The Clinical Study And The Related Mechanism Of Acute Myocardial Infarction Treatment Using The Method Of Supplementing Qi And Nourishing Yin,Promoting Blood Flow And Eliminate Phlegm

Objective:To research the efficacy of guanxingping which presents the method of supplementing qi and nourishing yin, promoting blood flow and eliminate phlegm in the treatment of Acute Myocardial Infarction(AMI) by observing the attack of angina pectoris in the first and forth week of the course of the treatment and improvement of ECG, Traditional Chinese Medicine(TCM) symptoms, at the same time, to investigate the relation between the efficacy and improving endothelial function through the changes of the serum concentration of blood lipid(TC、TG、LDL-C、HDL-C), endothelial function indexes (NO, ET, TXB2,6-keto-PGF1α), oxidative stress and inflammation indexes (SOD, hs-CRP) before and after the4weeks treatment.Methods:1.By using random, single blind and parallel group clinical reaearch method,40patients of AMI that were diagnosed as Qi-Yin deficiency and phlegm, blood stasis syndrom were enrolled and randomly divided into control group and treatment group according to the proportion of1:1.20cases in the treatment group were treated with routine western drugs and guanxinping for4weeks, while the control group only received routine treatment. The attack of angina pectoris in the first and forth week of the course of the treatment and the improvement of ECG, TCM symptoms, as well as the changes of the serum concentration of blood lipid, endothelial function indexes, oxidative stress and inflammation indexes were detected before and after the treatment.2.Data processing was done by SPSS19.0software. Descriptive statistic analysis, qualitative index used percentage and quantitative index used mean and standard deviation. Taking contrastive analysis between the two groups, the Chi-square analysis was used for qualitative data and "t" analysis or non-parametric test was used for quantitative data.Results:1.The attack of angina pectoris:Compared with the first week of the course of the treatment, scores, frequency, duration of angina pectoris and doses of nitroglycerin decreased significantly in the forth week (P<0.01), the treatment group showed lower. The change showed more noticeable in the treatment group, there were significant differences between the two goups (P＜0.05).2.ECG:The effective rates of ECG of the treatment group and the control group were70%and65%, but there was no significant difference between the two goups (P>0.05).3.TCM symptoms:Both two groups could decrease scores of TCM symptoms significantly after treatment (P＜0.01), the treatment group improved better (P<0.05). The effective rates of the treatment group and the control group were95%and85%. There was significant difference between the two goups (P＜0.05).4.Blood lipid indexes:The level of TC, LDL-C significantly decreased in both two groups after treatment (P＜0.01or P<0.05), the treatment group was more significant (P＜0.05). The level of TG decreased in two groups, the level of HDL-C increased in the treatment group and decreased in th control group, but there was no statistical significance of these change ((P>0.05). There was no significant difference between the two goups of TG and HDL-C (P>0.05).5.Endothelium functions indexes:The level of NO,6-keto-PGF1α increased and the level of ET、TXB2decreased in treatment group significantly after treatment(P<0.01, P＜0.05). The level of NO increased significantly after treatment in control group (P＜0.01). The change of the level of6-keto-PGFla, ET, TXB2in control group had no significance((P>0.05). The change of the level of NO,6-keto-PGFla, ET, TXB2after treatment is more noticeable in the treatment group, there were significant differences between the two goups (P＜0.05).6.Oxidative stress and inflammatory reaction indexes:The level of SOD increased (P＜0.05) and the level hs-CRP decreased (P＜0.01) in treatment group significantly after treatment. The level of hs-CRP decreased significantly (P＜0.05) in control group after treatment. The level of SOD increased in control group, but there was no statistical significance (P>0.05). The change of the level of hs-CRP and SOD after treatment is more noticeable in the treatment group, there were significant differences between the two goups (P＜0.05).Conclusions:Using guanxingping which presents the method of supplementing qi and nourishing yin, promoting blood flow and eliminate phlegm to treat AMI can significantly improve TCM symptoms of the patients and alleviate the attack of angina pectoris after the treatment. The therapeutic mechanism may be associated with regulating blood lipid, antioxidation and anti-inflammatory, and then improving EDF.