| This paper concludes the professor CAO Yushan’s clinical experience of treating cardiovascular disease and evaluate the clinical efficacy of CAO’s decoction and observe the effect on life quality of these patiants with hypertension (grade1and grade2, yin deficiency with yang hyperactivity) treated with the prescription. There are three innovations aspects in this paper:(DThis paper stresses on thinking of TCM and distinguishing thoughtway and application experience of the CAO Yushan’s,②atepressure product(RPP) was calculated to indirectly reflect heart oxygen consumption of the involved cases with in this paper, while the pulse pressure(PP) and the pulse pressure index(PPI) in the patients were used to evaluate degree of vascular sclerosis.③This paper evaluate the effect of CAO’s Jiangya Decoction on life quality of these patiants with hypertension.1.The clinical experience of CAO Yushan’s in treating cardiovascular diseaseThe general features of the CAO Yushan’s clinical experience will be discussed on6aspects:analysing inducement before examining disease and syndrome differentiation, harmonizing yin and yang, warming and and invigorating yangqi firstly, diagnosis and treatment based on syndrome and disease differentiation, grasping pathogenesis, sequential therapy, regulating qi and blood, synchronic treating phlegm and blood stasis, studying ancient works and thawing today, development and innovation.Based on professor CAO Yushan’s experience of treating hypertension, this paper analyses major characteristics:paying attention to inducing condition and inducement, distinguishing Yin-Yang firstly in clinical practice, emphasizing the pathology of qi, investigating water and dampness and phlegm and blood stasis, analysing minutely the fundamental aspect and external symptoms and the fu-organ, and laying stress on the seasons and solar term. In treatment, he concerns about harmonizing the relationship of the five internal organs, regulating the functional activities of qi, combining dynamic and static drugs, dispelling turbid pathogen and resolve phlegm and promoting blood circulation, purging the fu-organ and falling down stomach energy, as to establishing therapeutic principle according to changes of cold and warm.This paper summarizes major characteristics about professor CAO Yushan’s experience of treating coronary heart disease:paying attention to regulating qi and blood, the blood is the base of life based on combining heart and liver, heat-clearing according to phlegm-heat and stasis-toxin, clinical herb-prescribing and recipe-constructing with drugs for evil-wind, combining disease and syndrome and giving consideration to pharmacology, strengthening body resistance is fundamental measure based on detailed investigating accompanied syndromes.Professor CAO Yushan considers that the location of chronic pulmonary heart disease involves the five Zang and its nature was deficiency in origin and excess in superficiality. The characteristics of deficiency in origin is yang deficiency that based on qi deficiency or deficiency of both qi and yin. The characteristics of excess in superficiality includes two kinds of contents:one is that phlegm and blood stasis run through all the time, the other is that pathogenic factor await a favourable opportunity. The prescription based on Siziyangqing decoction and Qiangxin decoction are applied during acute attack and remission period separately. The thoughts and methods of combination of TCM and western medicine changes at different stages.The statistics data show that the drugs of treating hypertension in high use frequency were herba siegesbeckiae, eucommia ulmoides, uncaria, prunella vulgaris, salvia, etc, while the drugs of treating coronary heart disease in high use frequency were salvia, safflower, caulis perillae, allium macrostemon bunge,etc.2. Clinical study of CAO’s Jiangya Decoction in treating hypertensionObjective:To evaluate the clinical efficacy of CAO’s Jiangya Decoction and observe the effect on life quality of these patiants with hypertension (grade1and grade2, yin deficiency with yang hyperactivity) treated with the prescription.Methods:Randomized, single-blinded and positive drug controlled methods were adopted in this clinical observation. The patients with hypertension (yin deficiency with yang hyperactivity) were divided into two sub-layers(grade1and grade2),then the patients with hypertension(grade1and grade2) were divided into two groups,50in the observed group(CAO’s Jiangya Decoction combined with telmisartan group) and48in control group(telmisartan group). The test cycle was2course of treatment (four weeks). All patients’s symptoms, blood pressure, pulse pressure (PP), pulse pressure index(PPI), resting heart rate(RHR)、 rate pressure product(RPP)、total dose of telmisartan and life quality were contrasted between the two groups as well as their own control, the data was used to evaluate the clinic efficacy of CAO’s Jlangya Decoction.Results:1. Antihypertensive efficacy:The totale effective rate was84.00%in observed group and60.42%in control group, and there was significant difference between two groups (P<0.05).It was shown that SBP, SBP、 DBP、 PP、 PPI between the two groups comparing to itself came down obviously(P<0.05). The changes except PPI in the observed group were more significant than that in the control group (P<0.05).The rate of reaching standard blood pressure in the observed group was74.00%, while in the control group was52.08%,the difference was significant(P<0.05).2. Resting heart rate (RHR)The RHR were improved significantly in observation group after treatment (P<0.05),but which were not reduced significantly in control group(P>0.05). The difference between two two groups was remarkabe (P<0.05)3. Rate pressure product (RPP)The results showed that RPP between the two groups comparing to itself dropped obviously (P<0.05). The changes in the observed group were more significant than that in the control group (P<0.05).4. Total dose of telmisartanThe total dose of telmisartan in the observed group was significantly decreased than that in the control group (P<0.05).5. Therapeutic effect of syndromeThe total effective rates of traditional Chinese medicine syndromes was92.00%%in the observed group and66.67%in the control group, the difference was significant (P<0.05).The total symptomatic score in both groups after treatment were obviously lowered (P<0.05), and the difference was significant (P<0.05). There was significant improvement on symptoms in the observed group after treatment,especially on the symptoms of dizziness, headache, lumbago knee weakness, trouble in hot, palpitation, insomnia, tinnitus (P<0.05), also, dizziness, headache and palpitation improved obviously in the control group(P<0.05). The former had a better effect in relieving umbago, knee weakness, trouble in hot, palpitation, insomnia, tinnitus than the latter (P<0.05). 6. Quality of lifeThere was marked improvement on PF、 RP、 BP、 VT、RE、 MH、 GH of life quality in the two groups after treatment (P<0.05).The five dimesion of PF、RP、BP、VT、GH showed significant improvement in the observed group compared with in the control group(P<0.05).There was no change of SF in both groups after treatment (F<0.05).Conclusions:1. CAO’s Jiangya Decoction combined with telmisartan have a good antihypertensive effect for yin deficiency and yang hyperactivity hypertension than telmisartan, and there was marked improvement on PP、 PPI、RPP, also, the total dose of telmisartan was significantly decreased.2. CAO’s Jiangya Decoction combined with telmisartan could improve the clinical symptoms significantlyfor yin deficiency and yang hyperactivity hypertension than telmisartan.3. CAO’s Jiangya Decoction combined with telmisartan could improve the quality of life obviously for yin deficiency and yang hyperactivity hypertension than telmisartan. |
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