| Objective: To observe the clinical efficacy of Chaihu Shugan San and Danshen Yin in treating coronary artery myocardial bridge of Qi stagnation and blood stasis type,and to evaluate the safety of drugs,so as to provide new ideas for the clinical treatment of myocardial bridge and realize the dual-heart treatment.Methods: 80 patients with coronary myocardial bridge confirmed by coronary angiography in our hospital from May 2018 to February 2019 were divided into control group and treatment group according to the principle of randomized control.The control group was given metoprolol sustained-release tablets(47.5mg,once a day,one tablet at a time,and the dose was adjusted according to the heart rate);the treatment group was given Bupleurum chinense.Shugansan combined with Danshen Yin(orange peel 6g,Bupleurum 6g,Chuanxiong 4.5g,Xiangfu 4.5g,Aurantium aurantium 4.5g,Paeonia lactiflora 4.5g,Licorice 1.5g,Salvia miltiorrhiza 30 g,Sandalwood 4.5g,decoction,morning and evening separately),intervention for 4 weeks.The changes of TCM symptom score,self-rating anxiety and depression scale,angina pectoris and electrocardiogram,blood routine and lipid metabolism were observed before and after treatment,and adverse drug reactions were recorded.Results:1.The average age of the control group and the treatment group were(64.08±9.79 vs62.83±8.57)years old,p > 0.05;the male-female ratio of the control group and the treatment group were(16:24 vs 13:27),p > 0.05;the average body mass index of the control group and the treatment group were(24.76±2.54 vs 24.61±2.22)Kg/m2,p >0.05;the proportion of patients with coronary atherosclerosis,hypertension and diabetes mellitus in the control group and the treatment group were 10:22:6 vs 13:20:10,respectively,p > 0.05.2.In the control group,the effective rate was 0.00%,the effective rate was 65.00%,the ineffective rate was 35.00%,and the total effective rate was 65.00%.In the treatment group,the effective rate was 2.50%,the effective rate was 85.00%,the ineffective rate was 12.50%,and the total effective rate was 87.50%.The difference between the two groups was significant(p<0.05).Pain symptoms.3.In the control group,the effective rate was 2.50%,the effective rate was 5.00%,the ineffective rate was 92.50%,and the total effective rate was 7.50%.In the treatment group,the marked effective rate was 5.00%,the effective rate was 5.00%,the ineffective rate was 90.00%,and the total effective rate was 10.00%.There was no significant difference between the two groups(p > 0.05).4.The control group showed a marked efficiency of 0.00%,an effective rate of 62.50%,an ineffective rate of 37.50%,and a total effective rate of 62.50%.The treatment group showed a marked efficiency of 7.50%,an effective rate of 82.50%,an ineffective rate of 10.00%,and a total effective rate of 90.00%,showing a significant difference between the two groups(p <0.01).Good chest tightness,chest pain,palpitation and other TCM symptoms.5.The score of Self-rating Anxiety Scale before and after treatment in the control group was(51.41±3.40)vs(47.69±1.91),p < 0.01;the average score of Self-rating Anxiety Scale before and after treatment in the treatment group was(52.75±5.33)vs(45.88±3.64),p < 0.01;there was statistical difference between the two groups after treatment(p < 0.01);it showed that the two groups could effectively improve the anxiety of patients with myocardial bridge,and the treatment group was better than the control group.Group photo.6.The Self-Rating Depression Scale scores of the control group before and after treatment were(46.66%±5.13% vs 46.63%±5.02%),p > 0.05;the average Self-Rating Depression Scale scores of the treatment group before and after treatment were(47.28%±4.79% vs 45.86%±3.62%),p < 0.01;there were statistical differences between the two groups after treatment(p < 0.01);it showed that the treatment group could effectively improve the depressive mood of patients with myocardial bridge,while the control group had opposite effects.There was no significant improvement in depression.7.The Self-rating Anxiety Scale scores of male and female patients were(49.01±3.74 vs53.82±3.93),p < 0.01;the average Self-rating Anxiety Scale scores of control group before and after treatment were(48.83±2.30 vs 46.72±1.11),p < 0.01;the average Self-rating Anxiety Scale scores of control group before and after treatment were(53.13±2.90 vs 48.33±2.07),p < 0.01;After treatment,the average Self-rating Anxiety Scale scores were(49.23±5.09 vs 45.19±3.57),p < 0.01;before and after treatment,the average Self-rating Anxiety Scale scores of women in the treatment group were(54.44±4.63 vs 46.20±3.69),p < 0.01;after treatment,there was no statistical difference between the two groups of men(p > 0.05);after treatment,there was statistical difference between the two groups of women(p < 0.01).It shows that women with myocardial bridge are more likely to suffer from anxiety than men,and women in the treatment group are better than men in improving anxiety symptoms.8.The Self-Rating Depression Scale scores of male and female patients were(45.47%±4.24%vs 47.82%±5.14%),p < 0.05;the average Self-Rating Depression Scale scores of control group before and after treatment were(46.02%±4.75% vs 46.02%±4.57%),p > 0.05;the average Self-Rating Depression Scale scores of control group before and after treatment were(47.08% ±5.43% vs 47.03%±5.35%),p > 0.05;the treatment group was male.The average Self-Rating Depression Scale scores before and after treatment were(44.81%±3.60% vs 44.08% ±2.93%),p < 0.05;the average Self-Rating Depression Scale scores before and after treatment were(48.47% ±4.88%vs 46.71% ±3.66%),p < 0.01;there was no statistical difference between the two groups in self-rating depression scale after treatment(p > 0.05);there was statistical difference between the two groups in self-rating depression scale after treatment.(p<0.01).It shows that women are more likely to suffer from depression than men,and women in the treatment group are better than men in improving depressive symptoms.9.After treatment,WBC,NEUT,RBC,HGB,PLT,MPV,d-d,FIB,ALT,AST,BUN,Scr,TC,TG,Hd L-c,and Ld L-c in the control group showed no significant changes(p > 0.05).After treatment,MPV,TC,TG and Ld L-c in the treatment group all decreased compared with that before treatment(p < 0.01),and the remaining indexes showed no significant change after treatment(p > 0.05).After treatment,MPV,TC,TG and LDL in the treatment group were significantly decreased compared with the control group(p < 0.01),and there was no statistical difference in the remaining indexes between the two groups(p > 0.05).This indicated that the treatment group had the effect of reducing MPV,TC,TG and Ld L-c.10.In the clinical trial of this project,one case of sinus bradycardia occurred in the control group,and no adverse drug events occurred in the treatment group.Conclusion:1.Chaihu shugan powder and danshen decoction can effectively reduce the clinical symptoms of qi-stagnation and blood-stasis type patients with myocardial bridge,improve angina pectoris and TCM syndrome integral,better than metoprolol succinate sustained release tablets,worthy of clinical promotion and application.2.Patients with qi-stagnation and blood-stasis type myocardial bridge are prone to anxiety and depression,and women are more likely than men to have anxiety and depression,while chaihu shugan powder and danshen decoction can significantly improve anxiety and depression,and the efficacy of women is better than that of men,playing the role of dual heart treatment.3.Preliminary observation of chaihu shugan powder and danshen decoction showed that it could reduce MPV,TC,TG and ldl-c in patients with qi-stagnation and blood-stasis type myocardial bridge,which may reduce the occurrence of cardiovascular events related to myocardial bridge and is worthy of further study.4.Chaihu shugan powder and salvia miltiorrhiza decoction,combining qi and blood circulation skillfully,have no adverse reactions and side effects in clinical treatment,and are safe and reliable. |
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