Clinical Study Of Xinkang Decoction On Patients With Coronary Heart Disease And Heart Failure With Diuretic Resistance

Objective: To observe the clinical efficacy of Xin Kang Yin in Treating Diuretic Resistance in Coronary Heart Disease(Yang Deficiency of Heart and Kidney,Descent of zong qi).Methods: The paired design clinical trial and open a one-way mass reaction sequential trial,select diagnosed with CHD heart failure with diuretic resistance,at the same time, the patients were Yang deficiency of heart and kidney;descent of zong qi.A total of 18 patients were divided into two groups(9 for treatment group and 9 for control group).On the basis of western medicine heart failure treatment, the treatment group were given a dose of Xin Kang Yin and the control group were given the capsule of Qi Li Qiang Xin for 2 weeks.With the change of urine every 24 hours for determining test validity, and on the basis of mapping the se quential trial.At the same time,compare two groups and between the two groups before and after treatment of every 24 hours urine output,NT-pro BNP,LVEF,LVFS, cardiac functional grading,TCM syndrome scoring and clinical efficacy safety.Results: 1. In the Sequential trials,the treatment group all were effective eccept the 4-th patient.When we recorded the result of the 7-th patient,the experimental line touched the boundary line(P<0.01). We accepted the Xin Kang Yin decoction.The control group all were effective eccept the 3-th? 4-th and 7-th patient.When we recorded the result of the 9-th patient,the experimental line not touched the boundary line(P>0.01).We rejected the capsule of Qi Li Qiang Xin decoction. 2. The differences of the 24 h amount of urine were meaningful in statistical after treatment a week(P<0.05),there were raised to different level; after treatment differences between the two groups were significant since 1-day to 2-week(p<0.05).This prompted two groups have a diuretic effect,but treatment group was superior to control group. 3. Before treatment the NT-pro BNP were decreased to different level,differences were statistical significance(P<0.05);after treatment differences between the two groups were significant(p<0.05). 4. Before treatment the LVEF and LVFS were raised to different level,differences were statistical significance(P<0.05);after treatment differences between the two groups were significant(p<0.05). 5. After treatment the cardiac functional grading differences between the two groups were significant(p<0.05). 6. Before treatment the TCM syndrome scoring differences were statistical significance(P<0.05);after treatment differences between the two groups were significant(p<0.05).Conclusion: In the Sequential trials(qualitative),Xin Kang Yin decoction was obviously effective for diuretic resistance of Dilated Cardiomyopathy of syndrome of yang deficiency of heart and kidney and descent of zong qi.In two groups before and after their control and matched pair design(quantitative), two groups have a diuretic effect,but treatment group was superior to control group.It may increase amount of 24 h urine, Both may reduce the levels of NT-pro BNP,and raise the levels of LVEF and LVFS of heart and the cardiac functional grading were improvement. At the same time,furtherly could improve the clinical symptoms such as palpitation,dyspnea,shortness of breath,weekness of the limbs and cold clammy limbs, but treatment group was superior to control group. Also two groups of safe and effective,no serious adverse reactions.