To Explore The Clinical Efficacy Of Guizhi Fuling Pill And Simiaoyongan Decoction In The Treatment Of Unstable Angina Pectoris And The Influence On LP-PLA2 And Hs-CRP Based On The Theory Of Stasis-toxin

ObjectiveBased on the theory of "stasis-toxin",this study observed the clinical efficacy of Guizhi Fuling pill combined with Simiaoyongan decoction in the treatment of unstable angina pectoris(UA)of heat toxic and blood stasis syndrome,evaluated its effectiveness and safety,and explored the possible mechanism of Guizhi Fuling pill combined with Simiaoyongan decoction in the treatment of UA.MethodsA randomized controlled trial was adopted in this study.70 patients who met thecriteria of this study were randomly divided into treatment group and control group,35 cases in each group.The treatment group was treated with Guizhi Fuling pill and Simiao Yong ’an decoction,combined with western medicine,while the control group was treated with pure western medicine.The course of treatment was 4 weeks.The changes of Lp-PLA2,hs-CRP,blood lipid(TC,TG,LDL-C,HDL-C),hemorheology(plasma viscosity,whole blood high shear viscosity,whole blood medium shear viscosity,whole blood low shear viscosity,erythrocyte aggregation index,fibrinogen),electrocardiogram,angina pectoris symptom score,TCM symptom score and Seattle angina pectoris scale(SAQ)in 2 groups before and after treatment were observed and compared.Results1.Effective rate of angina pectoris: there was no significant difference in anginasymptom scores between the two groups before treatment(P>0.05).After treatment,the total score and individual score of angina pectoris symptom in both groups decreased compared with before(P<0.01),and the decrease was more obvious in the treatment group(P<0.05).The total effective rate of angina pectoris in treatment group was 88.2% and stopping rate of nitroglycer was 70.6%,while the total effectiverate of angina pectoris in control group was(78.8%)and stopping rate of nitroglycerin was(63.7%),the differences were statistically significant(P<0.05).After treatment,the electrocardiogram of the two groups was improved,but there was no significant difference between the two groups(P>0.05).2.TCM syndrome scores and efficacy: There was no significant difference in TCM syndrome scores between the two groups before treatment(P>0.05).After treatment,the TCM syndrome scores in both groups decreased significantly(P<0.01),and was more obvious in the treatment group(P<0.05).The total effective rate of the treatment group was 88.2%,which was higher than 72.7% in the control group,and the difference was statistically significant(P<0.05).3.Inflammation indicators: there was no significant difference in Lp-PLA2 and hs-CRP between the two groups before treatment(P>0.05).After treatment,Lp-PLA2 and hs-CRP were significantly decreased in both groups(P<0.01),and the decrease was more obvious in the treatment group(P<0.05).4.Blood lipid and hemorheology indexes: there was no statistical significance in blood lipid and hemorheology between the two groups before treatment(P>0.05);After treatment,blood lipid(TC,TG,LDL-C)and hemorheology(plasma viscosity,whole blood high shear viscosity,whole blood medium shear viscosity,whole blood low shear viscosity,erythrocyte aggregation index,fibrinogen)in two groups were decreased compared with that before treatment(P<0.05),while HDL-C was increased compared with before treatment(P<0.05).TC,LDL-C,hemorheology(plasma viscosity,whole blood high shear viscosity,whole blood medium shear viscosity,whole blood low shear viscosity,erythrocyte aggregation index,fibrinogen)decreased more significantly in the treatment group(P<0.05).5.SAQ: There were no significant differences in PL,AS,AF,TS and DP between the two groups before treatment(P>0.05).After treatment,PL,AS,AF,TS and DP in both groups were increased compared with before(P<0.05),and PL,AS,AF and TS in the treatment group were increased more obviously,and the difference with statistical significance(P<0.05).Conclusion1.Guizhi Fuling pill and Simiaoyong An decoction combined with the theory of "stasis and toxin" have a solid theoretical foundation and satisfactory clinical efficacy in the treatment of UA(heat toxin and blood stasis syndrome),which is of great significance for the prevention and treatment of UA(heat toxin and blood stasis syndrome)by traditional Chinese medicine;2.Guizhfuling pill combined with Simiaoyongan decoction can improve the scores of single symptom and curative effect of traditional Chinese medicine in patients with UA(heat toxin and blood stasis syndrome),especially the symptoms of chest tiredness,chest pain,irritable heat,dry mouth and bitter,bare skin and dry stool.3.Guizhi Fuling pill combined with Simiaoyongan decoction can reduce the levels of Lp-PLA2 and hs-CRP,which may act by inhibiting inflammatory response.4.Guizhi Fuling pill combined with Simiao Yong ’an decoction can reduce TC,LDL-C,hemorheology levels,reduce patients’ blood lipid levels,and improve hemorheology indexes;5.Guizhfuling pills combined with Simiaoyongan decoction can improve the symptoms of patients with angina pectoris,including reducing the frequency of angina pectoris attack and the duration of pain,reducing the frequency and dosage of nitroglycerin,and improving the quality of life of patients;6.No adverse reactions and toxic side effects were observed during the study,so it can be recommended for clinical use.