| The research using 162 patients with coronary angina pectoris (CHD), which confirmed by coronary angiography or have the obsolete cardiac arrest medical history, were collected. drug of elements of Syndrome of old TCM experts. And the correlation study of prescriptions correspondence degree to syndromes and the curative effect relevant carries on. And 76 patients with CHD were collected. And were intervened by basic western medicine combined with the experience in medicine of old TCM experts. The health economics evaluation of CHD was studied based on the experience of old TCM experts .1. Literature research of coronary disease angina pectorisThe research systematically summarizes the recognition of etiology and pathogenesis of chest stuffiness and pains in ancient literature and common treatment method of CHD. What is more, Summarize main current advance of clinical characteristics of CHD based on the combination of disease and syndrome in the past three years. Sum up the main points of current advance form three aspects:Chinese medicine syndrome of CHD and hematology index,Chinese medicine syndrome of CHD and special examination,Chinese medicine syndrome of CHD and gene. Research of clinical characteristics of coronary angina pectoris based on the combination of disease and syndrome should strictly according to Evidence-based Medicine. Put existent research to reach renewal administrative level and look for idiosyncracy and sensitivity evidence of differentiation of symptoms and signs. To carry out all-around research based on available data. Formulate unification standard of Chinese medical syndrome for CHD based on the combination of disease and syndrome.2. Inheritance of experiences of old doctors of TCM of CHDThe research systematically summarized experience of Xu Cheng-qiu, Chen Ding-qi, the Zhang Da-rong ,who come form Heart Internal medicine department of Chinese medicine Academy of science Guang'an Gate Hospital ,who are old doctors of TCM. Professor Xu Cheng-qiu advocate to passing and moving in treating the chest stuffiness and pains. To advocate that grasps the main syndrome, supplementing qi and nourishing yin was as the main method, To pay great attention to distinguish the actual situation, the prescription fining, blends is precise and appropriate, the medication is gentle in clinical. To pay attention to stomach-qi and opsonizate outcome. Professor Chen Ding-qi pays great attention to syndrome differentiation and treatment, applies flexibly the ancient Chinese medical classics, and formulates the proven prescription, the effect like drum and drumstick. Professor Zhang Da-rong picks out that this root deficiency and branch excess is core pathogenesis of CHD, advocates the symptoms and the causes are treated at the same time, replenishing qi and invigorating blood, tongmai and regulating qi activity are the base treatemt in CHD treatment throughout, pay attention to combination of disease and syndrome,syndrome differentiation and treatment,whole adjustment, and like double drugs in clinical. 3. The research of prescription formula corresponding to syndromes of CHD based on using drug of elements of Syndrome of old TCM experts.The research to discuss the relation of prescription formula and the syndromes in CHD, In order to clarify curative effect foundation of prescription formula. And to observe relevance prescription formula correspondence degree and curative effect. Through the forward-looking, randomized controlled trials,162 patients with CHD,which are deficiency of both qi and yin , divides into 3 groups stochastically, prescription formula and syndromes correspondence group gives the medicine of supplementing qi and nourishing yin(the medicine of supplementing qi of old TCM experts and the medicine of nourishing yin of old TCM experts), prescription formula and syndromes half correspondence group to give the medicine of supplementing qi(the medicine of supplementing qi of old TCM experts), prescription formula and syndromes no correspondence group to give the medicine of activating blood(the medicine of activating blood of old TCM experts). There are 13 patients falled off in the experiment, There were 149 appraisable patients. prescription formula and syndromes correspondence group has 51 patients, prescription formula and syndromes half correspondence group has 48 patients, prescription formula and syndromes no correspondence group has 50 patents. The intervention cycle is 28 days, Makes a follow-up visit for 6 months. Take the angina pectoris symptom integration, the TCM syndrome integration, the objective indicator and the clinical end point event formation rate as the curative effect target, To observe relevance prescription formula correspondence degree and curative effect. The result proves the prescription formula and syndromes corresponding treatment not only to be able to improve the clinical symptom integration, to the objective indicator, the end point event formation rate also has the improvement (to reduce) affects, the effect surpasses the prescription formula and syndromes half correspondence treatment, prescription formula and syndromes no correspondence treatment. Simultaneously the effect of prescription formula and syndromes half correspondence treatment also surpasses formula and syndromes no correspondence treatment. It is shows that clinical curative effect to be decided by the prescription formula and syndromes degree.4. The Clinical Study on Health Economics of Angina Pectoris based on the experience of old TCM expertsThe research in order to discuss the therapeutic and economic effects of the two therapeutic plan between integrated traditional and western medicine (basic Western medicine combined with the experience in medicine of old TCM experts) and purely western medicine to treat angina pectoris. Utilize the cost-effect analytic method in health economics to estimate integrated traditional and western medicine and purely western medicine to treat angina pectoris. And the result is, for angina pectoris, the way of integrated traditional and western medicine (basic Western medicine combined with the experience in medicine of old TCM experts) is better than purely western medicine. It is also shows that, for the clinical treatment of angina pectoris, integrated traditional and western medicine (basic Western medicine combined with the experience in medicine of old TCM experts) has obvious economic dominance, and is worth to be extended. It also suggests that health economics is optimizing the therapeutic plan and help to choose the best therapeutic way in the clinical decision making process so that we can use the minimal cost to obtain the maximal benefit.Characteristic and the innovation spot of the research lie in: First, the system summarized experience of 3 old doctors of TCM (Xu Cheng-qiu, Chen Ding-qi, Zhang Da-rong ) in Heart Internal medicine department of Chinese medicine Academy of science Guang'an Gate Hospital; Second, carried on the relevant of the prescription formula correspondence degree (to correspond, half correspondence completely, completely correspondence) and the clinical curative effect with stochastic and double blind research for the first time. Third, health economics evaluation of CHD was studied for the first time. |
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