all disease, the actual situation mixture, heart failure is the pathological features. Treatment of Qi and warm Yang cure, promote blood circulation and water solution as the main method of treatment. Combined with previous clinical research foundation, we suggest that Chinese medicine in the treatment of CHF can not only makes use of Qi, blood, water and other traditional methods, but also can use Detoxicating and activating blood method, according to the CHF chronic inflammatory response to intervention, thereby improving the CHF clinical symptoms and prognosis.Objective1. Clinical research:western medicine (WM) to standard treatment regimens for the control, the observation of hair holly and red ginseng granules on CHF inflammatory state and its effect on CHF treatment clinical effect, discuss Yiqi Huoxue Jiedu" in the treatment of CHF in rats.2. Experimental research:Observation of hairy holly on SD rats with CHF impact of inflammatory state, further validation of hairy holly for CHF effects.Methods1.Clinical research:â‘ Randomly dividing101ambulatory and hospitalized patients with CHF into2groups, each group according to the different syndromes are divided into yin deficiency, blood stasis and Yang water stop credit deficiency, blood stasis syndrome of water stop.49cases of the control group simply use the basic treatment of Western medicine; treatment group of52cases using the conventional treatment plus traditional Chinese medicine granule (hairy holly, red ginseng), at the same time, we selected20cases of normal healthy subjects served as normal control group.â‘¡Observed before treatment and4weeks after a blood test, urine, stool routine, liver, renal function, electrolyte, blood glucose and lipids as safety index, to determine whether hair holly, red ginseng, toxic side effects.â‘¢Before treatment and4weeks after the detection of CHF patients serum high sensitive C reactive protein (hs-CRP), tumor necrosis factor alpha (TNF alpha), interleukin lbeta (beta IL-1), nuclear factor kappa B and B type natriuretic peptide (BNP) level, and carries on the comparison, were observed before and after treatment for CHF in patients with inflammatory status and functional status of the heart.â‘£The first4weeks after the treatment effect of TCM, TCM syndrome integral, heart function, traditional Chinese medicine curative effect clinical symptom score, the Minnesota heart failure score of life quality comparison, evaluation of heart function improvement.2. Experimental research:â‘ The60SD male rats were randomly divided into operation group and sham operation group, operation group48, sham operation group12. Ligation of abdominal aorta established heart failure rat model, modeling success of rats were randomly divided into4groups, respectively, hairy holly low dose group, high dose group of hair holly, captopril group and control group.â‘¡The hairy holly low dose group gavage hairy holly10g/kg/D; hairy holly high dose group gavage hairy holly20g/kg/D; western medicine control group fed with captopril in100mg/kg/D; blank control group and sham operation group gavage ns2ml/d.â‘¢The groups were gavage for2weeks after transthoracic ultrasound heartbeat graph, line detection, the rat arterial blood centrifuge serum, using Elisa enzyme immunoassay kit for determination of serum interleukin lbeta (beta IL-1), nuclear factor kB target and carries on the comparison, the observation of hair holly on the SD rats with CHF inflammatory status and effect of heart function.Results1. Clinical research:â‘ Of heart failure in patients with serum hs-CRP, TNF A, IL-1, NF Beta Kappa B and plasma BNP levels were significantly higher than those in healthy population (P<0.05), and with the severity of heart failure the index rises further.â‘¡Two groups of patients after treatment, serum hs-CRP, TNF-A, IL-1, NF Beta Kappa B and inflammatory factor level, plasma BNP levels were significantly decreased, compared with before treatment, the changes were statistically significant (P<0.05), the two groups before and after treatment of every index value comparison, the difference has statistical significance (P<0.05). Before and after treatment in two groups of patients with different types of serum hs-CRP, TNF-A, IL-1, NF Beta Kappa B and plasma BNP level comparison shows, the treatment group two syndromes after each treatment index lower than those before therapy, the changes were statistically significant (P<0.05).â‘¢The conventional treatment of Western medicine are added on the basis of Chinese holly and red hair, can improve heart function, significantly reduce the efficacy of Chinese medicine symptom integral, the Minnesota heart failure score of life quality, compared with the control group had statistical significance (P<0.05).2.Clinical research:Chinese traditional medicine by gavage hairy holly CHF rats serum IL-lbeta, NF kappa B levels were significantly lower than those in the control group, the difference has statistical significance (P<0.05). The heart color surpasses the related indicators, gavage of hair holly CHF rat left ventricular diastolic diameter (LVDd), left ventricular systolic diameter (LVDs), ejection fraction (EF), fractional shortening (FS) and other groups than between groups, the difference was significant (P<0.05).Conclusion1. CHF process in the presence of immune and inflammatory system activation in patients with CHF, serum inflammatory factor hs-CRP, TNF-A, IL-1, NF kappa B levels were significantly higher than normal group.2.CHF patients serum inflammatory factor hs-CRP, TNF-A, IL-1, NF kappa B levels with the severity of HF (elevated plasma BNP level) and elevated during CHF, indicating systemic inflammatory activity.3. Hairy holly and red ginseng can improve the different syndrome type of CHF in patients with cardiac function and TCM syndromes, alleviate the clinical symptoms, the animal experimental verification of hair Holly can relieve the inflammatory status in patients with CHF.4.Detoxicating and activating blood method can improve CHF inflammatory state, improve clinical symptoms and prognosis of CHF.