| VMC is an ordinary heart disease caused by viral infection, its occurrence rate tends to be higher and higher, and it had become the fourth cardiac disease following coronary, rheumatic heart disease, congenital heart disease, VMC is badly harmful to human health. At present, there are not effective drugs to kill virus and adjust immune in treating VMC, but traditional Chinese drugs present some superiorities in treating VMC, so it is very important to hunt for new therapeutic method and theory from TCM, according to this aim, we reviewed the diagnose and treatment condition of VMC at the present stage first, then discussed detailedly the pathogenesis of VMC from the point of the spleen and stomach, and study Compound recipe Qiang Qi pill which has the function of benefiting qi, invigorating splenic yang and scattering fire to further interpret the pathogenesis of VMC, mechanism of action of Compound Qiang Qi pill and the theory value of benefiting qi, invigorating splenic yang and scattering fire.1. The review of VMC and the introduction of the type of qi deficiency and fire stagnation of VMCBased on the theory of TCM combined with Western medicine, and integrated academic thinking of famous doctor with the achievements of modern medicine, we reviewed the diagnosis and treatment condition of VMC at the present stage: There was no international uniform standard in diagnosing VMC, and the clinical manifestations and most accessory examnation of VMC lack of specificity, the pathogenesis are not totally knowed, so it is very difficult to diagnosis VMC, the effect of drugs is not satisfying and no specific effect treatment, combination of Chinese and Western medicine in treating VMC is one of the promising direction. We discussed the pathogenesis of VMC from the point of qi deficiency and fire stagnation. Being invaded by exogenous pathogen was the exopathic of VMC, and the deficiency of spleen-qi andstomach-qi was internal cause. Qi deficiency is the origin of VMC, and spleen and stomach is the root of qi deficiency, spleen and stomach have a closely relationship with heart, the deficiency of spleen-qi and stomach-qi may cause the deficiency of ascending the clear, so it may leads to rash act of yin fire. As Li-dongyuan sayed that since the deficiency of spleen-qi and stomach-qi, so the insufficiency of primordial qi, and excessive heart fire is flourishing, excessive heart fire is yin fire. The pathogenesis of VMC is excessive heart fire sink into the spleen and can not extend. To treat it, we should take the method of fire stagnation requiring dissipation as our aim, benefiting spleen-qi, invigorating splenic yang and scattering fire are our therapeutic principle.2. The study on the clinical curative effect of Compound recipe Qiang Qi pill in treating patients with VMCTo study the clinical curative effect of the therapeutic principle of benefiting spleen-qi, invigorating splenic yang and scattering fire represented Compound recipe Qiang Qi pill in treating patients with VMC. 120 patients with acute VMC had been observed from November 2003 to February 2005, and the condition of all the selected patients with VMC was not graveness, the clinical manifestation is the syndrome of qi deficiency and fire stagnation by differentiation symptoms and signs , The method of random double blind and simulation controlled trial was conducted, all the selected patients were distributed randomly to group A, group B, group C , and each group had 40 cases, one of three groups was treated with western medicine and two kinds of placebo of starch pill and brown sweet water which have the same appearance with Compound recipe Qiang Qi pill and Sheng Mai yin oral liquid, one group was treated with the same western medicine, Compound recipe Qiang Qi pill (astrsgulus, notoperygium root, white peony root, cimicifuga rhizome, kudzuvine root, bupleurum, ledebouriella root, licorice root) and the placebo of Sheng Mai yin oral liquid, anothergroup was was treated with the same western medicine, Sheng Mai yin oral liquid and the placebo of Compound recipe Qiang Qi pill. The period of treatment was a month. People who were in charge of clinical reaserch, collection data and analysis of data do not know the condition of grouping, and did not know the result until uncover its results, people who was in charge of making blinding method did not attend clinical research. The result showed that group A was treatment group, group B was positive control group, group C was control group. The main survey index included the symptoms, objective signs, ECG, Holter and the safety index of the patients before and after treatment. The results showed that there were no significant differences in the type, gender, occupation, age, course, motivation, pathogenetic condition of the patients in three groups before the treatment, so it was comparability; The improvement rate of abnormal ECG in treatment group was better than that of two control group, but there were no significant differences between them, it may be concerned with too little sample size, the comprehensive effect of treatment group had been improved greatly compared that of placebo control group(p<0.05), but there were no significant differences among treatment group and positive control group , positive control group and control group(p>0. 05). There were no significant differences in clinical symptom in three group before treatment ( p>0. 05 ), in three groups there were significant differences in improving clinical symptom before and after treatment (p<0.Olor p< 0. 05); chest distress, palpitation of treatment group had been improved markedly when compared two control group (p< 0.05), there were significant differences in improving other clinical symptoms in three group ( p>0. 05 ); Although they had some effects in improving effective index of symptom, there were no significant differences in three groups (p>0. 05). It showed that Compound recipe Qiang Qi pill has good curative effects in treating VMC, its curative effect was better than that of placebo control group, although there were no significantdifferences compared with Sheng Mai yin oral liquid, the number of recovery, excellence and total effective rate of treatment group was more than those of Sheng Mai yin oral liquid, so it deserved to further study.3. The study on the effect of Compound Qiang Qi pill on the level of SIL-2R, TNF-cts cTnl in patients with VMC.To investigate the relationship between the index such as SIL-2R, TNF-ct ^ cTnl and VMC, and to study the effect of Compound Qiang Qi pill on the level of SIL-2IL TNF-ct> cTnl in patients with VMC. Data and Methods were same with part 2. All the selected patients were detected the level of SIL-2R> TNF-a, cTnl before and after treatment (the level of CoxBIgM was detected before treatment only once), the level of SIL-2R, TNF-otwere detected by means of ELISA, and the level of cTnl was detected by means of immunochromatographic, The level of CoxBIgM cTnl were qualitative detection, and the level of SIL-2R, TNF-awere quantity detection. The results showed that the positive rate of CoxBIgM was only 23. 3%, the comparison of the positive rate of CoxBIgM were no significant difference in three groups, The positive rate of cTnl was 49. 17% before treatment, weakly positive rate accounted for 35%, the positive rate of cTnl was 21.70% after treatment, weakly positive rate account for 19. 2%, there was significant difference in three groups between before treatment and after treatment, it was significant different compared treatment group with two control group (p<0.05). it illuminated that drugs of three groups had certain therapeutic effect on myocardial damage and the curative effect of treatment was best in three groups. At the same time, the level of SIL-2R^ TNF-a reduced markedly after treatment, the level of SIL-2R was significant different after treatment compared treatment group with two control group( p<0. 05 ), but there was no significant difference between two control group ( p>0. 05 ); the level of TNF-a were no significant difference in three groups after treatment, So we couldconclude the disorder of cellular immunologic function relate to the pathogenesis of VMC, but the definitive mechanism need further research, and Compound Qiang Qi pill have certain therapeutic and regulation function in treating the disorder of immunoregulation induced by IL-2 and myocardial damage.4. The effect of Compound Qiang Qi pill on the quality of life of patients with VMC and the application study on fuzzy comprehensive evaluation of therapeutic efficiency.To study the effect of Compound Qiang Qi pill on the quality of life of patients with VMC and the application study on the fuzzy comprehensive evaluation of therapeutic efficiency. Data and methods were same with part 2. l.To study the effect of Compound Qiang Qi pill on the quality of life of patients with VMC: We took SF-36 which is generally accepted internationally as the measuring questionnaire of the patients with VMC, all the selected patients fill in the questionnaire before and after treatment, and the patients were ranked score and followed up survey, so we could compare the score of questionnaire before and after treatment, and find out the effect of compound Qiang Qi pill on the quality of life of patients with VMC. 2. Fuzzy Comprehensive Evaluation of therapeutic efficiency: We set up the collection of index and evaluation, chose QOL, the general effect, ECG, the effect of symptom index as index collection, and each index was ranked recovery, excellence, utility, ineffective as evaluation index collection, the evaluation denominator of curative effect refer to the standard of each index, and arrived at the distribution of absolute frequency of the above data according to their evaluation of therapeutic efficiency, we set up fuzzy matrix on the basis of the distribution of absolute frequency, and draw up the weight of the evaluation index refer to the proposal of related experts, so fussy mathematics was adopted to evaluate the comprehensive curative effect of Compound Qiang Qi pill. The results showed that there wasno significant difference in evaluating all regions of QOL in three groups before treatment (p>0. 05) , the score of all regions (except for RF) of QOL had been improved greatly after treatment and there were significant differences in three groups when compared before and after treatment, the scores of PF, GH, VT and general evaluation of group A were obviously higher than those of group B and C after treatment, the differences were markedly ( p<0. 01-0. 05 ) , but the differences were not significant in other regions in three group(p>0. 05). It could illuminate that all the drugs in three groups could improve the QOL of patients with VMC, and the curative effect of the treatment group was best in three groups. We evaluated the therapeutic effect of group A was 0. 31 which belonged to excellence according to the maximum attachment principle, group B and group C were all 0.40 and belonged to utility, we integrated recovery, excellence attachment degree, group B was 0. 80, group C was 0. 72, so we could consider the effective rate of group B was higher that that of group C. It could conclude that Compound Qiang Qi pill has some effects in improving QOL of the patients with VMC, especially in PF, GH, VT regions; Fuzzy comprehensive evaluation of therapeutic efficiency could make up the ambiguity disadvantages in classifying the patients according to clinical effect evaluation criterion that is in force, and evaluation extent enlarge obviously, so its outcome may be more confident than other evaluation methods, and it is worth being spread.To sum up, the clinical comprehensive effect, QOL and the level of SIL-2R, TNF-oc,cTnl of the treatment group based on the therapeutic principle of benefiting spleen-qi, invigorating splenic yang and scattering fire represented Compound recipe Qiang Qi pill were better than two control groups in treating patients with VMC, The therapeutic effect of treatment group belonged to excellence and two control groups belonged to utility according to fuzzy comprehensive evaluation of therapeutic efficiency. It could conclude that Compound Qiang Qi... |
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