Yang Deficiency Blood Stasis Of Coronary Heart Disease Heart Failure Heart Failure Kang Therapy Clinical Research And Natriuretic Peptide And The Type Of Syndrome,

Ten patients who elder than 65 will suffer CHF among 1000 cases in America today,similar data has not been affirmed in China. Considering our backward economy andmedical condition with a big amount of population, treatment of CHF is severe. CHD is aprimary disease of CHF, its therapy obtains epoch-making achievements because of the fastprogress in interventional therapy and regular statins' application. The knowledge of CHFalso obtains a breakthrough recently, while its general mortality has no apparentimprovement according to related large scale clinical tests, and mortality of symptomaticCHF is 45% per year. Therapeutic effect of CHF has not paralleled with that of CHD.Further more, major patients have a old age, complicated accompanying diseases andsymptoms, who cannot be included in those clinical tests, so the results of evidence-basedmedicine (EBM) are limited. Precious experiences accumulated in long history of treating CHF with TCM,pharmacology study of herbs also becomes more deeply and rich, but effective and widelyadapted TCM agent is few in clinic. Modern therapy of CHF trends to its prophaselong-term survival rate and life quality, correspondingly, it is urgent and advantaged tomanufacture new agents. BNP, a new HF index with high sensibility and specificity,economical and easily tested, is valued in study of new agent and TCM objectivity. XinShuaiKang Oral drug preparation is made up of membranous milk vetch rootcommon monkshood prepared daughter root Szechwan lovge rhizome pepperweed seedand figwort, with role of Supplementing Qi Warming Yang Activating blood andPromoting diuresis, it is coincident with basic CHF pathology mechanism of TCM.According to the Guidelines for Treatment of HF with Chinese Material Medical andGuidelines For New Drug Clinical Trials(1993),we designed the clinical trials ,which wasrandomized, double blind and controlled . XinBao Pill was used as the control drug .Weundertook this study to evaluate the effects and side effects of XinShuaiKang Oral drugpreparation treating HF patient with Syndrome of Yang-Qi deficiency and blood stagnation. 48 patients were randomly devided into test group and control group on ratio of 1:1 instudy of XinShuaiKang. Treatment duration is 4 weeks. Between two groups there was nosignificant difference in age, sex, illness course and severity degree before therapy, and alsono remarkable difference in improvement of CHF integra(Lee), Cardiac function , reducinguse of Digoxin, general integra of TCM Syndromes, hemodynamics index( EF,E and E/A)and neuroendocrine index(ANP and Ang )(p>0.05), but the test drug was more efficientthan control drug in two TCM symptoms: shortness of breath with gasp and abdominaldistention(p<0.05), besides of that , ANP improved significantly in test group with gradecardiac function (NYHA) (p<0.05). Test drug was not observed be obvious and serious sideeffects.- 4 - 心衰康治疗阳虚血瘀型冠心病心衰的临床研究及利钠肽与本证型的相关性探讨90 patients were brought into cross-sectional study with the same TCM syndromes above,bivariate correlation investigation was made among BNP, ANP, EF, NYHA cardiacfunctional classification and integra of TCM syndromes, only LG(BNP)has a significant andnegative linear correlation with EF(p<0.01), no correlation was showed among rest of index.The result initially manifests that BNP is high valued on predicting and diagnosingcontractile heart failure.In summery, XinShuaiKang Oral drug preparation is effective and safe for the treatmenton HF patients with syndrome of Yang-Qi deficiency and blood stagnation; The very index ,BNP, is worth of further clinical study by extending sample statistics.