Theoretical And Clinical Studies Of Treating Ischemic Cardiovascular And Cerebrovascular Disease Based On The Theory Of Treating Heart And Brain With Common Theory And Methods

Objective: Studying the theoretical frame of treatment heart and brain with common theory and methods under the guidance of viscera theory doctrine and the concept of organic wholeness. We analyze the syndrome's characteristic of the old people who are sick in heart together with brain which is a familiar disease phenomenon in clinic practice. We investigate the clinical therapeutic effect of Yiqixinnaoning on patients suffered from ischemic cardiovascular and cerebrovascular diseases so that we can provide a new theoretical basis or effective recipe, new pattern of scientific research and thinking.Methods: 1. Theories investigation: To study deeply on doctrine of viscera state and holism concept, the structure and function of viscera theory are analysed systematically. It is found that heart and brain are closely related to the relationship between them. The olderly individuals who suffer from both ischemic cardiovascular and cerebrovascular disease are considered as a whole study, so that we could investigate their etiology, pathogenesis and disease-bit. 2. Retrospectively research: To analyse retrospectively the characteristical syndrome of older who suffer from both heart and brain which are collected from Shandong University of TCM Affiliated Hospital. The total number are 112 and the time are limited within two years. Using the method of correlation analysis, the disciplines or characteristics in patients who are old and have two kinds of diseases at the same time are researched. 3. Clinical research: 40 cases with ischemic cardiovascular and cerebrovascular disease are taken as objects treated with Chinese medicine Yiqixinnaoning. By means of comparing the therapeutic effect of patients before and after the therapy between treatment group and control group which treated with Tongxinluo Capsule, the observations on effects are made. The whole course is 4 weeks. The indexes of therapeutic effects include such as: clinical symptoms integrals; nerves dysfunctions system(NIHSS), the level of cognitive dysfunction(MMSE), activities of daily living(Barthel index), cardiac function(SV, EF, FS), ECG, blood pressure, Carotid artery intimae-media thickness(IMT), blood flow of Carotid artery, blood- lipid(TC, TG, LDL-C, HDL-C), vascular endothelial (ET-1, NO), and fibrinogen, etc. The safety evaluation are monitored at the same time.Results: 1. Theoretical results: The result shows heart and brain are related closely in many aspects, such as structure and function. Vein and meridian are the disease-bit of ischemic cardiovascular and cerebrovascular disease. Qi asthenia, blood stasis and phlegm block are the common pathogenesis. 2. Retrospective research results: It is found that it is common in the clinic of olderly suffered from both ischemic cardiovascular and cerebrovascular disease in healthy care section office. Age and qi-deficiency, stagnation of phlegm-stasis, congestion block are positively correlated. Qi asthenia accompanied the entire period of old age. High positive correlation is showed among Qi asthenia, stagnation of phlegm-stasis, congestion block. 3. Clinical reach results: The conclusions are that the distinctly improved symptoms are observed after the end of treatment. Clinical symptoms and signs of ischemic cardiovascular and cerebrovascular disease are improved, in particular Yiqixinnaoning. In the treatment group, the indexes of NIHSS are reduced(P<0.05), the indexes of MMSE and the indexes of Barthel index are rised(P<0.01), compared with Tongxinluo. Frequencies and duration of angina pectoris decraese all(P<0.01) when cardiac function is improved(P<0.05). Blood pressure decreases(P<0.01), too. At the same time, it is found that Yiqixinnaoning can adjust blood lipid levels in TC, HDL-C, LDL-C, protect endothelial function(P<0.05), reduce fibrinogen (P<0.05) and increase carotid blood flow of CCA (P<0.05).Conclusions: Based on the doctrine of viscera state, heart relates to brain cosely. It is just this kind of relationship between them which construct the theoretical basis of heart and brain to be sicked together. It is the theoretical basis of curing them together, too. Through researching the theory of zangxiang, the pathogenesis of qi asthenia, blood stasis and phlegm block is explained clearly which are important to the old. Qi asthenia, stagnation of phlegm-stasis, congestion block are correlated positively with the old who is ill both in heart and in brain. Yiqixinnaoning is effective and safe in clinical research. Arised from the clinic, the theory of treating heart and brain with common theory and methods is constructed under the framework of doctrine of viscera state, including the physiologic, pathologic, diagnosis and treatment about this kind of special disease phenomenon. New ideas and methods are provided for the development of doctrine of viscera state in the respects of connotation and denotation. The clinical research pattern can be promoted further,which are constructed by three parts: investigation on the theory-retrospective study- prospective study.