The Clinical Research Of Compound Zhenwu Granules On Treatment Of Chronic Heart Failure Patients With Heart-kidney Yang Deficiency And Its Effect On HRV And NT-proBNP

Objective:The aim of this study was to observe the clinical efficacy and safety of compound Zhenwu granules combined with western medicine conventional therapy in treating patients with chronic heart failure(CHF)with deficiency of heart-YANG and kidney-YANG and to analyze the effect of compound Zhenwu granules on NT-proBNP and HRV,and to provide new ideas and new ways in syndrome differentiation of heart failure.Methods:1.56 patients with CHF were randomly divided into study group(n=28)and treatment group(n=28)based on the CHF diagnostic criteria,New York Heart Association(NYHA)cardiac function grading standard and Traditional Chinese Medicine(TCM)syndrome differentiation standard.The study group was treated with compound Zhenwu granules on the basis of conventional western medicine,and the treatment group was treated with basic anti-heart failure treatment with western medicine.The course of treatment lasted for 4 weeks.2.Comparing the medical efficacy index of the two groups before and after treatment(the changes of NYHA cardiac function grade,6MWT distance),TCM efficacy index(TCM syndrome score),the levels of NT-proBNP before and after treatment,and the levels of HRV time domain indicators such as SDNN,SDANN,RMSSD and PNN50 of the 24-hour dynamic electrocardiogram,record and organize various data separately.Results:Comparison of two groups before and after treatment: After treatment,the NYHA cardiac function grade,6MWT distance in patients were improved compared with before treatment.TCM syndrome score in patients were significantly lower than before treatment.There were significant differences between the indexes in two groups(P<0.01).HRV time domain indicators such as SDNN,SDANN,RMSSD were improved and PNN50 lower compared with before treatment(p<0.05,p<0.01).NT-proBNP levels in patients was significantly lower than before treatment(P<0.01).Comparison between the study group and the treatment group after treatment: NYHA cardiac function in the study group was superior to the treatment group(p<0.01).The improvement of TCM syndrome score,6MWT distance and HRV(SDNN?SDANN?RMSSD)in study group was more significant than that in treatment group(p<0.05,p<0.01).The levels of HRV PNN50 and NT-proBNP in the tstudy group was lower than those in the treatment group(p<0.01).Conclusion:The combination of compound Zhenwu granule and routine western medicine therapy can not only improve TCM syndromes score,cardiac function grading and the conscious symptoms of CHF patients,but also improve the indexes of heart failure such as HRV and NT-proBNP in 6-minute walking test.The curative effect is superior to the single routine western medicine treatment method,which also have high security.The mechanism of compound Zhenwu granule may be related to inhibiting the excessive activation of SNS system and RAAS system,reducing the excitability of SNS,increasing the tension of PNS and delaying ventricular remodeling.