| Objective Research the clinical effect of Traditional Chinese Medicine(TCM) treating chronic heart failure.Observe the relation of TCM syndromes with neuroendocrine factors and heart rate variability.Methods Randomly divided79chronic heart failure patients who were matched inclusive criteria into treatment group38cases and control group41cases.Patients in control group were given routine treatment of western medicine. Treatment group were divided into three patterns by syndrome differentiation, and patients of each pattern were respectively given the corresponding Chinese medicine decoction on the basis of routine western medicine. Observed the effect after two weeks treatment. Respectively detected ultrasonic heartbeat graph(left ventricular ejection fraction,left ventricular end diastolic diameter),heart rate variability indexes(SDNN, SDANN, RMSSD,PNN50), neuroendocrine factors(Pro-BNP, angiotensin Ⅱ,aldosterone) and security indicators (blood, urine, liver function, kidney function, etc) before and after treatment, and also observed the symptom score, heart function improvement before and after treatment, thereby judging curative effect.Results1Comparison of heart function improvement:the total effectiveness of treatment group was94.96%,while that of control group90.24%.There was no significant difference between the two groups and three syndromes of treatment group in heart function improvement(P>0.05).2Comparison of syndrome score: the total effectiveness of treatment group was97.37%, while that of control group92.68%.The improvement of syndrome score of treatment group was more significant than that of control group (P<0.05).Compared the single syndrome,treatment group was better than control group in the improvement of chest distress,fatigue,palpitation,swollen limbs and cyanosis (P<0.05),while the improment of dyspnea,cough and expectoration,oliguria and emotional depression was not different(P>0.05). There was no difference between three pattern of treatmeat group in the improvement of syndrome score.3Comparison of ultrasonic heartbeat graph improvement:Compared with those before treatment for both of the two groups, left ventricular end diastolic diameter was reduced (P<0.05) and left ventricular ejection fractionwasincreased (P<0.05).But there were no differences between the two groups in the improvement of left ventricular end diastolic diameter and left ventricular ejection (P>0.05). 4Comparison of neuroendocrine factors:Pro-BNP, angiotensin Ⅱand aldosterone of the two groups were reduced after treatment(P<0.05).Compared the two groups, the improvement of those were not different (P>0.05)5Comparison of HRV: SDNN,SDANN,RMSSD and PNN50of two groups were significantly increased (P<0.05).Compared two groups, the improvement of SDNN and SDANN of treatment group were more significant than those of control group (P<0.05),but the improvement of RMSSD and PNN50of two groups were not different.6Relationship between TCM syndrome and neuroendocrine factors:Pro-BNP in three syndromes shows the following relation:yang deficiency of heart and kidney with blood stasis and water stop> deficiency of qi and yinwith blood stasis and water stop>qi deficiency with blood stasis and water stop. The distribution of angiotensin Ⅱand aldosterone were not different in three syndromes.7Relationship between neuroendocrine factors and left ventricular end diastolic diameter, LVEF:there was a positive correlation between Pro-BNP and left ventricular diameter(r=0.331, P<0.05); there was a negative correlation between Pro-BNP and LVEF, and the relation was significant (r=-0.507,P<0.01). Angiotensin Ⅱ and aldosterone had no relation with left ventricular end diastolic diameter and LVEF (P>0.05)8Relationship between neuroendocrine factors and HRV indexes:there was a negative correlation between Pro-BNP and SDNN (r=-0.45,P<0.05); Pro-BNP had no correlation with SDANN, PNN50and RMSSD(P<0.05). Angiotensin Ⅱand aldosterone had no relation with HRV indexes (P>0.05)Conclusion1The treatment of Chinese medicine for supplementing qi,activating blood and inducing diuresis based on syndrome differentiation combined with western medicine can significantly improve symptoms and life quality of patients with chronic heart failure.2The treatment of Chinese medicine for supplementing qi,activating blood and inducing diuresis based on syndrome differentiation combined with western medicine can significantly increase heart rate variability and improve autonomic nervous function.3Pro-BNP may have a certain relationship with TCM patterns of chronic heart failure.4Pro-BNP has a certain relationship with ultrasonic heartbeat graph, as follows:Pro-BNP has a positive relation with left ventricular diameter and a negative relation with LVEF. 5Pro-BNP has a certain relationship with HRV indexes, as follows:Pro-BNP has a negative relation with SDNN. The higher Pro-BNP is, the lower SDNN is. |
PDF Full Text Request