Background:To evaluate the clinical efficacy of oral administration of Chinese medicines with warming Yang effects and Western medicine in the treatment of heart failure caused by dilated cardiomyopathy.Methods:Seven ...Background:To evaluate the clinical efficacy of oral administration of Chinese medicines with warming Yang effects and Western medicine in the treatment of heart failure caused by dilated cardiomyopathy.Methods:Seven databases including Chinese National Knowledge Infrastructure,Weipu database,Wanfang database,China Biomedical Literature Service System,Cochrane library,PubMed,and Embase were searched.The search date was from established to October 2019.Randomized clinical trials of dilated cardiomyopathy patients with heart failure under the combination treatment of Chinese medicines with warming Yang effects and Western medicine were included.We then assessed the methodological quality of included literatures,extracted valid data and conducted systematically evaluation according to the Cochrane systematic review method.Outcome index included clinical efficacy,left ventricular ejection fraction,and brain natriuretic peptide.Results:Meta-analysis results showed that the clinical effective rate was higher in the combination group than that in the control group(RR=1.24,95%CI(1.14,1.34),P<0.01).In addition,the combination group could improve left ventricular ejection fraction compared with the control group(Std.MD=0.85,95%CI(0.69,1.01),P<0.01).However,the meta-analysis of brain natriuretic peptide levels showed that the included literatures have higher heterogeneity and the meta-analysis results were unstable.So the results of brain natriuretic peptide were abandoned.Conclusion:Oral administration of Chinese medicines with warming Yang effects combined with Western medicine is better than Western medicine alone in improving clinical effect and left ventricular ejection fraction,but it is not clear whether brain natriuretic peptide can be improved.Because the quality of the included studies is not high and inconsistent outcome index,more standardized and rigorous randomized double-blind controlled trials are needed to validate and guide clinical use.展开更多
OBJECTIVE: To investigate on Left ventricular ejection fraction value and aldosterone of two medicinals of Traditional Chinese Medicine(TCM) with the properties of warming Yang and tonifying Qi in terms of TCM theory....OBJECTIVE: To investigate on Left ventricular ejection fraction value and aldosterone of two medicinals of Traditional Chinese Medicine(TCM) with the properties of warming Yang and tonifying Qi in terms of TCM theory.METHODS: An animal model of coronary ligation of heart failure after myocardial infarction was employed to study the influence of these two kinds of drugs on three batches of rats. On the basis of the average score of left ventricle ejection fraction during the investigation, there were some different groups, including Wen Yang(the warming Yang)group, Yi Qi(tonifying Qi) group, Wen Yang and Yi Qi group, captopril group, digoxin group. In additional, an artificial operation group was set for compari-son. The systemic intervention using these medicinal and drugs was taken effects on the 2nd day after the operation of myocardial infraction(MI) with once a day. At week one, two, and four after the MI treatment, evaluated were EF values, and ferritin,angiotensin-II and aldosterone in the rats' plasma.RESULTS: At week one and week two, the medicinal of Wen Yang, Yi Qi, Wen Yang pluse Yi Qi, and digoxin could improve left ventricular ejection fraction in rats with heart failure; Compared to the model group, captopril Left ventricular EF value increased, but there was not significant. At week four,heart failure and left ventricular EF values was improved in the intervention group and the other four captopril drug intervention. At week one in the rats with drug intervention, the medicinals of Yi Qi, Wen Yang plus Yi Qi, and captopril could inhibit activation in vivo hormone aldosterone in heart failure rats; aldosterone in Wen Yang group and digoxin group were not different from that in the model group at week two and four.CONCLUSION: Chinese medicinals with properties of Wen Yang, Yi Qi have significant effect on improving left ventricular EF in rats with heart failure; compared to Yi Qi medicinals, Wen Yang medicinals that inhibit the effectiveness of the time required for the activation of the role of aldosterone. The medicinals of Wen Yang and Yi Qi seems better by inhibiting the activation of the hormone aldosterone after failing to inhibit ventricular remodeling to improve heart failure.展开更多
目的观察温针灸治疗阳气亏虚血瘀型慢性心力衰竭的临床疗效及对患者心功能和生活质量的影响。方法将60例阳气亏虚血瘀型慢性心力衰竭患者用随机数字表法分为对照组(30例)和研究组(30例)。两组均予内科常规基础治疗,对照组另予常规针刺治...目的观察温针灸治疗阳气亏虚血瘀型慢性心力衰竭的临床疗效及对患者心功能和生活质量的影响。方法将60例阳气亏虚血瘀型慢性心力衰竭患者用随机数字表法分为对照组(30例)和研究组(30例)。两组均予内科常规基础治疗,对照组另予常规针刺治疗,研究组另予温针灸治疗。观察两组治疗前后明尼苏达心功能不全生命质量量表(Minnesota living with heart failure questionnaire,MLHFQ)评分、6分钟步行试验(6-minute walk test,6MWT)结果、心功能指标[左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末内径(left ventricular end systolic diameter,LVESD)和左室射血分数(left ventricular ejection fraction,LVEF)]以及血清肾素、醛固酮(aldosterone,ALD)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)和血浆N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)水平的变化,比较两组临床疗效。结果两组治疗后LVEDD、LVESD、肾素水平、ALD水平、AngⅡ水平、NT-proBNP水平和MLHFQ评分均较治疗前降低(P<0.05),LVEF和6MWT水平均较治疗前提高(P<0.05)。研究组治疗后LVEDD、LVESD、肾素水平、ALD水平、AngⅡ水平、NT-proBNP水平和MLHFQ评分均低于对照组(P<0.05),LVEF和6MWT水平均高于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。结论在内科常规治疗基础上,温针灸治疗阳气亏虚血瘀型慢性心力衰竭的临床疗效优于常规针刺,可改善心脏功能,提高生活质量。展开更多
文摘Background:To evaluate the clinical efficacy of oral administration of Chinese medicines with warming Yang effects and Western medicine in the treatment of heart failure caused by dilated cardiomyopathy.Methods:Seven databases including Chinese National Knowledge Infrastructure,Weipu database,Wanfang database,China Biomedical Literature Service System,Cochrane library,PubMed,and Embase were searched.The search date was from established to October 2019.Randomized clinical trials of dilated cardiomyopathy patients with heart failure under the combination treatment of Chinese medicines with warming Yang effects and Western medicine were included.We then assessed the methodological quality of included literatures,extracted valid data and conducted systematically evaluation according to the Cochrane systematic review method.Outcome index included clinical efficacy,left ventricular ejection fraction,and brain natriuretic peptide.Results:Meta-analysis results showed that the clinical effective rate was higher in the combination group than that in the control group(RR=1.24,95%CI(1.14,1.34),P<0.01).In addition,the combination group could improve left ventricular ejection fraction compared with the control group(Std.MD=0.85,95%CI(0.69,1.01),P<0.01).However,the meta-analysis of brain natriuretic peptide levels showed that the included literatures have higher heterogeneity and the meta-analysis results were unstable.So the results of brain natriuretic peptide were abandoned.Conclusion:Oral administration of Chinese medicines with warming Yang effects combined with Western medicine is better than Western medicine alone in improving clinical effect and left ventricular ejection fraction,but it is not clear whether brain natriuretic peptide can be improved.Because the quality of the included studies is not high and inconsistent outcome index,more standardized and rigorous randomized double-blind controlled trials are needed to validate and guide clinical use.
基金Supported by National Natural Science Foundation of China(No.81173408)Henan University of Chinese Medicine synergy innovation center
文摘OBJECTIVE: To investigate on Left ventricular ejection fraction value and aldosterone of two medicinals of Traditional Chinese Medicine(TCM) with the properties of warming Yang and tonifying Qi in terms of TCM theory.METHODS: An animal model of coronary ligation of heart failure after myocardial infarction was employed to study the influence of these two kinds of drugs on three batches of rats. On the basis of the average score of left ventricle ejection fraction during the investigation, there were some different groups, including Wen Yang(the warming Yang)group, Yi Qi(tonifying Qi) group, Wen Yang and Yi Qi group, captopril group, digoxin group. In additional, an artificial operation group was set for compari-son. The systemic intervention using these medicinal and drugs was taken effects on the 2nd day after the operation of myocardial infraction(MI) with once a day. At week one, two, and four after the MI treatment, evaluated were EF values, and ferritin,angiotensin-II and aldosterone in the rats' plasma.RESULTS: At week one and week two, the medicinal of Wen Yang, Yi Qi, Wen Yang pluse Yi Qi, and digoxin could improve left ventricular ejection fraction in rats with heart failure; Compared to the model group, captopril Left ventricular EF value increased, but there was not significant. At week four,heart failure and left ventricular EF values was improved in the intervention group and the other four captopril drug intervention. At week one in the rats with drug intervention, the medicinals of Yi Qi, Wen Yang plus Yi Qi, and captopril could inhibit activation in vivo hormone aldosterone in heart failure rats; aldosterone in Wen Yang group and digoxin group were not different from that in the model group at week two and four.CONCLUSION: Chinese medicinals with properties of Wen Yang, Yi Qi have significant effect on improving left ventricular EF in rats with heart failure; compared to Yi Qi medicinals, Wen Yang medicinals that inhibit the effectiveness of the time required for the activation of the role of aldosterone. The medicinals of Wen Yang and Yi Qi seems better by inhibiting the activation of the hormone aldosterone after failing to inhibit ventricular remodeling to improve heart failure.
文摘目的观察温针灸治疗阳气亏虚血瘀型慢性心力衰竭的临床疗效及对患者心功能和生活质量的影响。方法将60例阳气亏虚血瘀型慢性心力衰竭患者用随机数字表法分为对照组(30例)和研究组(30例)。两组均予内科常规基础治疗,对照组另予常规针刺治疗,研究组另予温针灸治疗。观察两组治疗前后明尼苏达心功能不全生命质量量表(Minnesota living with heart failure questionnaire,MLHFQ)评分、6分钟步行试验(6-minute walk test,6MWT)结果、心功能指标[左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末内径(left ventricular end systolic diameter,LVESD)和左室射血分数(left ventricular ejection fraction,LVEF)]以及血清肾素、醛固酮(aldosterone,ALD)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)和血浆N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)水平的变化,比较两组临床疗效。结果两组治疗后LVEDD、LVESD、肾素水平、ALD水平、AngⅡ水平、NT-proBNP水平和MLHFQ评分均较治疗前降低(P<0.05),LVEF和6MWT水平均较治疗前提高(P<0.05)。研究组治疗后LVEDD、LVESD、肾素水平、ALD水平、AngⅡ水平、NT-proBNP水平和MLHFQ评分均低于对照组(P<0.05),LVEF和6MWT水平均高于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。结论在内科常规治疗基础上,温针灸治疗阳气亏虚血瘀型慢性心力衰竭的临床疗效优于常规针刺,可改善心脏功能,提高生活质量。
