坎离颗粒加载对慢性心力衰竭患者骨骼肌受损的影响

doi:10.3736/jcim20120312

Abstract

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

Na Mu-hai, Yao Cheng-zeng, Yu Xiao-tian, Jiang Mei-xian. Effects of added therapy with Chinese herbal medicine Kanli Granule on skeletal muscle dysfunction in patients with chronic heart failure. Journal of Chinese Integrative Medicine, 2012, 10(3): 324-329.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20120312

http://www.jcimjournal.com/EN/Y2012/V10/I3/324

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References 9

[1]	Carvalho RF, Cicogna AC, Campos GE, De Assis JM, Padovani CR, Okoshi MP, Pai-Silva MD . Myosin heavy chain expression and atrophy in rat skeletal muscle during transition from cardiac hypertrophy to heart failure. Int J Exp Pathol. 2003; 84(4):201-206. doi: 10.1046/j.1365-2613.2003.00351.x
[2]	Lu ZH. ABC of heart failure pathophysiology. Yingguo Yi Xue Za Zhi Zhong Wen Ban. 2001; 4(2): 91-94. Chinese.
	卢朝晖 .心力衰竭( 二)病理生理学.英国医学杂志中文版. 2001; 4(2) : 91-94.
[3]	Ruan XF, Jiang MX, Xu Y, Cui S, He X, Jia MJ . Effects of addition of Kanlijian on exercise tolerance, quality of life and worsened times in the patient of chronic heart failure. Zhong Yi Za Zhi. 2006; 47(7): 505-508. Chinese with abstract in English.
	阮小芬, 蒋梅先, 徐燕, 崔松, 何翔, 贾美君 . 加用中药坎离煎对慢性心力衰竭患者活动耐量、生活质量及心衰加重次数的影响.中医杂志. 2006; 47(7):505-508.
[4]	McKee PA, Castelli WP, McNamara PM, Kannel WB . The natural history of congestive heart failure : the Framingham study. N Engl J Med. 1971 ; 285(26):1441-1446. doi: 10.1056/NEJM197112232852601
[5]	Chinese Society of Cardiology , Editorial Board of Chinese Journal of Cardiology. Guidelines for diagnosis and treatment of chronic heart failure. Zhonghua Xin Xue Buan Bing Za Zhi. 2007; 35(12) : 1076-1095. Chinese.
	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 慢性心力衰竭诊断治疗指南.中华心血管病杂志. 2007; 35(12):1076-1095.
[6]	Feng LS, Li KG. The physiological and biochemical testing methods and applications of athletes commonly used functional assessment. Beijing: People’s Sports Publishing House of China. 2002: 69. Chinese.
	冯连世, 李开刚 . 运动员机能评定常用生理生化指标测试方法及应用.北京: 人民体育出版社. 2002: 69.
[7]	Tang Q, Jiang WK, Ding NW, Qin XL, Lu YN, Ji SM . The application of blood lactate in the maximal oxygen uptake and Wingate anaerobic test of track and field athletes. Zhongguo Lin Chuang Kang Fu. 2003; 7 (6) : 992-993. Chinese with abstract in English.
	汤强, 姜文凯, 丁宁伟, 秦学林, 陆永宁, 季师敏 . 田径运动员最大摄氧量和无氧功测试中血乳酸的应用. 中国临床康复. 2003; 7(6):992-993.
[8]	Yao CZ, Jiang MX . Effects of Kanli Granule Decoction on capacity of endurance exercise and hemodynamics in rats with chronic heart failure. Zhongguo Shi Yan Fang Ji Xue Za Zhi. 2009; 15(1): 21-23. Chinese with abstract in English.
	姚成增, 蒋梅先 . 坎离颗粒对慢性心衰大鼠血流动力学和耐力型运动能力的影响.中国实验方剂学杂志. 2009; 15(1) : 21-23.
[9]	Hua ZJ, Feng QG, Qiu JM , Li F. Effect of warming kidney yang medicine on LDH isoenzyme activity in rats. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1992 ; 12 (2): 103. Chinese.
	华中健, 冯群光, 仇健明, 李飞 . 温补肾阳药对大鼠 LDH同工酶活性的影响.中国中西医结合杂志. 1992; 12(2):103.

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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

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^*

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^**

Group	n	Lactate level in peripheral blood
Group	n	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

Group	n	LDH isoenzyme
Group	n	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

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

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