The Relationship Between Coronary Lesions And TCM Syndrome Type And The Effect Of Zhilong Hongxue Tongyu Capsule On Vascular Endothelial Function In Patients With Qi Deficiency And Phlegm Blood Stasis Syndrome Type Of Coronary Heart Disease(CHD)

Objective:（1）To investigate the relationship between TCM Syndromes of coronary heart disease（CHD）and coronary artery stenosis and Gensini scores.（2）To observe the Zhilong Hongxue Tongyu capsule effecting on vascular endothelial function in patients with Qi deficiency and phlegm blood stasis syndrome type of CHD.Methods:（1）Collected 371 Patients with CHD who were diagnosed by coronary arteriography（CAG）in Cardiac-Neurology department of The affiliated TCM hospital of XiNan medical university From May 2013 to April 2015.（2）Record the basic information and the rerult of coronary angiography,type the TCM syndrome differentiation,calculate Gensini scores,fill in the case report form（CRF）,establish the detabases,etc.（3）The hospitalized patients from May 2015 to September2015 who were diagnosed by CAG in our Department and belonged to Qi deficiency and phlegm blood stasis syndrome type were randomly divided into control group and treatment group,and selected healthy people 20 as health group who had physical examinations over the same period in the outpatient department.Besides the western medicine standardized treatment,treatment group was given Zhilong HongxueTongyu capsule 1.2 three times a day for one month.By detecting the three groups of blood nitric oxide（NO）,endothelin（ET）,6-keto prostaglandin（6-Keto-PGF1 α）,thromboxane B2（TXB₂）.separately observe the changes of vascular endothelial function between CHD group and healthy group,and between the control group and the treatment group.（4）Statistical software SPSS 20.0 is used for description and analysis of the data.Result: Part 1:（1）The 371 CHD patients had different TCM syndrome type,their basic diseases（hypertension,diabetes）and risk factors（smoking history,drinking history）was no statistically significant difference（p > 0.05）.The average age of phlegm blocking heart vessel type is younger than Qi deficiency and blood stasis type and Yang Asthenia type,Qi deficiency and blood stasis type is older than qi stagnation and blood stasis type.differences were statistically significant.（2）The TCM syndrome type distribution of the 371 CHD patients : Qi deficiency and blood stasis type of 110 cases（29.65%）,phlegm blocking heart vessel type 101 cases（27.22%）,qi stagnation and blood stasis type of 99 patients（26.68%）,qi and Yin deficiency type 46 cases（12.40%）,Yang Asthenia Type 15 cases（4.04%）.There are differences（P < 0.05）between different TCM syndrome types of coronary lesion branches,Yang Asthenia Type average coronary lesion branches count（2.13 + 0.92）at best,qi stagnation and blood stasis type average coronary lesion branchescount Minimum（1.41 + 0.67）,Compared with two other type patients,differences were statistically significant（P< 0.05）.TCM syndrome types also exist differences on the distribution of the coronary lesion branches（P< 0.05）,Qi stagnation and blood stasis type（68.7%）,Qi deficiency and blood stasis type（37.3%）are more common in single-vessel disease,phlegm blocking heart vessel type（50.5%）and qi and Yin deficiency（45.7%）were more common in the double-vessel lesion,Yang Asthenia Type（46.7%）were more common in multi-vessel disease（P< 0.05）.the Gensini scores of different TCM syndrome types had statistically significant（P<0.05）,Yang deficiency type had the highest score42.00[30.00,90.00],qi stagnation and blood stasis type had the lowest14.00[8.00,22.00].Part 2:（1）The comparison between CHD group with Qi deficiency and phlegm blood stasis syndrome type and health group of gender had no statistical significance（P>0.05）,the average age of CHD group（64.73+ 9.41）older than health group（27.25 + 3.07）（P<0.05）.Before and after treatment ET（ng/L）,TXB₂（ng/L）in the CHD group were higher than the healthgroup,NO（umol/L）,6-Keto-PGF1α（ng/L）,N/E,6-Keto-PGF1α/TXB₂ were lower than the health group,the difference was statistically significant（P<0.001）.（2）The control group and the treatment group: age,sex ratio,disease（hypertension,diabetes,hyperlipidemia,cerebral vascular accident）,lifehistory（smoking history,drinking history）had no significant difference（P> 0.05）.（3）Before treatment the difference between control group and treatment group with NO、ET、TXB₂、6-Keto-PGF1α had no statistical significance.After treatment NO、6-Keto-PGF1α of the both groups were higher than before,ET、TXB₂ were lower than before,the difference was statistically significant（P < 0.05）.（4）Compare the difference between the treatment group and the control group before and after treatment: the difference with NO、ET、TXB₂ in treatment group were higher than treatment group;the difference with 6-Keto-PGF1α were no statistically significant difference（P>0.05）.Conclusion: Different TCM Syndrome types of CHD mainly distributed to Qi deficiency and blood stasis type,Phlegm blocking heart vessel type,qi stagnation and blood stasis type.Yang Asthenia type had an average age of maximum.qi stagnation and blood stasis type had the minimum average coronary lesion branches and had a lowest Gensini score,Yang Asthenia type had the maximum average coronary lesion branches and had a highest Gensini score.Qi stagnation and blood stasis type,Qi deficiency and blood stasis type are more common in single-vessel disease;phlegm blocking heart vessel type and qi and Yin deficiency were more common in the double-vessel lesion,Yang AstheniaType were more common in multi-vessel disease.Therefore,TCM syndrome types of CHD associates with coronary lesions and Gensini score.In the treatment group and the control group patients who with Qi deficiency and phlegm blood stasis syndrome type compared with the health group that endothelial function were damaged.After treatment,the NO、ET、TXB₂、6-Keto-PGF1α of control group and treatment group both were changed,compared with before treatment.After treatment,After treatment,the NO、ET、TXB₂ in control group had a greater efficacy difference,indicating that patients who taking Zhilong Hongxue Tongyu capsule have more significant effect and improve endothelial function better.