Viral Myocarditis

Findings from a recent Cochrane systematic review of Chinese herbs used in viral myocarditis provide limited supportive evidence for its use; however, further research is required before a definitive conclusion can be made (Liu JP et al 2004). Several in vivo and in vitro studies have found some antagonistic effects on the enterovirus coxsackie B and a reduction in myocardial injury (Lu et al 1999, Peng et al 1995, Rui et al 1993, Yang et al 1990) thought to be due to the astragalosides in the herb (Lu et al 1999).

CARDIOVASCULAR DISEASE, INCLUDING ISCHAEMIC HEART DISEASE, CONGESTIVE HEART FAILURE, ANGINA PECTORIS

Congestive heart failure Some of the clinical signs and symptoms recognised as indicators for this medicine by TCM practitioners suggest that the herb may be useful for congestive heart failure. Recent positive results obtained in clinical studies have reinforced this possibility.

The two clinical trials have investigated continuous intravenous administration of astragalus. One study involving 19 patients found that after 2 weeks' continuous administration of astragaloside IV, major symptoms were alleviated in 1 5 patients. Treatment produced a positive inotropic effect, improved left ventricular modelling and ejection function (Luo et al 1995).

The second study, involving 38 patients with congestive heart failure who were administered astragalus 24 g intravenously for 2 weeks, found that 13.6% had significantly shortened ventricular late potentials (Shi et al 1991). Angina pectoris Two clinical studies have suggested that astragalus may be an effective treatment for angina pectoris. One study used Doppler echocardiography to study the action of astragalus on left ventricular function in 20 patients with angina pectoris. Treatment resulted in increased cardiac output after 2 weeks, but no improvement in left ventricular diastolic function (Lei et al 1994). One Chinese study reported 92 patients with ischaemic heart disease who were successfully treated with astragalus as measured by electrocardiogram readings. Results obtained with the herb were considered superior to those obtained with nifedipine (Li et al 1995).

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