The therapeutic effects of Chinese formulated products combined with glucocorticoid for treatment of patients with refractory heart failure / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the therapeutic effect of Qili Qiangxin capsule combined with glucocorticoid for treatment of patients with dilated cardiomyopathy accompanied by refractory heart failure. Methods A prospective study was conducted. Forty-eight patients with dilated cardiomyopathy and refractory heart failure in Hebei Cangzhou Central Hospital were enrolled,and they were randomly divided into three groupscontrol group,treatmentⅠand treatmentⅡgroups(each,16 cases). All groups were treated with conventional anti-heart failure western treatment, meanwhile additionally prednisone was given to treatment groupⅠand groupⅡ,firstly 40 mg/d,then the dosage of 5 mg was decreased in every 5 days until reaching 5 mg per day;in treatment groupⅡ,besides the same treatment of group I,the traditional Chinese medicine therapy Qili Qiangxin capsule 4 granules(one capsule 0.3 g)each time and 3 times a day was added,2 months being the therapeutic course in all the patients. The clinical efficacy and cardiac functional indexes,such as the left ventricular end-diastolic volume(LVEDV),the left ventricular end-systolic volume(LVESV),the left ventricular ejection fraction(LVEF)and the plasma B type brain natriuretic peptide (BNP),etc. were observed in 1 week and 2 months after treatment. Meanwhile the electrocardiogram(ECG),aspartate transaminase(AST),alanine aminotransferase(ALT),urea nitrogen(BUN),serum creatinine(SCr),blood routine, urine routine examination and the adverse effects were investigated. Results The total effective rates in treatment groupⅠand treatment groupⅡwere significantly higher than those in the control group〔after treatment for 1 week81.2%(13/16),81.2%(13/16)vs. 43.8%(7/16);after 2 months87.5%(14/16),93.7%(15/16)vs. 50.0%(8/16), all P<0.05〕. After treatment,the LVEDV,LVESV and BNP were lowered and the LVEF was increased in the three groups,and the above indexes in treatment groupⅡwere improved more significantly than those in groupⅠ〔LVEDV (mL)142.4±33.0 vs. 174.8±52.5,LVESV(mL)111.6±23.7 vs. 132.4±29.0,LVEF0.421±0.037 vs. 0.390±0.045,BNP(μg/L)1.944±0.751 vs. 3.038±1.905,all P<0.05〕. Conclusion Qili Qiangxin capsule combined with glucocorticoid may effectively improve the cardiac function and clinical symptoms in near and forward future in patients with dilated cardiomyopathy accompanied by refractory heart failure,thus it may elevate the patients' life quality.