Effect of co-administration of &lt;i&gt;Linggui zhugan&lt;/i&gt; decoction and Western medicine on inflammatory cytokines, and immune and cardiac functions of patients with chronic heart failure

He Xin,Ji Yunxi

doi:10.4314/tjpr.v18i2.20

Abstract

Purpose: To investigate the combined effect of Linggui zhugan decoction and Western medicine on inflammatory cytokines, and immune and heart functions of patients with chronic heart failure (CHF), and the underlying mechanism(s). Methods: Patients with CHF ( n = 140) were randomly assigned to two groups: control group and study group (70 per group). Patients in the control group were treated with furosemide, metoprolol, spironolactone, isosorbide mononitrate, trimetazidine and irbesartan, once, twice or thrice daily. Study group patients were treated with a combination of Linggui zhugan decoction, in addition to the treatment given to the control group. Levels of inflammatory cytokines, T-lymphocyte subsets and cardiac function were determined by enzyme-linked immunosorbent assay (ELISA), flow cytometry and color Doppler echocardiography, as appropriate. Clinical effectiveness for the two groups were also assessed. Results: Following the treatments, the serum levels of interleukin-6 (IL-6), interleukins-18 (IL-18) and tumor necrosis factor α (TNF-α) significantly decreased in the study group, when compared with the control group ( p < 0. 05). However, the study group had markedly higher levels of CD3+ T, CD4+ T, and CD4+ T /CD8+ T than the control group ( p < 0. 05). In addition, CD8+ T was significantly lower in the study group than in control group ( p < 0. 05). Patients in the study group had significantly higher total treatment effectiveness than those in the control group ( p < 0. 05). Conclusion: These results suggest that co-administration of decoction of Linggui zhugan and western medicine improves ventricular function and reduces clinical symptoms in patients with CHF via a mechanism involving inhibition of inflammatory reactions. Keywords: Chronic heart failure, Linggui zhugan decoction, Inflammatory cytokines, T- lymphocyte subsets, Cardiac function

Highlights

Chronic heart failure (CHF) is a clinical condition caused by changes in cardiac structure and function
These results suggest that co-administration of decoction of Linggui zhugan and western medicine improves ventricular function and reduces clinical symptoms in patients with CHF via a mechanism involving inhibition of inflammatory reactions
Pulmonary hypertension is a major determinant of poor prognosis in CHF [3]

Summary

Introduction

Chronic heart failure (CHF) is a clinical condition caused by changes in cardiac structure and function. Treatment of CHF improves symptoms such as dyspnea, and prevents the development of myocardial remodeling [1]. Pulmonary hypertension is a major determinant of poor prognosis in CHF [3]. Pulmonary vascular occlusion is the most common mechanism of pulmonary hypertension in heart failure, and it is due to an increase in pulmonary venous pressure caused by increased chronic left ventricular filling pressure. Pulmonary hypertension may be completely or partially reversed by reducing blood volume and/or improving left ventricular function, and restoring normal left ventricular filling pressure. Pulmonary vasoconstriction and remodeling is another mechanism of pulmonary hypertension, and it is associated with increased pulmonary vascular resistance (PVR). The side effects are enormous and it is not clinically effective [5]

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Results

Conclusion