Shenfu decoction as adjuvant therapy for improving quality of life and hepatic dysfunction in patients with symptomatic chronic heart failure.
BACKGROUND
Shenfu decoction (SFD) is a water extract of the dried root or root stalk of Panax ginseng C. A. Mey (Asian ginseng) and the lateral root of Aconitum carmichaeli Debx (prepared by Fuzi, Heishunpian in Chinese). It has been used to treat heart failure for over a thousand years. The main active components of SFD, ginsenosides and higenamine, enhance heart contractility, increase the coronary blood supply, improve ischemic myocardial metabolism, scavenge free radicals and protect myocardial ultrastructure.


OBJECTIVE
To investigate the effect of SFD on quality of life (QOL) and hepatic function in symptomatic chronic heart failure (CHF) patients.


METHODS
Forty patients enrolled in the study were randomized into two groups: an SFD group (18 cases) and a control group (22 cases). All the patients received standard heart failure therapy, and the SFD group patients were also treated with Shenfu granules for 14 days as an adjunctive therapy. The effects of SFD on QOL, plasma alanine aminotransferase (ALT) level, cardiac function, left ventricular ejection fraction (LVEF) and tumor necrosis factor-α (TNF-α) level were studied. ALT threshold in hepatic injury are 21U/L for men and 17U/L for women.


RESULTS
Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores were improved by 35.27±10.72 vs. 23.87±11.96 in the SFD and control groups respectively (p<0.01). Subgroup analysis of the MLHFQ results demonstrated that both physical and emotional scores were significantly higher in the SFD group (21.00±5.66 vs. 16.75±6.25, p<0.05; 4.64±4.84 vs. 1.13±2.85, p<0.05). Circulating ALT was significantly decreased by SFD (13.3IU/L vs. 0.6IU/L, p<0.01). The grading of cardiac function and LVEF were increased by 1.6±0.5 vs. 1.1±0.3 and 18%±13% vs. 8%±8% in the SFD and control groups respectively (p<0.05 and p<0.05). The level of TNF-α declined more in SFD than control group (64.8±5.0 to 57.6±4.1, p<0.05; vs. 61.6±5.9 vs. 57.7±3.2. p>0.05).


CONCLUSIONS
Compared with standard heart failure treatment, oral SFD as an adjuvant therapy significantly improved QOL and hepatic injury in CHF patients.
Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China; Guang׳anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Huamin
H
Wei
Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China. Electronic address: whjyuanzhang@aliyun.com.
Hongjin
H
Wu
Beijing Hospital of Integrated Traditional and Western Medicine, Beijing 100039, China.
Wen
W
Yu
Beijing Hospital of Integrated Traditional and Western Medicine, Beijing 100039, China; Postdoctoral Workstation of the Zhongguancun Haidian Science Park, No.6 Sijiqing Road, Haidian District, Beijing 100195, China.
Xu
X
Yan
Beijing Hospital of Integrated Traditional and Western Medicine, Beijing 100039, China.
Xiaoyu
X
Zhang
D031841:Aconitum / Q000737:chemistry; D000277:Adjuvants, Pharmaceutic / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002908:Chronic Disease; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D036145:Ginsenosides / Q000032:analysis / Q000737:chemistry; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008107:Liver Diseases / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D015394:Molecular Structure; D011788:Quality of Life; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D016277:Ventricular Function, Left / Q000187:drug effects
D000277:Adjuvants, Pharmaceutic; D004365:Drugs, Chinese Herbal; D036145:Ginsenosides; C492793:Shen-Fu; D014409:Tumor Necrosis Factor-alpha; D000410:Alanine Transaminase
Clinical trials; Heart failure; Liver; Shenfu decoction; Traditional Chinese medicine