The Evaluation Study On The Effectiveness Of Chinese Herbal Medicines For Nourishing Qi And Resolving Blood Stasis In The Treatment Of Unstable Angina After Percutaneous Coronary Intervention Based On Markov Model

Objective:(1)To compare the therapeutic effect of nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine with western medicine for qi deficiency and blood stasis syndrome patients in unstable angina (UA) after Percutaneous Coronary Intervention (PCI) based on Markov model;(2)To test the feasibility and scientific nature of Markov model in effective evaluation of the intervention with nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine.Methods:Based on the patients in UA after PCI as the research object, we constructed a Markov model that included four states as revascularization, non-fatal myocardial infarction, non-fatal stroke and all cause death; evaluated the superiority of therapeutic effect based on probabilities and Quality-adjusted Life Years (QALYs) gained for40Markov circles(6months interval for one Markov circle). According to the one-dimensional sensitivity analysis, the comparison of predictive probabilities with the similar studies at home and abroad, the consultation of cardiovascular experts, the comparison of predictive probabilities with the study cohort, we conducted the fitting and validity of Markov model included four aspects as technical validity, external validity, face validity, predictive validity and tested the feasibility and scientific nature of Markov model in effective evaluation field of nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine.Results:For the forecast in20years, the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke and all cause death in nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine group accounted for56.65%,6.53%,5.16%and31.66%; the transition probabilities of which in western medicine group accounted for55.31%,6.87%,5.25%and32.57%. Patients receiving nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine could, on average, expect to experience12.945QALYs, whereas in western medicine group that could be expected to12.84QALYs over the 20-year period, resulting in an additional0.105QALYs gained from nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine. Based on the outcomes of technical validity, external validity, face validity, predictive validity, the effective evaluation of the intervention with nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine was a certain feasibility and scientific nature.Conclusion:Based on the forecast results of Markov model, the treatment of the patients in nourishing qi and resolving blood stasis Chinese herbal medicines plus western medicine group was better than Western medicine group,nourishing qi and resolving blood stasis Chinese herbal medicines had a certain effect in the treatment of UA after PCI; Besides, the effective evaluation of Traditional Chinese Medicine based on Markov model had a certain feasibility and scientific nature.