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Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (3): 324-329.doi: 10.3736/jcim20120312

• Original Clinical Research • Previous Articles     Next Articles

Effects of added therapy with Chinese herbal medicine Kanli Granule on skeletal muscle dysfunction in patients with chronic heart failure

Na Mu-hai1,Yao Cheng-zeng2,Yu Xiao-tian3,Jiang Mei-xian2()   

  1. 1. Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
    2. Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China
    3. Office of Journal of Forensic Medicine, Shanghai 200063, China
  • Received:2011-09-14 Accepted:2011-12-15 Online:2012-03-20 Published:2018-10-10

BACKGROUND: The pathological changes of skeletal muscle dysfunction in chronic heart failure (CHF) have caused widespread concern, and evaluating the functional properties of medication to improve these pathological changes has become a common area of study for clinicians.
OBJECTIVE: To investigate the characteristics of skeletal muscle dysfunction in patients with CHF and the effects of Kanli Granule, a compound traditional Chinese herbal medicine, on the skeletal muscle dysfunction based on Western medical treatment in patients with CHF.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: All patients with CHF enrolled in this study were outpatients or inpatients in Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from December 2005 to December 2007. The patients were divided into Western medicine group (treatment with Western medicine) and Chinese herbs group (treatment with Kanli Granule based on Western medicine) based on their preference. The treatment course lasted for 12 weeks.
MAIN OUTCOME MEASURES: The grip strength, grasp times, rate of perceived exertion (RPE), estimated heart rate, peripheral blood lactate levels and lactate dehydrogenase (LDH) isoenzyme activity in patients were measured.
RESULTS: A total of 92 patients were recruited and 12 patients withdrew from the Western medicine group, therefore a total of 80 patients were included in the follow-up study. There were 46 cases in the Chinese herbs group and 34 cases in the Western medicine group. After treatment, grip strength and grasp times increased significantly compared with before treatment. RPE score and estimated heart rate significantly decreased in the two groups, showing greater changes in the Chinese herbs group than the Western medicine group (P<0.01). Peripheral blood lactate levels of the CHF patients in a resting state decreased, and the Chinese herbs group displayed a greater decrease than the Western medicine group (P<0.05); lactate levels 3 min after exercise decreased after treatment in both treatment groups, but no significant difference was found compared with before treatment; LDH1 levels in the two treatment groups were decreased compared with before treatment but showed no statistically significant changes; LDH5 levels in the two treatment groups increased after treatment, and an obvious difference was found in the Chinese herbs group (P<0.01).
CONCLUSION: Treatment with the addition of Kanli Granule can significantly improve the function of skeletal muscle in patients with CHF by improving skeletal muscle energy metabolism.

Key words: heart failure, function of skeletal muscle, drugs, Chinese herbal, controlled clinical trial

Table 1

Baseline characteristics of patients in two groups"

Item Traditional Chinese medicine group (n=46) Western medicine group (n=34)
Gender (male/female) 30/16 21/12
Age (x±s, years) 64.15±11.50 66.38±9.46
Course of disease (x±s, years) 3.40±3.00 3.28±3.16
Basic disease (n)
Coronary heart disease 11 9
Hypertensive heart disease 16 6
Hypertrophic cardiomyopathy 0 4
Dilated cardiomyopathy 13 12
Rheumatic heart disease 4 2
Congenital heart disease 1 0
Arrhythmia 1 0
NYHA grade (x±s) 2.72±0.51 2.72±0.39

Figure 1

Flow diagram of this trial"

Table 2

Grip strength and grasp times of patients with chronic heart failure before and after treatment (x±s)"

Group n Grip strength (mmHg) Grasp times
Traditional Chinese medicine 46
Before treatment 50.81±10.56 60.76±20.05
After treatment 59.91±12.13** 72.78±20.03*△
Western medicine 34
Before treatment 53.02±11.02 56.74±16.93
After treatment 58.99±9.34** 62.71±17.93*

Table 3

RPE score and estimated heart rate of patients with chronic heart failure before and after treatment (x±s)"

Group n RPE score Estimated heart rate (beats/min)
Traditional Chinese medicine 46
Before treatment 17.22±1.28 172.17±12.81
After treatment 15.04±1.37**△△ 150.43±13.66**△△
Western medicine 34
Before treatment 16.82±1.06 168.24±10.58
After treatment 15.79±1.12** 157.94±11.22**

Table 4

Lactate level in peripheral blood of patients with chronic heart failure before and after treatment (x±s, mmol/L)"

Group n Lactate level in peripheral blood
Resting state After 3-minute exercise
Traditional Chinese medicine 46
Before treatment 1.77±0.89 1.78±0.69
After treatment 1.42±0.50* 1.65±0.43
Western medicine 34
Before treatment 1.88±0.83 1.79±0.74
After treatment 1.64±0.56 1.73±0.50

Table 5

Activities of LDH isoenzymes of patients with chronic heart failure before and after treatment (x±s, %)"

Group n LDH isoenzyme
LDH1 LDH2 LDH3 LDH4 LDH5
Healthy 10 26.04±3.63 39.99±2.28 23.01±1.57 4.80±2.89 6.16±2.18
Traditional Chinese medicine
Before treatment 36 30.93±6.29▲ 39.41±3.34 21.89±3.01 4.05±2.62 2.92±2.38▲▲
After treatment 36 29.60±5.43 37.34±3.62▲ 21.72±4.62 5.75±3.26 5.21±3.73**
Western medicine
Before treatment 28 33.75±4.90▲▲ 37.98±2.95 20.80±2.88▲ 3.27±2.02 3.44±2.57▲▲
After treatment 28 31.16±7.45▲ 37.77±4.07 21.80±3.79 4.54±2.79 4.77±2.26
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