Effects of Kanlijian on exercise tolerance, quality of life, and frequency of heart failure aggravation in patients with chronic heart failure

Objective: To observe the effects of conventional therapy combined with Kanlijian (KLJ) on exercise tolerance, quality of life and frequency of heart failure aggravation in patients with chronic heart failure(CHF).Methods: Sixty CHF patients differentiated as sufferring from the syndrome of Xin-Shen Yang deficiency were included in the study and randomly assigned at the ratio of 2: 1 into the KLJ group (n = 39) and the control group(n = 21). All the patients were treated with conventional therapy of Western medicine, but to those in the KLJ group, KLJ was medicated additionally one dose daily with 24 wks as one therapeutic course. The efficacy on TCM syndrome and changes of scores on TCM syndrome were observed after treatment. The indexes, including 6-minute walking distance (6MWD), quality of life (QOL, accessed by LHFQ scoring), NYHA grade, hemodynamic indexes and reducing/withdrawal rate of diuretic and digoxin before and after treatment were recorded and compared. Also the frequency of re-admission due to aggravation of heart failure in one year’s time were observed.Results: (1) The efficacy on TCM syndrome, improvement on scores of TCM syndrome, therapeutic effects on 6MWD, QOL, and NYHA grade in the KLJ group were superior to those in the control group. (2) Hemodynamic indexes after treatment, left ventricular fractional shortening (LVFS) and E peak/A peak (E/A), between the two groups had no significant difference, while left ventricular ejection fraction (LVEF) was increased significantly in the KLJ group, but with no obvious change in the control group. (3) The reducing/withdrawal rate of diuretic and digoxin in the KLJ group was significantly higher than that in the control group. (4) The 1-year frequency of re-admission significantly decreased in the KLJ group.Conclusion: The adjuvant treatment of KLJ on the basis of Western conventional therapy can significantly improve CHF patients’ exercise tolerance, quality of life and cardiac function, reduce the dosage of diuretic and digoxin needed, and decrease the re-admission frequency due to aggravation of heart failure. Supported by the Item of Shanghai Municipal Ministry of Health on Standard for Quality Controling of Single Disease     

Effects of Kanlijian (坎离煎) on Exercise Tolerance, Quality of Life, and Frequency of Heart Failure Aggravation in Patients with Chronic Heart Failure

Inthelast20years,theaiminthetreat mentofchronicheartfailure(CHF)hasbeenturnedtointervenethepathogenesisofthedis ease,which,undoubtedly,isarevolutionaryprogressascomparedwiththetreatmentusedinthepastwhichsimplyaimedathemodynamicdisorders.However,themortalityofthepa tientswithCHFisstillhighandthequalityoflifestilllow.Furthermore,theapplicationofsomeWesternmedicineislimitedtoagreatex tentowingtotheirside effects.Alongwiththeincreasingofinterven tionwithChineseherbsintreatingCHF,thecombinedtre…     

心力衰竭时动脉功能变化及坎离煎对其影响的研究

目的:观察心力衰竭患者动脉功能的变化及中药坎离煎干预对心衰时动脉功能的影响。方法:对门诊及住院心衰患者26例进行脉象仪描记脉象图(h5、h5/h1等)、超声测量前臂桡动脉血流介导的血管舒张功能(FMD)、辅以国际公认的动脉弹性指数(C1、C2)验证脉象仪客观性,并观察中药干预的影响。结果:坎离煎加载治疗后,心衰患者FMD(P<0.05)和动脉弹性指标(h5/h1,P<0.05)显著增加,其作用优于单纯西药治疗组。结论:中药坎离煎有改善心衰动脉功能的作用。     

坎离煎对心衰兔心肌细胞凋亡调控蛋白表达的干预作用

目的 观察中药验方坎离煎对心衰时心肌细胞凋亡的影响。方法 40只家兔随机分为假手术组、模型组、开搏通组和坎离煎组。以结扎兔冠状动脉前降支的方法造成心肌梗死后心衰模型，造模后分别以坎离煎和开搏通干预，2周后处死取样，作心肌凋亡调控蛋白bcl-2和bax检测，比较各组间差异。结果 坎离煎和开搏通都能够促进心衰兔心肌bcl-2表达，增加bcl-2／bax的比值，起到抑制细胞凋亡的作用，坎离煎在促进bcl-2表达方面优于开搏通（P〈0．01）；坎离煎和开搏通均能明显改善心衰兔水钠潴留状态。结论 坎离煎通过抑制心肌细胞凋亡而减少心衰进程中的心肌细胞丢失，以保存心脏的功能，这可能是该药振奋心脏阳气的作用机制之一。