ABSTRACT
Objective To observe the effects of different traditional Chinese medicine therapeutic methods on heart function and red cell volume distribution width (RDW) in patients with chronic heart failure (CHF). Methods A randomized, blinded and controlled study was conducted. One hundred and ninety patients with CHF accompanied by yang deficiency syndrome in Department of Cardiology of Chengdu Municipal First People's Hospital were divided into five contrast groups according to randomized envelope method:namely control group, warming yang group, nourishing yin group, activating blood group and combined warming yang and nourishing yin therapeutic group (combined group), each group being 38 cases. The patients not consistent with the criteria to enroll into the study and those lost contact were excluded from the study, thus the final total patients were 183 in number, including control 37, warming yang 36, nourishing yin 36, activating blood 37 and combined group 37 cases. All the cases were treated with routine medical therapy in accord to the guideline for CHF. In addition, placebo oral liquor was given to the control group, Wenyangjianxinling oral liquor (main ingredients:Aconiti Lateralis Radix Preparata, Astragali Radix, Chuanxiong Rhizoma, Epimedii Folium, Periplocae Cortex, Descurainiae Semen, Ginseng Radix et Rhizoma Rubra) was given to the warming yang group, Ophiopogonis Radix and Anemarrhenae Rhizoma oral liquor (main ingredients:Ophiopogonis Radix,Anemarrhenae Rhizoma) was taken by the nourishing yin group, Salviae Miltiorrhizae Radix and Chuanxiong Rhizoma oral liquor (main ingredients: Salviae Miltiorrhizae Radix, Chuanxiong Rhizoma) was administered by the activating blood group, and the main ingredients of oral liquors given to the warming yang and nourishing yin groups were assigned to the combined group, each group 10 mL, three times a day for one year. According to the prognosis, the patients were divided into survival group (168 cases) and death group (15 cases). The re-hospitalization situations such as aggravation of heart failure, acute myocardial infarction, angina, stroke, etc. were observed. The changes of hemoglobin (Hb) and RDW in the survival and death groups were investigated and compared between them. Results Compared with the control group, the rate of re-hospitalization was significantly decreased in the activating blood group [27.03% (10/37) vs. 54.05%(20/37), P0.05). Before treatment, the levels of left ventricular ejection fraction (LVEF), fractional shortening (FS), the ratio of early to late ventricular filling velocities (E/A ratio) and E deceleration time (DT) showed no significant differences among five groups (all P>0.05). Compared with the control group at the same period, the LVEF, FS, E/A and DT were significantly increased in activating blood group and combined group after the treatment [LVEF: 0.453±0.131, 0.448±0.104 vs. 0.394±0.112, FS:(27.9±9.8)%, (27.0±11.5)%vs. (22.2±13.3)%, E/A:0.88±0.16, 0.92±0.20 vs. 0.75±0.27, DT (ms): 265.4±30.3, 251.4±37.5 vs. 225.7±35.4, all P 0.05). The level of Hb in death and survival groups also had no statistical significant difference (P > 0.05). The RDW of dead group was markedly higher than that of the survival group [(14.39±2.17)%vs. (13.02±2.08)%, P<0.05]. Conclusion The level of RDW is related to the prognosis of CHF patients, the level of RDW in death group is higher than that in survival group, and the activating blood circulation and removing blood stasis therapy can decrease the level of RDW, reduce the rate of re-hospitalization and improve the heart function in CHF patients.
ABSTRACT
OBJECTIVE: To evaluate the effect of Xiangdan Injection on mRNA expression of the endothelial vaso-active factors of patients with coronary heart disease and blood stasis. METHODS: Fifty-six patients were randomly divided into two groups:twenty-eight patients were treated according to the therapeutic guide for coronary heart disease as the control group and 28 were given the same treatment plus Xiangdan Injection as the treated group. The expressions of ET-1 and eNOS mRNA were examined with RT-PCR before experiment and ten days later. RESULTS: The positive rate of eNOS mRNA of the treated group increased, while the positive rate of ET-1 mRNA of the treated group decreased after ten day's treatment, with significant differences as compared with that before the experiment. Xiangdan Injection up-regulated the eNOS mRNA expression and suppressed the ET-1 mRNA expression. Changes of expression were not observed in the control group. CONCLUSION: Xiangdan Injection improves the endothelial function of patients with coronary heart disease and blood stasis by regulating the expressions of ET-1 and eNOS mRNA.