| Objective:To explore the relationship between Helicobacter pylori (Hp) infection and the related risk factors of coronary heart disease(CHD), to analyze the role of Helicobacter pylori infection in the pathogenesis of CHD. To investigate the correlation between Helicobacter pylori infection and syndrome of traditional Chinese medicine of CHD. To observe the clinical efficacy of Qingwei Xingzhi recipe in treatment of unstable angina pectoris(UAP) of coronary heart disease combined with Helicobacter pylori infection and phlegm-heat and blood stasis, and the influence on blood lipids, hemorheology and inflammatory cytokines (high sensitivity C reactive protein, resistin, and adiponectin), and to analyze its possible treatment mechanisms for the patients.Methods:1.112diagnosed CHD patients (including57cases of unstable angina pectoris and55cases of stable angina pectoris) were collected, to detailedly recorded their gender, age, whether or not CHD combined with hypertension,diabetes, hyperlipidemia, smoking history, drinking history and family history, and to confirm the syndromes of traditional Chinese medicine. All the patients received the carbon14expiratory test to detect fasting Hp level, and to compare with non CHD group (59cases).2.Sixty inpatients suffered from unstable angina pectoris(UAP) of coronary heart disease combined with Helicobacter pylori infection and phlegm-heat and blood stasis at the Cardiology Department of the first affiliated hospital of Hunan University of TCM were randomly assigned to the treatment group (30cases) and the control group (30cases) form June2013to August2014. Those in the treatment group were treated with routine Western medicine treatment and Qingwei Xingzhi recipe, while those in the control group were treated with routine Western medicine and Compound Danshen dripping pills. The therapeutic course for all was6weeks. The clinical efficacy was compared between the two groups, and the serum level of lipids, hemorheological parameters and inflammatory cytokines (hs-CRP, resistin and adiponectin) were observed before and after treatment.3.Statistical methods:the data was analyzed after observation.The measurement data, enumeration data and the rank data were examined respectively with T-test, Chi-square test and Wilcoxon signed rank test.Results:1. The study results about clinical related factors of CHD combined with Hp infection①The Helicobacter pylori infection rate (45.54%) of the CHD group was significantly higher than that of non CHD group (23.72%)(P<0.01). In CHD group, the Helicobacter pylori infection rate of patients with unstable angina pectoris was56.14%, and that of patients with stable angina pectoris was34.54%. The difference was statistically significant (P<0.05)②In various types of coronary heart disease risk factors, the Helicobacter pylori positive rate of family history, smoking history, drinking history, hyperlipidemia, hypertension, diabetes history, and male patients was respectively48.65%,50.88%,46.67%,45.16%,46.88%,47.92%,46.67%;the Helicobacter pylori positive rate of non family history, smoking history, drinking history, hyperlipidemia, hypertension, diabetes history and female patients was respectively46.67%,43.64%,42.31%,48.00%,45.83%,45.31%,43.24%, the comparison between the corresponding groups was not significant difference (P>0.05).③In CHD group, the Helicobacter pylori positive rate of the patients with heat syndrome, Qi deficiency syndrome, Qi and yin syndrome and phlegm and blood stasis syndrome was respectively69.23%,44.12%,29.41%,33.33%.The Helicobacter pylori infection rate of the patients with cold syndrome and Qi stagnation syndrome were o%. The Helicobacter pylori infection rate of the patients with heat syndrome group higher than those of the patients with Qi deficiency syndrome, Qi and yin deficiency Syndrome and Phlegm Blood Stasis Syndrome groups (P<0.01); while the difference has no statistical significance among Qi deficiency syndrome group, Qi and yin deficiency syndrome and Phlegm Blood stasis groups (P>0.05).2. The study results about intervention effect of Qingwei Xingzhi recipe for patients with UAP of coronary heart disease combined with Helicobacter pylori infection and phlegm-heat and blood stasis①The clinical curative efficacy of angina pectoris syndromes, the total effective rate of the treatment group (93.33%) was better than that of the control group (70.00%)(P<0.05).In effects of improvement of angina pectoris,the treatment group showed very significant difference on reducing frequency of angina pectoris attacks and duration of angina pectoris (P<0.01).Nitroglycerin consumption of the treatment group was significantly lower than that of the control group after treatment(P<0.01).②In syndrome of TCM,’the total effective rate of the treatment group (93.33%) was better than the control group (66.67%)((P<0.05).The clinical symptoms were improved to different degrees in the two groups after the treatment. In symptoms of TCM, such as chest pain, chest tightness,etc. the treatment group showed better clinical curative effect than that of the control group (P<0.05or P<0.01),except for the shortness of breath. Total scores of TCM syndrome after the treatment were lower than those before the treatment in the two groups, score changes in the treatment group were superior to those in control group (P<0.01).③In electrocardiogram improvement, the total effective rate of the treatment group and the control group were76.67%and50.00%respectively, there were statistical difference between the two groups (P<0.05).④In changes of the serum lipids levels in two groups, the levels of TC, TG, LDL-C were decreased after the treatment (P<0.01), and the treatment group showed better curative effect than that of the control group (P<0.01).The levels of HDL-C in two groups changed inconspicuously after the treatment (P>0.05).⑤In the hemorheological parameters improvement, in addition to the whole blood viscosity (low shear) of the control group,the hemorheological parameters in two groups were decreased to different degrees after the treatment (P<0.01), and the effects of the treatment group were superior to those of the control group (P<0.05or P<0.01).⑥In changes of the serum levels of hs-CRP, resistin and adiponectin in two groups before and after treatment, the serum levels of hs-CRP and resistin in two groups were significantly decreased after the treatment (P<0.01),and the decrement of serum levels of hs-CRP and resistin of the treatment group were obviously higher than those of the control group (P<0.01). The serum levels of adiponectin significantly increased in the two groups after treatment (P<0.05or P<0.01), and the increment of serum level of adiponectin of the treatment group were higher than that of the control group (P<0.01).⑦Eradication of Hp in treatment group, total effective rate of the treatment group in treating Hp infection was80.00%, and the Hp eradication rate of the treatment group was43.33%.Conclusion1. There may be associated with the pathogenesis of coronary heart disease and Helicobacter pylori infection, it suggests that Hp infection is an independent risk factor of CHD.Hp infection may induce and aggravate the inflammatory reaction of the coronary atherosclerosis, leading to the formation of unstable plaques due to acute cardiovascular events.2.In TCM syndromes of CHD patients with Hp infection, heat syndrome are in the majority, and different TCM syndromes are in order by heat syndrome, Qi deficiency, phlegm and blood stasis, Qi and yin deficiency syndrome,stagnation of cold and Qi.3.The study indicates that Qingwei Xingzhi recipe has favorable clinical curative effect on unstable angina pectoris patients with Helicobacter pylori infection and the syndrome of phlegm heat and blood stasis,can alleviate angina pectoris,improve the serum lipids levels and hemorheological parameters for the patients, and enhance the effect of clinical curative and TCM syndromes. Qingwei Xingzhi recipe is worthy of using in the clinical practice widely. It’s mechanism could relate to regulating blood lipid, increasing anti-coagulation activity, reducing the platelet adhesion for intervening thrombosis, and improving myocardial microcirculation. Qingwei Xingzhi recipe could inhibit Helicobacter pylori activity and obviously reduce the serum levels of hs-CRP and resistin, increase the serum level of adiponectin, indicating that partial therapeutic effects of QingweiXingzhi recipe might come from its anti-inflammation and thus the stability of vulnerable plaque.The study abundances and develops the theory thinking and methods for treating coronary heart disease from spleen and stomach. |
PDF Full Text Request