Department of Cardiovascular Diseases, Wuxi Municipal Hospital of Traditional Chinese Medicine, Wuxi City, Jiangsu Province 214001, China.
Chin J Integr Med. 2011 Feb;17(2):146-9. doi: 10.1007/s11655-011-0647-9. Epub 2011 Mar 9.
To explore the dose-effect relationship of Astragalus granule (AG) on improving the quality of life (QOL) of the patients with chronic heart failure (CHF).
Ninety CHF patients of Fei ()-qi-deficiency and/or Xin ()-Shen () yang-deficiency syndromes were equally randomized divided with a random number table into three groups; they received the high (7.5 g), moderate (4.5 g), and low dosage (2.25 g) of AG orally taken twice a day, respectively, and 4 mg of perindopril tablet once a day for 30 successive days. The heart function grade, patients' left ventricular ejection fraction (LVEF) and walking distance in 6 min (6mWD) were measured before and after treatment, and the patients' QOL was scored by the Minnesota Questionnaire for QOL evaluation in the patients with CHF at the same time.
The heart function grades of all the three groups after treatment were improved compared with those before treatment, but the improvements in high-dose group and moderate dose group were better than that in the low dose group (P<0.05). LVEFs were increased significantly in all the three groups, but the improvements in the high-dose group (59.42%±7.50%) and moderate dose group (61.98%±6.82%) were better than that in the low dose group (51.45%±6.80%, P<0.01); the 6mWDs in the all groups were also significantly increased (P<0.01), up to 419.80±36.23 m, 387.15±34.13 m, and 317.69±39.97 m, respectively; and Minnesota scores in them were lowered to 29.59±4.69 scores, 35.74±5.89 scores, and 42.78±6.06 scores, respectively; comparisons in aspects on 6mWD and Minnesota score showed that the effectiveness with high dose is the most effective, moderate dose as the second, and low dose as the lowest (P<0.01).
AG was sufficient to display an optimal effect on improving heart contraction at the moderate dose. In aspects of improving the QOL of CHF patients, the effectiveness of AG showed a dose-dependent trend. It should be applied discriminatively depending on the actual condition of patients and the aim of treatment in clinic.
探讨黄芪颗粒改善慢性心力衰竭（CHF）患者生活质量（QOL）的量效关系。
90 例气阴两虚、心肾阳虚证 CHF 患者，按随机数字表法分为 3 组，分别给予黄芪颗粒高（7.5 g）、中（4.5 g）、低（2.25 g）剂量，每日口服 2 次，同时给予培哚普利 4 mg，每日 1 次，连续 30 天。治疗前后测量心功能分级、左心室射血分数（LVEF）和 6 min 步行距离（6mWD），同时采用明尼苏达心力衰竭生活质量量表评价 CHF 患者的 QOL。
3 组治疗后心功能分级均较治疗前改善，但高、中剂量组改善优于低剂量组（P<0.05）。3 组 LVEF 均显著升高，高、中剂量组分别为（59.42%±7.50%）、（61.98%±6.82%）优于低剂量组（51.45%±6.80%，P<0.01）；6mWD 均显著增加，分别达到（419.80±36.23）m、（387.15±34.13）m、（317.69±39.97）m；明尼苏达心力衰竭生活质量量表评分均降低，分别为（29.59±4.69）分、（35.74±5.89）分、（42.78±6.06）分；6mWD 和明尼苏达心力衰竭生活质量量表评分方面的比较显示，高剂量疗效最佳，中剂量次之，低剂量最差（P<0.01）。
黄芪颗粒在中剂量下可充分发挥改善心脏收缩的最佳疗效。在改善 CHF 患者 QOL 方面，黄芪颗粒的疗效呈剂量依赖性趋势。在临床应用中，应根据患者的实际情况和治疗目的进行有针对性的应用。
