Research On Characteristics Of Dynamic Change Of Traditional Chinese Medicine And Western Medicine Outcome Evaluation Of Angina Pectoris

Research approachTake angina pectoris as an example to explore the characteristics of dynamic change of Traditional Chinese Medicine and Western Medicine outcome,which included traditional Chinese syndrome score, dosage of nitroglycerin and score of angina pectoris symptoms (the extent, duration and frequency of attacks) by doing retrospective research on data of former clinical trials on heart blood stasis syndrome of angina pectoris, build the curve model of traditional Chinese syndrome score, dosage of nitroglycerin and score of angina pectoris symptoms. And validated each correlation between time and efficacy about these three variables by small sample peospective sequence study.PurposeTake angina pectoris as an example to explore the dynamic changes of traditional Chinese syndrome score, dosage of nitroglycerin and score of angina pectoris symptoms, build the curve model of the of traditional Chinese syndrome score, dosage of nitroglycerin and score of angina pectoris symptoms.And provide new methods for evaluation of traditional Chinese medicine in treating angina pectoris,build the foundation of clarifying the location of outcome level measured by traditional Chinese syndrome MethodsStudy1:retrospective studyMore than1000cases were studied. All the included clinical trials are strict randomized, double blinded, multicenter and parallel-controlled study. And all the subjects are diagnosed as angina pectoris (stable exertional angina), with heart blood stasis, and cardiac function of Ⅰ,Ⅱ, or Ⅲ level. Sort and merge the original data, and use exploratory data analysis methods, to explore the changing trend of traditional Chinese syndrome score, dosage of nitroglycerin, and score of angina pectoris symptoms,and build the curve model of the of traditional Chinese syndrome score, dosage of nitroglycerin and score of angina pectoris symptoms,clarify the characteristics of dynamic change of Traditional Chinese Medicine and Western Medicine outcome evaluation of angina pectoris.Study2:prospective studyOn the basis of the retrospective study, we collected100cases. All the subjects are angina pectoris patients (stable exertional angina), and diagnosed as heart blood stasis syndrome, with cardiac function of Ⅰ, Ⅱ, or Ⅲ level. Treat all the patients with traditional Chinese medicine. The whole course of the treatment is6weeks. Visit the patients before the treatment,2weeks after the treatment begins,4weeks after it begins, and6weeks after it begins. The evaluation indexes include the score of traditional Chinese syndrome, the dosage of nitroglycerin, and score of angina pectoris symptoms. Do statistical analysis on these3variables, to analyze how they change with time. And verify the conclusion of the retrospective study.ResultsStudy1Through the analysis on data of1190cases of angina pectoris patients (heart blood stasis syndrome) in clinical trials, we get the following results:Descriptive statistical analysis shows that:the score of traditional Chinese syndrome, score of angina pectoris symptoms and dosage of nitroglycerin decreased as the time passing. Trend analysis on the variables shows that:for each subject, the score of traditional Chinese syndrome, score of angina pectoris symptoms, and everyday dosage of nitroglycerin show a trend of linear decreasing.Correlation analysis shows that:regardless of visit,there are positive correlation between the score of traditional Chinese syndrome, score of angina pectoris symptoms, and everyday dosage of nitroglycerin.Analysis with mixed-effects models in longitudinal data shows that:when only take everyday dosage of nitroglycerin, course of treatment, and which medicine used into consideration, we can see that the latter two indicators have obvious influence on the score of traditional Chinese syndrome, score of angina pectoris symptoms, and everyday dosage of nitroglycerin.And all of these3variables decreased as the time passing.Analysis with generalized estimating equations shows that:course of treatment, and which medicine used into consideration have obvious influence on the score of traditional Chinese syndrome, score of angina pectoris symptoms, and everyday dosage of nitroglycerin. And all of these3variables decreased as the time passing.Study2By continuously collecting100cases of angina pectoris patients (heart blood stasis syndrome) and analyzing the change trend of score of traditional Chinese syndrome, score of angina pectoris symptoms and everyday dosage of nitroglycerin before and2weeks,4weeks,6weeks after treatment begins, we find out that:Descriptive statistical analysis shows that:the score of traditional Chinese syndrome, score of angina pectoris symptoms decreased as the time passing.Trend analysis on the variables shows that:for each subject, the score of traditional Chinese syndrome, score of angina pectoris symptoms show a trend of linear decreasing.But the reducing degree of the average of each variable only show in the first two weeks. Correlation analysis shows that:regardless of visit,there are positive correlation between the score of traditional Chinese syndrome, score of angina pectoris symptoms.Analysis with mixed-effects models in longitudinal data shows that:course of treatment have obvious influence on the score of traditional Chinese syndrome, score of angina pectoris symptoms, and everyday dosage of nitroglycerin.Analysis with generalized estimating equations shows that:course of treatment have obvious influence on the score of traditional Chinese syndrome, score of angina pectoris symptoms, and everyday dosage of nitroglycerin.Conclusion1. The domino effect of intervention and treating duration are the influence about dynamic change of Traditional Chinese Medicine and Western Medicine outcome evaluation of angina pectoris.2. The trend of changes of traditional Chinese syndrome score, angina pectoris symptoms score and everyday dosage of nitroglycerin are the same. They all show a decreasing trend when time passed.Among the three indicators, traditional Chinese syndrome score, angina pectoris symptoms score decrease most obviously from baseline to2weeks, the trend of declining slows down since4weeks after the treatment begins.3. After6weeks’ treatment, the score of TCM syndrome and angina pectoris symptom is still declining. It suggests that6weeks’treatment is insufficient for evaluation of the efficacy of Chinese medicine in treating angina pectoris.