| Objective: To observe the effect of complex prescription basedon "deficiency-stasis-toxin" pathogenisis (Qi-supplementing,blood-activating and toxin-resolving prescription) on patients with unstableangina pectoris (UA) of CHD, and discuss its mechanism from inhibitingactivation of platelet, regulating blood lipids, protecting endothelium,anti-inflammation and anti-oxidation. Methods:60cases of UA (according tothe diagnosis criterion) were randomly divided into two groups:Qi-supplementing, blood-activating and toxin-resolving group (treatmentgroup,30cases) and conventional west medicine group (control group,30cases). Patients in the control group were administrated with conventionalwestern medicine, and patients in the treatment group were combined withQi-supplementing, blood-activating and toxin-resolving prescription(composed with Huangqi, Dangshen, Danshen, Danggui, Chuanxiong and Huanglian),one dose daily, tow time a day. After14days of treatment, to observe theeffect on total effective rate of angina effect, effective rate of EKG,discontinue rate of nitroglycerin, total effective rate of TCM syndrome, heartfunction and its security indexes (blood and urina routine, liver and kidneyfunction); and to detect the changes of platelet activation indexes (CD62p,vWF), blood lipid level (TC,TG,LDL-C,HDL-C), vascular endothelial factors (ET-1,NO,CGRP), inflammatory factor (Hs-CRP,TNF-α), oxidative indexes (SOD,MDA). Results:1. Clincal effect and safety: After14days of treatment, totaleffective rate and obvious effective rate were93.3%and63.3%compared withcontrol group86.7%and33.3%, and the obvious effective rate in treatmentgroup was superior to control group (P＜0.05); effective rate of EKG anddiscontinue rate of nitroglycerin in treatment group were77.3％and47.8％, and was superior to those of control group; total effective rate of TCMsymptoms in treatment group (90%) was superior to control group (60%), andthe effect in improving TCM symptoms such as chest pain, tiredness, upsetandirritability, insomnia and dreamful sleep and dry stool is superior to controlgroup (P＜0.05or P＜0.01); heart function comparation, EF,SV,PFVE elevatedand PFVA reduced in treatment group (P＜0.05或P＜0.01), and the effect inimproving heart function was superior to that of control group. There was nochanges of blood and urina routine, liver and kidney function.2. Mechanismexploration: TC and LDL-C reduced in both group, and the treatment group wassuperior to control group in lowering LDL-C (P＜0.05); CD62p and vWF reducedin both group, and the treatment group was superior to control group inlowering CD62p (P＜0.05); ET-1reduced, NO elevated in both group(P＜0.05or P＜0.01), and CGRP elevated in treatment group (P＜0.05); Hs-CRP,TNF-α reduced in both group, and the treatment group was superior to control groupin lowering Hs-CRP (P＜0.05); SOD elevated and MDA reduced in threatment group,but there was no changes in control group, and the treatment group was superiorto control group in elevating SOD. Conclusion: Qi-supplementing,blood-activating and toxin-resolving prescription based on the "deficiency-stasis-toxin" pathogenisis has good clinical effect and safety in treatingunstable angina pectoris of CHD, and its mechanism might related withinhibiting platelet activation, regulating blood lipid, protecting vascularendothelium, anti-inflammation and anti-oxidation, and deserved furtherstudies. |
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