Bharani A, Ganguly A, Bhargava K D
Department of Medicine, M.G.M. Medical College, Indore, India.
Int J Cardiol. 1995 May;49(3):191-9. doi: 10.1016/0167-5273(95)02320-v.
Twelve patients with refractory chronic congestive heart failure (Class IV NYHA), related to idiopathic dilated cardiomyopathy (10 patients); previous myocardial infarction (one patient) and peripartum cardiomyopathy (one patient), received Terminalia Arjuna, an Indian medicinal plant, as bark extract (500 mg 8-hourly) or matching placebo for 2 weeks each, separated by 2 weeks washout period, in a double blind cross over design as an adjuvent to maximally tolerable conventional therapy (Phase I). The clinical, laboratory and echocardiographic evaluation was carried out at baseline and at the end of Terminalia Arjuna and placebo therapy and results were compared. Terminalia Arjuna, compared to placebo, was associated with improvement in symptoms and signs of heart failure, improvement in NYHA Class (Class III vs. Class IV), decrease in echo-left ventricular enddiastolic (125.28 +/- 27.91 vs. 134.56 +/- 29.71 ml/m2; P < 0.005) and endsystolic volume (81.06 +/- 24.60 vs. 94.10 +/- 26.42 ml/m2; P < 0.005) indices, increase in left ventricular stroke volume index (44.21 +/- 11.92 vs. 40.45 +/- 11.56 ml/m2; P < 0.05) and increase in left ventricular ejection fractions (35.33 +/- 7.85 vs. 30.24 +/- 7.13%; P < 0.005). On long term evaluation in an open design (Phase II), wherein Phase I participants continued Terminalia Arjuna in fixed dosage (500 mg 8-hourly) in addition to flexible diuretic, vasodilator and digitalis dosage for 20-28 months (mean 24 months) on outpatient basis, patients showed continued improvement in symptoms, signs, effort tolerance and NYHA Class, with improvement in quality of life.(ABSTRACT TRUNCATED AT 250 WORDS)
12例难治性慢性充血性心力衰竭（纽约心脏协会IV级）患者，病因包括特发性扩张型心肌病（10例）、既往心肌梗死（1例）和围产期心肌病（1例），接受了印度药用植物诃子，以树皮提取物形式（每8小时500毫克）或匹配的安慰剂进行治疗，各为期2周，中间有2周的洗脱期，采用双盲交叉设计，作为最大耐受常规治疗的辅助治疗（I期）。在基线时以及诃子和安慰剂治疗结束时进行临床、实验室和超声心动图评估，并比较结果。与安慰剂相比，诃子与心力衰竭症状和体征的改善、纽约心脏协会分级改善（III级 vs. IV级）、超声心动图左心室舒张末期容积降低（125.28±27.91 vs. 134.56±29.71 ml/m2；P<0.005）和收缩末期容积降低（81.06±24.60 vs. 94.10±26.42 ml/m2；P<0.005）、左心室每搏输出量指数增加（44.21±11.92 vs. 40.45±11.56 ml/m2；P<0.05）以及左心室射血分数增加（35.33±7.85 vs. 30.24±7.13%；P<0.005）相关。在开放设计的长期评估（II期）中，I期参与者除了灵活使用利尿剂、血管扩张剂和洋地黄外，继续以固定剂量（每8小时500毫克）服用诃子，门诊治疗20 - 28个月（平均24个月），患者的症状、体征、运动耐力和纽约心脏协会分级持续改善，生活质量也有所提高。（摘要截取自250字）
