The Effect Of Salvianolate On Elderly Unstable Angina (Qi Deficiency To Blood Stasis) And TAFI

Background:Unstable angina (UA) is a clinical status between stable angina and Acute myocardial infarction (AMI), it includes initial onset angina pectoris、Exertional Angina、angina pectoris at rest。It is caused by coronary arteries beneath the bleeding、 broken plaque、platelet aggregation protein and fiber line into blood clots、coronary artery spasm、distal embolization in small blood vessel causing the acute or subacute myocardial oxygen to reduce, is a common type of acute coronary syndrome (ACS). With the aged getting older, The cardiovascular system will change in structure and function and the incidence of diabetes and hyperlipemia rising, the infection of increasing age factors and coronary heart disease risk factors, so ACS is becoming a life-threatening disease for old people。Pain With Chest Discomfort is included in ACS in traditional medicine, according to Chinese medicine dialectica, UA is divided into Heart chakras haemorrheological nature、stagnation of the circulation of vital energy、Phlegm turbidity resistance、Blood stasis resistance、Insufficient head、lack of heart-yin and heart-yang deficiency seven types。Recent years many doctors divides UA into qi depression to blood stasiss、qi deficiency to blood stasis、turbid phlegm to blood stasis、phlegm to blood stasis according to the type of blood stasis.In the last decade, some foundation and clinical studies confirm inflammation playing a important part in AS. More and more evidences confirm antigenic specificity and adaptive immunity playing a important role in plaque developing. Recent years the abnormalities of blood coagulation are taking seriously in the occurrence development of AS. TAFI(Thrombin Activatable Fibrinolysis Inhibitor)is a glycoprotein which can make fibrinolytic system regulation, some studies find the level of TAFI in plasma is related to occurrence of UA, and it’s level also relates the level of TC(total cholesterol)、fibrin and reactant in acute phase, these may prompt TAFI participate in inflammatory reaction. So it is important to regulate the level of TAFI for the treatment of UA.Objective:To investigate the clinical effect of Salvianolate on UA (qi depression to blood stasis) of the aged and the plasma level of TAFI (Thrombin Activatable Fibrinolysis Inhibitor).Methods:Totally120patients of UA are divided randomly into two groups, conventional treatment group and Salvianolate group,60in every group. The former was given conventional antianginal medicine (Anti Platelet Aggregation、beta-blockers、nitrate medications、calcium channel antagonist), the latter are given Salvianolate based on the conventional antianginal medicine. After two weeks,detect the general condition(including temperature. blood pressure、rhythm of the heart、heart rate) of two groups, and observe the changes of ST Segment of12leads ECG, clinical symptom, and the plasma level of TC、TG、LDL-C、PT. APTT、TAFI.Results:①No significant difference in terms of weight, height and age, gender between the conventional treatment group and Salvianolate group (P<0.05), and in the drug treatment there is no difference between the two groups, so the groups can be compared。②The efficient of ST segment of12leads ECG on Salvianolate group patients is higher than the conventional group obviously (P<0.05)③Compared of levels of inflammatory factors, after drug treatment the level of hs-crp and IL-6of the conventional group is higher than the Salvianolate group obviously,(P<0.05).④Compared with levels of livid,the level of TC.TG and LDL-C of the Salvianolate group is lower than the conventional group obviously(P<0.05), and the level of HDL is higher than the conventional group obviously.(P<0.05)⑤Observing the level of TAFI and the Coagulation system, the level of TAFI of the Salvianolate group is lower than the conventional group obviously (P<0.05). and in the coagulation system, the level of PT and APTT in the Salvianolate group is higher than the conventional group obviously(P<0.05), the level of Fib in the in the Salvianolate group is lower than the conventional group obviously(P<0.05).⑥According to the efficient of the Clinical symptoms dissolve, the efficient of the Salvianolate group is higher than the conventional group(P<0.05).⑦According to the Symptom score, before the drug treatment there is no significant between the two groups. After drug treatment the score of Salvianolate group is lower than the conventional group obviously(P<0.05).Conclusion:①Salvianolate can effectively reduce elderly patients with unstable angina blood lipid levels, so as to stabilize the artery atherosclerotic plaque, and reduce the probability of cardiovascular events。②Salvianolate can reduce the level of plasma TAFI, plasma TAFI levels were significantly affect the coagulation system, and thus provides a new approach for salvianolate prevention and treatment of coronary heart disease with unstable angina。...