| Objective:By observing the therapeutic effect of Zhishi Xiebai Guizhi Decoction on patients with phlegm-obstructing heart pulse syndrom of stable coronary heart disease,the clinical value of the original classical prescription was verified.Based on the detection of the inflammatory factors,MHR,MLR,NLR,CRP and so on,the mechanism of the effect of Zhishi Xiebai Guizhi Decoction on the inflammatory response was preliminarily discussed,which opened up a new idea and molecular mechanism basis of clinical efficacy for the modern application of the original classical prescription in preventing and treating stable coronary heart disease.Methods:176 outpatients and inpatients in the department of cardiovascular medicine of wuxi hospital of traditional Chinese medicine from January to December 2018 were selected as the research objects.According to the random number table,the enrolled patients were divided into the control group(N=88 cases)and the experimental group(N=88 cases).During the treatment,7 cases were lost in each group,and the final effective cases were 81 cases in each group.After admission,both groups were given standard western medicine treatment for stable coronary heart disease.The experimental group was treated with Zhishi Xiebai Guizhi Decoction on the basis of the control group.Both groups were treated for two consecutive months.After 2 months of treatment,the differences of the short-term efficacy,TCM symptom score,Seattle Angina Scale score,SF-36 score,levels of inflammatory factors such as NLR,MLR,MHR,CRP,serum lipid and AIP.SOD and Hcy levels,hemorheology and adverse drug reactions were compared between the two groups.All data in this study are processed by SPSS 19.0 software.Results:(1)The short-term efficacy rate of the experimental group was 92.59%after the treatment with Zhishi Xiebai Guizhi Decoction,which was higher than 80.25%in the control group(P<0.05);(2)After the comparison of TCM syndrome points between the two groups before and after treatment,the difference has statistical significance,suggesting that both combined therapy and western medicine alone can reduce TCM syndrome points,and the effect of combined therapy in reducing points is better;(3)The scores of PL,AS,AF,TS and DS in the experimental group were improved after treatment(P<0.05),and were higher than those in the control group(P<0.05);(4)Through the comparison of sf-36 scores,the eight dimensions of PF,RP,BP,GH,VT,SF,RE and MH scores in the experimental group after treatment were all higher than those in the control group(P<0.05):(5)After two months treatment,the levels of whole blood high tangential viscosity,plasma viscosity and whole blood low tangential viscosity in the experimental group were all lower than those in the control group(P<0.05);(6)The levels of MLR,MHR and NLR in the two groups after treatment were lower than those before treatment(P<0.05),and the levels of MLR,MHR and NLR in the experimental group were lower than those in the control group(P<0.05);(7)Although CRP level in both the experimental group and the control group decreased after 2 months treatment(P<0.05),there was no significant difference between the experimental group and the control group(P>0.05);(8)Before and after treatment.SOD and Hcy levels in the experimental group and the control group were statistically significant(P<0.05),and SOD levels in the experimental group were higher than those in the control group after treatment,and Hcy levels in the experimental group were lower than those in the control group after treatment;(9)TC,TG,LDL-c and AIP levels of the experimental group were lower than those of the control group after treatment(P<0.05).Two months after treatment.HDL-c level in the experimental group was higher than that in the control group(P<0.05);(10)During the treatment,diarrhea,abdominal pain,dizziness,drowsiness,blood pressure fluctuation,liver and kidney dysfunction,gastrointestinal bleeding and other adverse reactions occurred in the experimental group and the control group,but the incidence of the two groups was not statistically significant(P>0.05).Conclusion:(1)Zhishi Xiebai Guizhi Decoction can obtain relatively high short-term curative effect on patients with phlegm-obstructing heart pulse syndrom of stable coronary heart disease,and can improve the scores of TCM syndromes,SAQ scores and sf-36 scores of patients,which can help alleviate the clinical symptoms of patients and improve the quality of life of patients;(2)Zhishi Xiebai Guizhi Decoction can significantly reduce the level of inflammatory factors,which may be the relevant mechanism for improving its clinical efficacy;(3)The use of Zhishi Xiebai Guizhi Decoction does not increase the incidence of adverse reactions,which is worthy of promotion and application. |
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