| Objective: The aim of this study was to observe the clinical efficacy of compound Zhenwu granules in treating patients with chronic heart failure(CHF)with deficiency of heart-YANG and kidney-YANG,and to explore the possible mechanism of compound Zhenwu granules on CHF.Methods:1.52 patients with CHF were randomly divided into treatment group(n=26)and control group(n=26)based on the CHF diagnostic criteria,New York Heart Association(NYHA)cardiac function grading standard and Traditional Chinese Medicine(TCM)syndrome differentiation standard.2.The treatment group was treated with compound Zhenwu granules on the basis of conventional western medicine,and the control group was treated with basic anti-heart failure treatment with western medicine.The course of treatment lasted for 4 weeks.3.Echocardiography was performed to record LVEF,and the levels of NT-pro BNP was measured before and after treatment.Finally,the changes of NYHA cardiac function grade,TCM syndrome score,TCM single syndrome score,6MWT distance,Lee integral and the above indexes were analyzed before and after treatment.4.All data collected were analyzed by SPSS21.0 software.The measured data were expressed as sx ±.the paired t test was used for comparison in each group.The independent sample t test was applied to the comparison between the groups.The count data were analyzed by ?2 test.If P>0.05,there was no significant difference;P<0.05 or P<0.01,the difference was statistically significant,the latter difference means more significant statistical difference.Results:1.Comparison of treatment group before and after treatment: After treatment,the NYHA cardiac function grade,TCM syndrome score,TCM single syndrome score,6MWT distance and Lee score in patients were improved compared with before treatment.LVEF of patients were significantly higher than before treatment.NT-pro BNP levels in patients was significantly lower than before treatment.There was significant difference between the indexes in the treatment group(P<0.01).2.Comparison of the control group before and after treatment: After treatment,NYHA cardiac function grade,TCM syndrome score,TCM single syndrome score,6MWT distance and Lee score in patients were improved compared with before treatment;LVEF of patients were improved significantly;NT-pro BNP levels was significantly lowered.There were significant differences between the indexes in the control group(P<0.01).3.Comparison between the treatment group and the control group after treatment:NYHA cardiac function in the treatment group was superior to the control group(P<0.05).The improvement of TCM syndrome score,6MWT distance and Lee integral in treatment group was more significant than that in control group(P <0.01).TCM single symptom score in treatment group was more significant than that in control group(P<0.05).LVEF in the treatment group was significantly higher than that in the control group(P<0.05).The levels of NT-pro BNP in the treatment group was lower than those in the control group(P<0.01).Conclusions:1.Compound Zhenwu granules can further improve NYHA cardiac function grade,TCM syndrome score and single symptom score,6MWT distance and Lee integral in CHF patients with deficiency of heart-YANG and kidney-YANG based on the basic treatment of conventional western medicine.2.Compound Zhenwu granules can further increase LVEF in CHF patients with deficiency of heart-YANG and kidney-YANG based on the basic treatment of conventional western medicine.3.Compound Zhenwu Granules can further reduce the NT-pro BNP levels in CHF patients with deficiency of heart-YANG and kidney-YANG based on the basic treatment of conventional western medicine.4.Compound Zhenwu granules possess good security.Compound Zhenwu Granules can be used to treat CHF by TCM differentiation from Heart-kidney Yang deficiency theory.The prescription has rigorous compatibility,meanwhile,it has the efficacy of warming and invigorating the heart and kidney,warming yang for diuresis,activating blood removing stasis,which can significantly improve the symptoms of heart failure patients,enhance their exercise endurance.It was found in Modern pharmacological studies that many herbs in this prescription have effect of cardiotonic,diuretic and coronary vessel dilatation and so on.Therefore,the mechanism of compound Zhenwu granules on CHF may be as follows: This prescription can reduce the secretion of neuroendocrine and inflammatory factors by inhibiting sympathetic nerve and RAAS system,further play a role of anti-myocardial ischemia,reducing cardiac load and anti-myocardial fibrosis,and finally achieve the effect of delayed ventricular remodeling. |
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