Clinical Study On The Treatment Of Microvascular Angina Pectoris (Qi Deficiency And Blood Stasis Type) With Modified Bazhen Decoction

Objective: To observe the clinical effect of Bazhen Decoction on microvascular angina pectoris of Qi deficiency and blood stasis type,and to explore its effect on TCM syndromes,angina attack,blood lipid level and inflammatory response.To provide a new method for TCM treatment of microvascular angina pectoris.Methods: A total of 60 patients(2021.1-2021.10)who were diagnosed with microvascular angina pectoris in the Department of Cardiology of the First Affiliated Hospital of Shandong University of Traditional Chinese Medicine were screened,aged 18-75 years old,with no gender requirement.The patients were divided into the experimental group and the control group by random number coding,30 cases in each group.patients were treated with standardized western medicine(metoprolol succinate sustained-release tablets,nicorandil,trimetazidine hydrochloride,rosuvastatin calcium tablets),and the treatment group was given Bazhen decoction on the basis of standardized western medicine treatment Flavored treatment.The control group only received standard western medicine treatment.The course of treatment was 4 weeks,and the TCM syndrome score,angina pectoris score,Seattle angina pectoris scale,electrocardiogram efficacy,dynamic electrocardiogram,exercise treadmill test,blood lipid levels(HDL-C,TC,TG,LDL-C),inflammation and inflammation of the two groups were observed before and after treatment.Response indicators(Hs-CRP,Lp-PLA2)were detected,and chi-square test,t test and other methods were used for statistical analysis.At the same time,using network pharmacology research,using TCMSP database,BATMAN-TCM database,Genecards database,Dis Ge NET database,CTD database,to predict the action gene targets of Bazhen Decoction in the treatment of MVA.Results: 1.Results of clinical observation and research:(1)TCM syndrome score: The treatment group was better than the control group in improving the total TCM syndrome score,chest pain,chest tightness,shortness of breath,and fatigue in individual TCM syndromes.The difference was statistically significant(P < 0.05).In terms of palpitations,dark lips,and insomnia,the difference was not statistically significant(P > 0.05).(2)Angina pectoris score:The treatment group was better than the control group in improving the total score of angina pectoris and the individual scores of angina pectoris,and the difference was statistically significant(P<0.05).(3)Seattle Angina Pectoris Scale: The treatment group was better than the control group in improving PL,AS,AF,TS,and the difference was statistically significant(P<0.05),but there was no significant difference in DS(P> 0.05).(4)Electrocardiogram: The effective rate of the treatment group was 86.67%,and the effective rate of the control group was63.33%,and the difference between the two groups was statistically significant(P<0.05).(5)Dynamic electrocardiogram: The number of ischemic attacks and the total ischemia time were better than those of the control group,and the difference was statistically significant(P<0.05),but there was no significant difference in the average heart rate(P>0.05).(6)Treadmill exercise test: the treatment group was better than the control group in improving the maximum ST segment depression amplitude,ST segment depression duration,total exercise time,and maximum metabolic equivalent,and the difference was statistically significant(P<0.05).In terms of maximum heart rate and maximum systolic blood pressure,the curative effects of the two methods were similar,and the difference was not statistically significant(P>0.05).(7)Blood lipid level: There was no significant difference in improving TC,TG,HDL-C and LDL-C(P>0.05).(8)Inflammation reflection index: the treatment group was better than the control group in reducing Hs-CRP and Lp-PLA2,and the difference was statistically significant(P<0.05).2.Network pharmacology research: There are 205 main active ingredients in Bazhen Decoction,including quercetin,saffron and so on.There are 33 core targets,including IL6,TNF,INS,IL1 B,etc.Gene Ontology entry171,including processes such as nitric oxide biosynthesis.There are 96 KEGG pathways,and the pathways involved mainly include NOD-like receptor signaling pathway.Conclusion: Modified Bazhen Decoction combined with western medicine has obvious curative effect in the treatment of MVA,which can improve TCM syndrome,improve angina pectoris symptoms,improve myocardial ischemia and reduce inflammatory response.Modified Bazhen Decoction can treat microvascular angina pectoris through multiple targets such as IL6,TNF,INS,and IL1 B,as well as multiple pathways such as nitric oxide biosynthesis and NOD.