| ObjectiveEarly clinical studies have confirmed the effectiveness of the "blood-pluse-heart-spirit" integral view to guide the treatment of coronary heart disease.Therefore,based on the previous research basis,patients with severe coronary stenosis were selected to further explore the clinical efficacy of Rong Xin Bao Mai and Huo Xue Tiao Shen method under the guidance of the "blood-pluse-heart-spirit" concept in treating patients with severe coronary stenosis,and discussed its work mechanism from an inflammatory perspective,in order to clarify the treatment efficacy of traditional Chinese medicine,enrich the scientific connotation of "blood-pluse-heart-spirit" integral concept and provide more ideas for clinical treatment.MethodIn this study,87 patients with severe coronary stenosis meeting the inclusion criteria were included.They were divided into two groups,with 43 cases in the treatment group,44 cases in the control group.Two groups were treated with conventional medical therapy.The control group was given PCI,and the treatment group was superimposed with Rong Xin Bao Mai and(or)Huo Xue Tiao Shen prescriptions.With 0 and 4 weeks as the observation point,clinical data of two groups of patients were recorded separately,and the serum was taken for comparison.The angina pectoris,TCM syndromes were compared to prove the difference of curative effect before and after treatment between the two groups;the treatment group prolonged the observation time to 8 weeks,and increased the quality of life assessment,performed multi-period efficacy observations by self-contronl,and explored its possible mechanism from the inflammatory perspective.Result1 The baseline data of patients in the treatment group and the control group before treatment were not significantly different by statistical methods and were comparable.2 The treatment group and the control group were compared in angina pectoris,TCM syndromes before and after treatment.2.1 The scores of angina in both groups after treatment were significantly lower than before treatment,the difference was statistically significant(P>0.05),and the difference wasno significant between the two groups(P>0.05).2.2 The main symptoms,secondary symptoms and total symptoms scores of the two groups after treatment were lower than those before treatment,with statistical significance(P<0.05).There was no statistical significance before and after treatment between the groups(P> 0.05).Compared with before treatment,the chest tightness,palpitations,and chest pain scores of two groups was statistically significant(P<0.05),and the difference did not prove a statistical significance between the two groups before and after treatment(P> 0.05).3 The changes of the efficacy of angina pectoris,TCM syndromes,and quality of life in the treatment group in prolonged research.3.1 Efficacy of angina pectoris: There was a dramatic decline in 0-4 weeks,and a slow decline in 4-8 weeks.The difference between 0 weeks and 4 weeks and 8 weeks was a statistically significant(P<0.05).3.2 Curative effect of TCM syndromes:TCM major syndrom score,secondary syndrom score,and total syndrom score decreased significantly at 0-4 weeks,and slowed down at 4-8weeks.The comparison results between 0,4,and 8 weeks showed statistical significance(P<0.05).3.3Seattle Scale:Physical activity restriction,disease awareness,and treatment satisfaction all significantly increased in 0-4 weeks and 4-8 weeks(P<0.05).The upward trend of angina pectoris stability and angina pectoris attacks was significant in 0-4 weeks(P<0.05),and still increased in 4-8-weeks,but no statistically difference was observed(P>0.05).3.4SF-36 Scale:Physiological health score(physiological effects,physiological functions,somatic pain),mental health score(energy,social functions,emotional functions and mental health),health changes all increased between 0 weeks and 8 weeks(P<0.05),with no statistical significance between 0 weeks and 4 weeks(P> 0.05).The obvious difference existed when comparing 8 weeks with 0 weeks in physiological effects,physiological functions,social functions and health changes(P<0.05),and the other four items were not statistically significant between 4 weeks and 8 weeks(P> 0.05).The difference of physiological health score(general health score)was statistically striking at 0,4 and 8 weeks(P<0.05).4 Comparison of serological indicators between the two groups4.1 hs-CRP:The hs-CRP level of the two groups after treatment was slightly lower than before treatment,and the difference was not obvious between the groups in the group(P>0.05).4.2 IL-6:After 4 weeks of treatment,the level of IL-6 in the two groups decreased slowly and the trend was not obvious(P>0.05).No significant difference existed between the groups before and after treatment(P>0.05).4.3 MCP-1: Compared with before treatment,the MCP-1 value of both groups after treatment was slightly higher,with no significant difference between two groups(P>0.05).4.4 MMP-9: The MMP-9 level in the treatment group significantly decreased,and the difference was statistically significant(P<0.05);the MMP-9 level in the control group gradually increased,but did not reach statistical significance(P>0.05);Before treatment,the difference was significant(P<0.05),but no statistical significance was attained after treatment(P>0.05).5 The influence of “Rong Xin Bao Mai and Huo Xue Tiao Shen” method on serological indicators5.1 hs-CRP: 0,4,and 8 weeks showed a gradual downward trend.And there was a significant difference between 8 week and 0 week,8 week and 4 week(P<0.05).5.2 IL-6: Slowly decreased during the period of 0-4 weeks,and significantly increased during the period of 4--8 weeks.There was no significant difference in pairwise comparison(P>0.05).5.3 MCP-1: 0-4 week period gradually increased,4-8 week period gradually decreased.And it was not significantly different when comparing two by two(P>0.05).5.4 MMP-9: The period from 0 to 4 weeks showed a significant downward,and the difference was statistically significant(P<0.05);the period from 4 to 8 weeks showed a gradual upward trend,and the difference was no statisical significance(P>0.05).Conclusion1.The "blood-pluse-heart-spirit" concept has plentiful scientific connotation and clinical guidance significance.Trational Chinese medicine plan of Rong Xin Bao Mai and Huo Xue Tiao Shen method under the guidance of this theory is equivalent to the stent group inthe effection of improving angina pectoris points,TCM main points,TCM secondary syndrome score and total symptom points,which is feasible.2.To extend the observation period,the Rong Xin Bao Mai and Huo Xue Tiao Shen method tends to be stable in terms of the curative effects of angina pectoris and TCM syndromes.It has improved angina pectoris related quality of life,and physical health,mental health and health changes in various degrees.3.The effect mechanism of Rong Xin Bao Mai and Huo Xue Tiao Shen method intervention on severe coronary stenosis is related to inflammation,it may also lower the serum MMP-9level to suppress inflammation,stabilize plaque,and delay atherosclerosis. |
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