| Objective:Through the observation and application of the clinical therapeutic effect and safety of "Thoracic Obstruction Decoction" in the treatment of stale angina pectoris of coronary heart disease, we provide the interventional therapy for the Qi stagnancy with phlegm blocking type of CHD as well as a new thought through regulating Qi method. Hopefully we can make some contributions such as references and clinical instructions to the theory of thoracic obstruction by the way of analyzation and summary of the academic and prescribing characteristics of the mentor.Method:60 patients with SAP of CHD that meet inclusion criteria were randomly divided into therapeutic group of 30 cases and control group of 30 cases. Control group was provided with Aspirin Enteric-Coated Tablets, Metoprolol Tartrate Tablets, Lotensin, Isosorbide-5-mononitrate, Atorvastatin, low molecular heparin calcium; Therapeutic group was provided with traditional western medicine therapy along with "Thoracic Obstruction Decoction". The experiment lasted 21 days. During the treatment we didn’t use any Chinese patent medicine. Patients with high blood pressure, diabetes and infection were treated symptomatically. Observe the TCM syndrome, frequency of angina occurrence, amount of nitroglycerin, ECG ST-T change and hs-CRP, LDL-C, Non-HDL-C before and after the treatment of both groups.Result:1. based on improving TCM syndrome, the results showed:the total effective rate of therapeutic group was 93.33% and control group was 80%. There was significance difference between two groups (P<0.05). There was a statistical difference that therapeutic group was better than control group.2. Compare the two groups before and after treatment symptoms integral change:The results showed that, regardless of treatment group and control group compared to the control group before and after the treatment itself, or after treatment compared to the control groups, symptom scores before and after treatment were significantly lower, the difference was significant (P<0.01), there are significant differences in the treatment group than the control group.3. The two groups before and after treatment of angina pectoris, the results showed that the treatment group, the total efficiency of 93.33% in the control group, the total efficiency of 83.33%, a significant difference between the two groups angina (P<0.05), there are significant differences in the treatment group was significantly superior in the control group.4. Nitroglycerin stopped by two groups:The results showed that the treatment group stopped by the rate of 93.33% in the control group stopped by the rate of 86.61%, contrasting the two groups was significant difference (P<0.05), there are significant differences between the treatment group was significantly superior in the control group.5. ECG efficacy:The results showed that after treatment the efficacy of ECG comparison, the total efficiency of 90% in treatment group and control group, the total efficiency of 76.67%, a significant difference between two groups (P<0.05), the treatment group than in the control group.6. hs-CRP control groups:The results showed that, regardless of the treatment group and the control group compared to the control group before and after the treatment itself, or after treatment compared to the control groups, before and after treatment groups hs-CRP were significantly lower, the difference was significantly (P<0.05), there are significant differences in the treatment group than the control group.7.Control of two groups of LDL-C, Non-HDL-C:the results show, regardless of treatment group the group before and after treatment compared with the control group, or after treatment group comparison, LDL-C, and Non-HDL-C are both before and after treatment in both groups decreased, there was statistical difference (P<0.05), the treatment group than the control group.8.Two sets of blood pressure (systolic pressure, diastolic pressure) control:results showed that group before and after treatment in the treatment group and the control group comparison, or after treatment group comparisons, the two groups before and after two sets of systolic and diastolic blood pressure were reduced, there was statistical difference (P<0.05), the treatment group than the control group.9.Blood glucose control through specification hypoglycemic treatment ideal, but because the two groups of patients with diabetes duration, pre-hospital treatment, drug selection and other factors, less blood glucose before and after treatment could not be statistically significant sample size calculation differences.Conclusion:Stable angina pectoris, one of the important form of Coronary heart disease(CHD), belong to the category of traditional Chinese medicine"Chest or heartache" From the Han and Tang dynasties to song yuan Ming and qing dynasties, people got a general understanding of the pathogenesis about angina, thought that it Caused by deficiency of qi and blood, Yin and Yang,or blocking of phlegm and fluid retention or blood stasis.The main pathogenesis is heart vessel blockage stasis,the pathological change is asthenia in origin and asthenia in superficiality or intermingled deficiency and excess. Benxu can be qi deficiency, blood deficiency, Yin deficiency or Yang deficiency, biaoshi can be phlegm turbidity, qi stagnation, blood stasis or congealing cold. The mentor thought most chronic diseases were related to Qi deficiency, Qi disorder and phlegm obstruction which caused excessive and the deficiency syndrome and varieties. He emphasized the theory of "all Diseases result from disorder of Qi" and applying regulating Qi method to the treatment of endogenous miscellaneous diseases. He thought regulating Qi was most important in treating all diseases. He also suggested treating CHD SAP, heart failure (left/right/whole heart, acute/chronic, systolic/diastolic) based on different phases which meant first we regulated Qi deficiency, second we regulated functional activities of Qi, last we regulated phathological products such as phlegm, bruise and water. The tutor thinks that the occurrence and development of coronary heart disease, the heart of the main blood and the heart of the sun in the sun. It is considered that the function of the heart, first of all, is the leading of TCM Qi (Yang), which can realize the cardiovascular cycle of Western medicine and the physiological function of the Chinese medicine. Qi, Zong Qi abundant harmony is the premise of the heart of the power source and the circulation system and take nursed back to health, tonic "stretch" pay attention to the Yin and Yang of the two gas, congenital and acquired Qi, Ying and Wei Qi, take the warm Yangsheng provided. Business health and adjustment is pulse Tongli, Ying and Wei disorder is the initial factor of blood disease, blood disease in the early stage of given "loss of cardiac, regulating Ying and Wei". The triple energizer is Qi, yin and Yang, fire elevator access, and body fluid compress channel, stagnation of Qi and phlegm, stasis in the heart arteries and veins is throughout the pathological basis of coronary heart disease and blood stasis in the heart vessels is a turning point in the coronary heart disease, therefore impose phlegm knot, promoting blood circulation and removing blood stasis in powder,It appears chest pain symptoms of coronary heart disease, always the "yin yang micro strings" of pathogenesis; coronary heart disease wheezing, swelling and other symptoms, is the development of "blood Unsmooth water", "Yang internal organs to exhaust "for the pathogenesis of Heart water (CHF) "stage, when the provisional certificate" full effort on the yin and yang intend, "Fu Yang Dafa to transfer gas of coronary heart disease," all yang Rise and Fall of the outcome " Fu Yang to warm through for the law, pay attention to regulating qi. Therefore,It runs through a phased transfer gas law in the course of treatment of coronary heart disease. stagnation of qi causing phlegm retention is an important stage in the development process of stable angina pectoris of coronary heart disease,and regulating qi-flowing for eliminating phlegm is the corresponding Important stage that My tutor In the treatment of heart disease by adjustable air method in stages.By applying "obstruction of soup" which my tutor frequently used to regulating qi-flowing for eliminating phlegm, and Observe the clinical curative effect and safety of treatment of coronary heart disease stable angina,to provide the Intervention therapy of traditional Chinese medicine for complicated syndrome of Coronary heart disease(Merge two or more factors), Providing a new method for tuning method of gas treatment.The method of regulating the Qi flow to eliminate phlegm conbined with regular Western therapy could significantly improve the clinical therapeutic effect of SAP. Comparing with simple Western treatment, it could improve clinical symptoms, improve the quality of life, improve the ischemic change of ECG, lower hs-CRP, increase the attainment rate of LDL-c or Non-HDL-C, etc. We didn’t find any significant side effects during the research. It was worthy to do further research and application. The project showed the distinctive thought in academy of the mentor. |
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