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Objective To observe the clinical therapeutic effect of Qingxuan Jiangya decoction on patients with primary hypertension (PH) and its influence on their rennin-angiotensin-aldosterone system (RAAS). Methods A prospective study was conducted, including 178 patients with definite diagnosis of PH (Ⅰ-Ⅱ grade) who came from Guanggu district to the third Hospital of Wuhan City from April 2016 to March 2017, and they were divided into a control group and an observation group according to the method of taking medicine, each group 89 cases. The control group received 5 mg amlodipine besylate, orally once a day; the observation group on the basis of treatment in the control group, the Qingxuan Jiangya decoction (gastrodia rhizome 20 g, uncaria 20 g, ligusticum rhizome 15 g, salviae miltiorrhizae 10 g, puerarin 20 g, radix ophiopogonis 20 g, fructus lycii 25 g, chrysanthemum 10 g, root poria 15 g, poria cocos 10 g, radix glycyrrhizae 5 g) was added, a dose (400 mL) divided into two parts, one part taken twice daily, in the morning and in the evening after meals; the two groups took the treatment continuously for 4 weeks. The blood pressure dynamic changes and plasma levels of renin, angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) and clinical efficacy were observed, and the safety of the drugs was evaluated by measuring the changes of liver and kidney functions. Results After treatment in the two groups, the daytime systolic pressure (D-SBP) and diastolic pressure (D-DBP) and nighttime SBP (N-SBP) and DBP (N-DBP), the mean of 24 hours-SBP and 24 hours-DBP were all lower than those before treatment, and the D-DBP, N-SBP and 24 hours-DBP of the observation group were significantly lower than those of control group [D-DBP (mmHg, 1 mmHg = 0.133 kPa): 78.24±5.35 vs. 81.56±6.23, N-SBP (mmHg):117.35±5.42 vs. 122.63±7.23, 24 hours-DBP (mmHg): 74.15±5.26 vs. 80.51±6.52, all P < 0.05]; after treatment, the levels of renin, Ang Ⅱ and ALD in two groups were also declined, and the degrees of decrease in the observation group were more significant than those in the control group [renin (ng/L): 5.46±0.41 vs. 7.82±0.36, ALD (ng/L):128.48±31.42 vs. 168.48±28.32, Ang Ⅱ (ng/L): 52.35±14.27 vs. 75.38±15.65, all P < 0.05]; there were no significant changes in the levels of alanine aminotransferase (ALT), aspartate transaminase (AST), urea and creatinine (Cr) before and after treatment in the two groups, showing that the treatment was safe. Conclusion Qingxuan Jiangya decoction can effectively and safely reduce the blood pressure in PH patients, and its mechanism is possibly related to its influence on RAAS.
ABSTRACT
Objective To observe the clinical therapeutic effect of Qingxuan Jiangya decoction on patients with primary hypertension (PH) and its influence on their rennin-angiotensin-aldosterone system (RAAS). Methods A prospective study was conducted, including 178 patients with definite diagnosis of PH (Ⅰ-Ⅱ grade) who came from Guanggu district to the third Hospital of Wuhan City from April 2016 to March 2017, and they were divided into a control group and an observation group according to the method of taking medicine, each group 89 cases. The control group received 5 mg amlodipine besylate, orally once a day; the observation group on the basis of treatment in the control group, the Qingxuan Jiangya decoction (gastrodia rhizome 20 g, uncaria 20 g, ligusticum rhizome 15 g, salviae miltiorrhizae 10 g, puerarin 20 g, radix ophiopogonis 20 g, fructus lycii 25 g, chrysanthemum 10 g, root poria 15 g, poria cocos 10 g, radix glycyrrhizae 5 g) was added, a dose (400 mL) divided into two parts, one part taken twice daily, in the morning and in the evening after meals; the two groups took the treatment continuously for 4 weeks. The blood pressure dynamic changes and plasma levels of renin, angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) and clinical efficacy were observed, and the safety of the drugs was evaluated by measuring the changes of liver and kidney functions. Results After treatment in the two groups, the daytime systolic pressure (D-SBP) and diastolic pressure (D-DBP) and nighttime SBP (N-SBP) and DBP (N-DBP), the mean of 24 hours-SBP and 24 hours-DBP were all lower than those before treatment, and the D-DBP, N-SBP and 24 hours-DBP of the observation group were significantly lower than those of control group [D-DBP (mmHg, 1 mmHg = 0.133 kPa): 78.24±5.35 vs. 81.56±6.23, N-SBP (mmHg):117.35±5.42 vs. 122.63±7.23, 24 hours-DBP (mmHg): 74.15±5.26 vs. 80.51±6.52, all P < 0.05]; after treatment, the levels of renin, Ang Ⅱ and ALD in two groups were also declined, and the degrees of decrease in the observation group were more significant than those in the control group [renin (ng/L): 5.46±0.41 vs. 7.82±0.36, ALD (ng/L):128.48±31.42 vs. 168.48±28.32, Ang Ⅱ (ng/L): 52.35±14.27 vs. 75.38±15.65, all P < 0.05]; there were no significant changes in the levels of alanine aminotransferase (ALT), aspartate transaminase (AST), urea and creatinine (Cr) before and after treatment in the two groups, showing that the treatment was safe. Conclusion Qingxuan Jiangya decoction can effectively and safely reduce the blood pressure in PH patients, and its mechanism is possibly related to its influence on RAAS.
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Objective:To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up.Methods:In the study,299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included.The patients were divided into AKI group with AKI and control group without AKI after operation.The data during perioperative stage were compared,and multivariable Logistic regression modeling was used to identify the risk factors of AKI.The complications were compared after surgery and the patients were followed up for 3 years to observe the difference of MACCE between the two groups.Results:AKI occurred in 37.1％ patients (111/299).The elevated serum creatinine levels (Wald =9.276,P =0.002,95 ％ CI 1.006-1.028),chronic obstructive pulmonary disease(COPD) (Wald =3.469,P =0.063,95％ CI 0.950-7.630),decreased left ventricular ejection fraction (LVEF) (Wald =4.414,P =0.036,95 ％ CI 0.965-0.999),and implantation of intraaortic balloon pump (IABP) before or after operation(Wald =6.745,P =0.009,95％ CI 1.336-7.925)were risk factors of AKI in multivariable logistic regression modeling.More complications occurred in AKI group,such as the duration of mechanic ventilation,the time of ICU and the length of stay post operation,reintubation,pulmonary infection,stroke,hemorrhage of digestive tract,the volume of blood transfusion (plasma and red blood cell) and renal replacement therapy(P ＜ 0.05).The difference of mortality rate had no statistical significance between the AKI group and the control group,but two patients died in the AKI group.The difference of MACCE between the two groups had no statistical significance after 3 years' follow-up either.Conclusion:The incidence of AKI was high (37.1％) after off-pump CABG.The elevated serum creatinine levels,COPD,decreased LVEF,and implantation IABP before or after operation were independent risk factors of AKI in multivariable Logistic regression modeling.More complications occurred in AKI group during perioperative period,but the difference of MACCE between the two groups after 3 years' follow-up had no statistical significance.
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Objective:To evaluate the role of the left ventricular ejection fraction (LVEF) in coronary artery bypass grafting(CABG)patients. Methods: From 2004 to 2005,215 patients underwent CABG and there were 36 cases with LVEF0.40(normal LVEF group). Correlative data of the two groups were compared and analyzed statistically. Results: Compared with the normal EF group, the EuroSCORE of the low EF group was much higher (mean 6.4?1.7) and many more patients of the low EF group had concomitant moderate to severe mitral valve insufficiency and aneurysm that needed simultaneous surgical operation(55.6%).Two patients died in hospital(5.5%)in the low EF group whereas five patients in the normal EF group(2.8%, P
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Objective To analyze the efficacy and debase the toxicity of radiotherapy combined with composite Kushen injection in treatment of esophageal carcinoma patients. Methods A total of 126 cases of esophageal cancer were treated by radiotherapy were analysed. All patients were treated with the continuative hyperfractionated radiotherapy. The total dose was 66 ~ 74 Gy/5 ~ 7 wk, 2.2 ~ 2.4 Gy/d of esophageal carcinoma patients. Two groups were given respectively delivered with the same radioactive dosages and methods.But the synthetic group was treated by radiotherapy with composite Kushen injection. composite Kushen injection was given at the dosage of 20 ml with 500 ml of saline infusion for 20 consecutive days. Results X-ray grades of esophageal cancer after radiotherapy. The grade I of X-ray manifestation after radiotherapy for patients in synthetic group was superior to that patient in the radiotherapy alone group. (60.4 % vs 41 %; ?2 =4.57, P
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Objective: To investigate the peri-operative incidence of depression and anxiety symptoms of coronary artery bypass grafting (CABG). Methods: 73 patients,who underwent scheduled consecutive CABG between July 2005 and May 2006,were assessed with self-rating depression scale( SDS) and self-rating anxiety scale(SAS)before operation and before leaving hospital.Results: 21 patients (28.8%) had depression and/or anxiety symptoms before CABG, including 11 patients with depression, 7 patients with both depression and anxiety and the other 3 patients had anxiety symptoms. 34 patients (46.6%) had depression and/or anxiety symptoms after CABG, including 18 patients who had depression, 13 patients had both depression and anxiety symptoms and the other 3 patients had anxiety symptoms. The SDS score(47.9?10.0)after surgery was significantly higher than that before surgery(43.7?10) ,t=3.55, P=0.001. The SAS score after surgery (41.6?8.5) was significantly higher than that before surgery (39.3?7.4),t=2.20, P=0.031. Patients with bad mood before operation had lower educational levels (8?3/10?3,t=2.18,P=0.032). Four patients had multiple myocardial infarctions, all of them were in the anxiety-depression group postoperatively (4/34 vs 0/39,P=0.043). There was no difference in post-operative length of hospital stay between the two groups.Conclusions: The peri-operative incidence of depression and anxiety of CABG patients was very high and even higher after surgery. Less education is a risk factor for preoperative depression and anxiety states, multiple infarctions is a risk factor of post operative anxiety and depression.