Objective:To discuss the clinical efficacy of Tianwang Buxindan treatment to atrial fibrillation combined with coronary heart disease (Yin deficiency and fire prosperity) and investigate its mechanism of anti-inflammatory action. Method:One hundred and eighteen patients were randomly divided into control group and observation group by random number table at ratio of 1:1

59 cases in each group. Patients in control group got warfarin sodium tablets

2.5-5.0 mg/days

qd

with international normalized ratio (INR) monitoring for 2.0-3.0 times. Metoprolol succinate sustained-release tablets

23.75-47.5 mg

qd

and atorvastatin calcium tablets

20 mg/days

qd at night. Based on the treatment in control group

the patients in observation group added Tianwang Buxindan treatment

1 dose/day. The treatment course was 8 weeks for both groups. Before and after treatment

electrocardiogram and echocardiography examinations were conducted[left ventricular ejection fraction (LVEF)

cardiac output (CO)

left ventricular end systolic diameter (LVESD)

and stroke volume (SV) were recorded]. Scores of Yin deficiency and fire prosperity were graded; levels of triglyceride (TG)

total cholesterol (TC)

high density lipoprotein (HDL-C)

low density lipoprotein (LDL-C)

NT-pro btype natriuretic peptide (NT-proBNP)

interleukin-6 (IL-6)

tumor necrosis factor-α (TNF-α)

C reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) were detected; and the safety was also evaluated both before and after treatment. Result:In the rank sum test

in observation group were superior to that in control group (P<0.05). After treatment

the ventricular rate in observation group was lower than that in control group (P<0.05)

and the number of atrial fibrillation combined with abnormality of electrocardiogram was lower than that in control group (χ2=6.631

P<0.05). The scores of palpitation

insomnia

irritability

chest tightness

chest pain

scores of the secondary symptoms and total score of Yin deficiency and fire prosperity were all lower than those in control group(P<0.01). Number of cases of dyslipidemia was also lower than that in control group (χ2=4.417

P<0.05). Levels of LVEF

CO and SV in observation group were higher than those in control group (P<0.05)

while the levels of NT-proBNP

IL-6

TNF-α

CRP and MCP-1 were lower than those in control group (P<0.01). During the study

no serious adverse event and hemorrhage happened

and there was no statistical significance in the abnormality of liver and kidney function and clotting routine. Conclusion:Based on the treatment of routine western medicine treatment

Tianwang Buxindan treatment can control ventricular rate

relieve clinical symptoms

regulate lipid metabolism

ameliorate heart function and inhibit inflammatory reaction

which is effective for atrial fibrillation.