| Objective1.To observe the influence of Yi An Ning Wan on the level of LVEF value and BNP concentrations of RHF patients.And to observe its effect on the sympathetic nervous system (SNS) and renin angiotensin aldosterone system (RAAS).2.To observe the clinical effect of Yi An Ning Wan on the treatment of RHF;To seek the possible modern physiological and pathological mechanisms and pave the way for the further experimental and clinical studies of Yi An Ning Wan.3.To investigate the treatment philosophy of "strengthening treatment of heart and kidney, balance of yin and yang, conditioning gas and blood; and elimination without damage blood stasis due to resistance and water retention"value in the treatment of RHF.And to provide new traditional Chinese medicine intervention for RHF treatment.MethodsSelect60patients who were standardized anti-heart failure treatment, but their clinical symptoms and signs still no improvement or worsen, LVEF≤40%of the RHF as research subjects,30cases were randomly divided into experimental and control groups. Control group were treated by the standardized treatment of "Diagnosis and treatment of chronic heart failure guide" in2007. And the experimental group were given the western medicine treatment combine with Yi An Ning Wan (oral,2times a day,10pills at a time).After eight weeks of treatment, left ventricular ejection fraction (LVEF). plasma BNP concentration,NYHA grade and heart failure credits were performed before and after treatment, and to observe the change of plasma renin activity and24-hour average heart rate.Analysis the resulting data,to investigate the clinical efficacy of Yi An Ning Wan on the treatment of RHF.ResultsThe level of LVEF value,BNP concentration,NYHA grade,heart failure credits,24-hour average heart rate,PRA and Angll concentration after treatment in both groups was improved than that before treatment,which has a statistically significant difference(P<0.05).After treatment,comparing two groups of patients with the LVEF value,BNP concentration,NYHA grade and heart failure credits;the experimental group was improved than the control group,which has a statistically significant difference(P<0.05).The value of LVEF was negative correlation with the grade of NYHA,and the level of BNP concentration was positively correlated with the grade of NYHA.The value of LVEF and the level of BNP concentration were negatively correlated,but the correlation is not strong. 1.Before treatment,compared the baseline levels of the patients’general condition (including age,duration,gender,underlying diseases),LVEF value,BNP concentration, NYHA grade,heart failure credits,24-hour average heart rate,PRA and Angll concentration;there was nostatistically significant (P>0.05).Therefore, the two groups were comparable.2. After8weeks of treatment,the efficacy of cardiac function assessment results suggest that the total effective rate in the treatment group was76.67%and56.67%in the control group, which has a statistically significant difference (P<0.05).3.The value of LVEF after treatment in both groups was improved significantly than that before treatment,which has a statistically significant difference (P<0.05).After treatment,there was significant difference in the values of LVEF between groups(P<0.05).there was also significant difference in the differences value of LVEF value(P<0.05).4.The level of BNP concentration after treatment in both groups was declined significantly than that before treatment,which has a statistically significant difference (P<0.05).After treatment, there was significant difference in the level of BNP concentration between groups(P<0.05). There was significant difference in the differences value of the level of BNP concentrations(P<0.05).5. After treatment,there was significant difference in the level of heart failure credits between groups (P<0.05);there was also significant difference in the differences value of the level of heart failure credits (P<0.05).6.The level of average HR,PRA and AngⅡ concentration after treatment in both groups was declined than that before treatment,which has a statistically significant difference(P<0.05). After treatment,there was no significant difference in the level of average HR,PRA and Angll concentration between groups(P>0.05).And there was no significant difference in the differences value of level of average HR,PRA and AngII concentration(P>0.05).After treatment, the value of LVEDD was no significant difference between groups(P>0.05).7.The correlation analysis showed that the value of LVEF was negative correlation with the grade of NYHA,and the level of BNP concentration was positively correlated with the grade of NYHA.The value of LVEF and the level of BNP concentration were negatively correlated,but the correlation is not strong.Conclusion1.Experimental group on the basis of western medicine standardized treatment plus Yi An Ning Wan can increase the patients’left ventricular ejection fraction,lower BNP levels,and better than western medicine. RHF patients with low LVEF and high BNP level can be used as an objective indicator of the use of Yi An Ning Wan.2.After treatment,there was no significant change in the24-hour average heart rate and PRA, Angll concentration.It can be seen that Yi An Ning Wan can improve cardiac output of RHF patients,the modern mechanism wasn’t through activation of the sympathetic nervous system (SNS) and (or) excited renin angiotensin aldosterone system (RAAS).3.Yi An Ning Wan not only improve the RHF patients with LVEF values and BNP levels,but also be effective in improving the patient’s clinical symptoms and signs (including fatigue, weakness, chest tightness, difficulty breathing, limb swelling, etc).It can improve the patient’s activity tolerance, and improve patients’quality of life. The study did not see a significant toxic side effects.The drug is safe.4.It could reflect the overall treatment philosophy of Yi An Ning Wan in the RHF Chinese medicine treatment. Yi An Ning Wan play in medicine multi-link,multi-channel,multi-target healing advantages.It may provide a new pharmaceutical intervention program for RHF treatment. |
PDF Full Text Request