Influence Mechanism of Myocardial Fibrosis and Vascular Regeneration of Shexiang Tongxin Pills to Syndrome of Qi Deficiency and Blood Stasis in Ischemic Heart Failure / 中国实验方剂学杂志

ABSTRACT

Objective:To discuss clinical effect of Shexiang Tongxin pills to syndrome of Qi deficiency and blood stasis in ischemic heart failure （IHF） and to study the mechanism to myocardial fibrosis and vascular regeneration. Method:One hundred and forty patients were randomly divided into observation group （70 cases） and control group （70 cases） with the same cases. 66 patients in control group finish the therapy （3 patients fall off or lost visit， 1 were eliminated）. 65 patients in observation group completed the therapy （4 patients were falling off， 1 were eliminated）. Both groups patients got combined treatment according to the guiding. Patients in control group got simulated medicine of Shexiang Tongxin pills， 2 pills/time， 3 times/day. Patients in observation group got Shexiang Tongxin pills， 2 pills/time， 3 times/day. The treatment was continued for 24 weeks. Before and after treatment， the left ventricular ejection fraction （LVEF）， cardiac output （CO）， end diastolic diameter （LVEDd）， left posterior wall thickness （LVPW）， left ventricular mass index （LVMI） and left ventricular remodeling index （LVRI） were measured by echocardiography. And scores of six minute walking test （6 MWT）， Lee's heart failure score， Qi deficiency and blood stasis syndrome score and Minnesota Heart Failure Quality of life questionnaire （MLHFQ） were graded. And levels of N-terminal B-type natriuretic peptide （NT-proBNP）， transforming growth factor-β1 （TGF-β1）， soluble ST2 （sST2）， matrix metalloproteinase-2 （MMP-2）， matrix metalloproteinase inhibitor-2 （TIMP-2）， insulin-like growth factor-1 （IGF-1）， vascular endothelial growth factor （VEGF）， angiopoietin1 （Ang1） and angiopoietin2 （Ang2）， and the safety was evaluated. Result:The total clinical effect in observation group was 90.77% （59/65） higher than 74.24% （49/66） in control group （χ2=6.179， P<0.05）. Levels of LVEF， CO， LVRI， 6 MWT， TIMP-2， IGF-1， VEGF and Ang1 were higher than those in control group （P<0.01）. And levels of LVEDd， LVPW and LVMI were lower than those in control group （P<0.05）， levels of NT-proBNP， TGF-β1， sST2， MMP-2 and Ang2 were lower than those in control group （P<0.01）， scores of Lee's heart failure score， Qi deficiency and blood stasis syndrome score and MLHFQ were lower than those in control group （P<0.01）. Besides， there was no adverse reactions caused by Shexiang Tongxin dropping pills. Conclusion:On the basis of conventional western medicine treatment， Shexiang Tongxin drop pills can improve the ventricular remodeling， improve the heart function， reduce the clinical symptoms， increase the exercise tolerance and quality of life of the patients by affecting the myocardial fibrosis and vascular regeneration factor， which has better clinical efficacy and safety.