Clinical Study Of Gualou Xiebai Banxia Decoction Combined With Danshen Decoction In The Treatment Of Unstable Angina Pectoris

1.Experience summarizationThe clinical efficacy of traditional Chinese medicine in the treatment of coronary heart disease is definite.Professor Li Jun has accumulated rich clinical experience in the treatment of angina pectoris.Professor Li thinks that angina pectoris is caused by the comprehensive effect of diet,exogenous factors,emotion and so on,which is the syndrome of deficiency in origin and excess in superficiality.The priority of the disease should be considered first in the treatment of coronary heart disease.Syndrome differentiation is based on Qi and blood.The treatment follows the principle of "treating the symptoms in case of emergency,and treating the root cause in case of delay".The attack stage of angina pectoris is often caused by deficiency of vital-Qi or excess of pathogenic factors.Therefore,it’s necessary to strengthen the body resistance or dispel pathogenic factors and dredge them.The specific treatment methods include warming Yang and promoting arthralgia,promoting Qi and activating blood circulation,resolving phlegm and dampness,dispersing cold and activating pulse,dredging Fu organs and reducing turbidity.Besides,professor Li pays special attention to the overall concept when prescribing,adopts the diagnosis and treatment mode of combination of disease,syndrome and disease,considers prescription medication from the aspects of Qi movement and viscera correlation,and is good at flexibly combining classical prescriptions.Through clinical learning with tutors and collected the clinical medical records of Professor Li Jun in the treatment of angina pectoris,I analyzed them under the guidance of the tutor,and summarized the experience from three aspects:the understanding of etiology and pathogenesis,dialectical thinking and classification,and commonly used therapies and prescriptions.2.Clinical studyObjective:To verify the clinical efficacy and safety of Gualou Xiebai Banxia Decoction combined with Danshen Decoction in the treatment of unstable angina(UA)with phlegm and blood stasis syndrome.Methods:A total of 80 patients of low or intermediate risk UA with phlegm and blood stasis syndrome were included and randomly divided into experimental group and control group,40 cases in each group.The control group was treated with conventional western medicine,and the experimental group was treated with Gualou Xiebai Banxia Decoction and Danshen Decoction on the basis of the control group.The course of treatment was 4 weeks.Before and after the intervention,the attack of angina pectoris(the number of attacks per week and the duration of each attack),the changes of ECG(ST segment,T wave),the use of nitroglycerin,TCM syndrome score,Seattle angina pectoris scale score,blood lipid level and coagulation index were observed and recorded.Results:(1)Clinical total effective rate:The total effective rate was 90.0%in the experimental group and 65.0%in the control group,the difference was statistically significant(P<0.05).(2)Curative effect of angina pectoris:after 4 weeks of treatment,the frequency and duration of angina pectoris in the two groups were reduced compared with those before treatment,and the reduction degree in the experimental group was more obvious than that in the control group,with statistical significance(P<0.05).(3)The stopping rate of nitroglycerin:the stopping rate of nitroglycerin in the experimental group was 90.0%,and that in the control group was 67.5%,the difference was statistically significant(P<0.05).(4)TCM syndrome score:after treatment,the TCM syndrome score of the two groups decreased compared with that before treatment,and the decrease degree of the experimental group was more obvious than that of the control group,with statistical significance(P<0.05).(5)Seattle angina pectoris scale(SAQ):after treatment,the scores of SAQ in the experimental group increased compared with those before treatment(P<0.05),and the scores of PL,AS,AF and DP in the control group increased compared with those before treatment(P<0.05),among which the scores of PL,AS,AF and TS in the experimental group increased more significantly than those in the control group(P<0.05).(6)Blood lipids level:after treatment,the levels of low density lipoprotein(LDL-C),triglyceride(TG)and total cholesterol(TC)in the two groups were lower than those before treatment,and the levels of high density lipoprotein(HDL-C)were higher than those before treatment(P<0.05).The levels of LDL-C and TC in the experimental group decreased more significantly than those in the control group(P<0.05).(7)Coagulation index:after treatment,the prothrombin time(PT)values of the two groups were increased compared with those before treatment,and the fibrinogen(FIB)values were decreased compared with those before treatment,the difference was statistically significant(P<0.05).Compared with the control group,the PT value of the experimental group increased more significantly,the difference was statistically significant(P<0.05).(8)Safety indicators:during the study period,the subjects had no obvious adverse reactions,and the relevant safety indicators were normal.Conclusions:Gualou Xiebai Banxia Decoction and Danshen Decoction Combined with conventional western medicine has better efficacy than conventional western medicine in the treatment of UA with phlegm and blood stasis syndrome in improving clinical symptoms,regulating blood lipid,improving blood coagulation and improving the quality of life of patients,and the safety is quite well.