| Objective:Through clinical research to observe the curative effect of Jianxin Decoction Treatment of qi deficiency and blood stasis in patients with chronic heart failure,the simultaneous detection of the renin angiotensin aldosterone system(RAAS)related neuroendocrine index of plasma renin activity(PRA),angiotensin II(Ang II),aldosterone(ALD)changes,and explore the possible mechanism and target of the treatment of chronic heart failure with Qi deficiency and blood stasis.Method:40 patients were randomly divided into experimental group and control group,each with a total of 20 people,and the two groups were treated with the standardized treatment of heart failure in 2014.On the basis of routine western medicine treatment,the experimental group was added with Jianxin decoction,two groups were treated for a period of 28 days.Before and after treatment in the two groups were observed in patients with cardiac function,TCM syndrome integral,Lee Minnesota’s failure to score,life quality score(MLHFQ),6 minutes walking distance(6MWD),left ventricular ejection fraction(LVEF),serum brain natriuretic peptide(BNP)and renin activity(PRA),angiotensin II(Ang II),aldosterone(ALD)changes.Result:1.This study included 40 cases,experimental group and control group with 20 cases in each group,the two groups had no statistical significance with age,gender,underlying diseases,heart function difference(P>0.05),The comparison between the experimental group and the control group.2.Clinical efficacy: There were significant differences in cardiac function between the two groups by rank sum test(P<0.01).However,there was no difference in the total effective rate by chi square test(P>0.05).And there are significant differences in efficiency(P<0.05).The effective rate of the experimental group was 55% and the control group was 15%.;After treatment,the 6MWD of the two groups was significantly longer than that before treatment(P<0.01),and the experimental group was significantly longer than the control group(P<0.05);The LVEF value of the two groups after treatment was significantly improved,the difference was statistically significant(P<0.01)before and after treatment,and there was significant difference between the two groups after treatment(P<0.05),the experimental group was better than the control group;The two groups after treatment the scores were significantly decreased,compared with before treatment were significantly different(P<0.01),the test group patients after treatment of TCM syndrome integral,Lee’s failure to score lower than the control group(P<0.05),quality of life score was significantly lower than the control group(P<0.01).3.Physicochemical index:The two group after treatment,serum PRA,Ang II and ALD and the level of BNP was significantly decreased(P<0.01),experimental group after treatment,serum BNP was lower than the control group(P<0.05),the serum PRA,Ang II,ALD was significantly lower than the control group(P<0.01).4.During the study,compared with the control group,the experimental group had no significant or serious adverse reactions,and the safety of Jianxin decoction was better.Conclusions:Through the observation of the Jianxin decoction treating qi deficiency and blood stasis type the clinical curative effect of chronic heart failure,suggesting that on the basis of Western medicine plus Jianxin decoction,can more effectively improve cardiac function,reduce the TCM syndromes,Lee’s failure to score and life quality score,increase 6MWD and LVEF,decreased serum BNP the level and improve the quality of life of patients.The results showed that Jian Xin Tang can significantly reduce the levels of serum PRA,Ang II and ALD in patients with heart failure,suggesting that the possible mechanism and the target of the treatment of heart failure in the treatment of chronic heart failure patients with RAAS.Clinical application of Jianxin decoction has good safety. |
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