Research On Dog-days Paste Treating Winter Diseases In Summer For The Prevention And Treatment Of Patients With Angina Pectoris

Background:The secondary prevention is very important in patients with Coronary Heart Disease (CHD),Which always treat with wen yang tong mai, promoting blood circulation to remove blood stasis method in Traditional Chinese Medicine (TCM). "Treating winter diseases in summer" is an important method for TCM Prevention and cure of some chronic diseases, according to the "spring and summer nourish yang" principle in the "Yellow Emperor’s Canon of internal medicine". By the time the human body of Yang is in the most productive time in summer. For Some diseases which are easy to attack or aggravate in winter with Yang medicine.so as to help Yang qi, eliminating cold, tonifying Qi, dispelling diseases. According to the etiology and pathogenesis of chest pain patients, Whether Dog-days paste could prevent or treat the attack of angina pectoris or not? At present, our country has already exist some small sample researches of Acupoint Application in treating stability angina pectoris,to verify the effects of the treatment of coronary heart disease,but the experimental research on Dog-days paste for chest pain is little. In order to further verify the prevention and clinical efficacy of Dog-days Paste to the winter disease in patients with coronary heart disease, we conducted the study.Objectives:The purpose of this study was to evaluate clinical effects of Dog-days paste in the prevention and treatment of coronary heart disease patients with angina pectoris. Compared with sticking group and the control group in the winter of angina pectoris attack,attack time and improvement of TCM symptoms. Analysis of the relationship between the Dog-days Paste and hospitalization event, In order to expand the clinical application of Dog-days paste in treating winter disease in summer,Complementary advantages of traditional Chinese medicine and Western Medicine, Give full play to the advantages of theory of preventive treatment, to further improve the level of the two grade prevention of coronary heart disease with stable angina pectoris.Methods:This is a prospective cohort study which is in order to observe the effects of Dog-days paste on patients with angina pectoris and changes of clinical symptoms and related indexes.In accordance with inclusion criteria, a total of 230 cases of angina pectoris of coronary heart disease patients were selected, Divided into acupoint sticking group 116 cases,114cases of the control group. In July 18,2014 (the first day of canicular days) started the acupoint sticking,each time the application takes three points,as Danzhong,Xinshu (double). Sticking to one times daily, Every application for 4 hours, with Three consecutive days. Then Stop using for 7 days and repeated it the second period. For the completion of the operat ion (3 days per period, sticking to a total of 9 days,for a total of 30 days). Follow-up the completion of "treating winter diseases in summer" of Dog-days Paste patients after half a year.Through the TCM clinical symptoms, the attack of angina pectoris and TCM syndrome type in two groups of patients with angina pectoris count data and in the T test, X2 test and non parametric analysis were compared between the two groups. On two groups of patients rehospitalization in winter was used to analyze the data of single factor analysis and binary regression analysis, to study the clinical curative effect of treating winter diseases in summer of acupoint sticking therapy in the prevention of coronary heart disease and angina pectoris to compared the curative effect difference.Results:1. A total of 230 cases of patients with angina pectoris were selected,Divided into 116 cases of acupoint sticking group and 114 cases of the control group. Eventually, eliminated the false acceptance and lost 10 cases,220 cases of patients were entered the final analysis. Including sticking group 110 cases, 110 cases in the control group. Two groups of patients with gender, age, smoking history, revascularization, angina severity grading and basic, there was no statistically significant difference on these baseline data(P> 0.05).2.Angina pectoris curative effect:We followed up the group of patients after half of a years. The results show that sticking group in the symptoms of angina, the dosage of nitroglycerin were improved significantly compared with the control group.Winter angina symptoms to improve the situation:sticking group 33 cases,41 cases were effective,36 cases ineffective, the total efficiency of 67.27%; 19 cases of control group were effective,16 cases effective,70 cases ineffective and 5 patients were seriously ill, the total efficiency is 31.82%. The application group total efficiency is better than the control group, the difference was statistically significant (P< 0.01); winter angina score:sticking group in the winter the angina attack frequency, duration, degree of pain and other aspects of the integral and the total angina scores were observed before improved (P< 0.01), while the control compared with no obvious changes in winter; the dosage of nitroglycerin:sticking group nitroglycerin stop reduction rate (77.40%) than the control group the total reduction rate (28.60%) stopped, the difference was statistically significant (P< 0.01)3. Curative effect of TCM syndrome:After six months of follow-up, the two groups of patients with shortness of breath, lassitude, soreness and weakness of waist and knees, sweating and other symptoms have significant difference before we observed (P< 0.05), integral sticking group. These symptoms were higher than the control group, the other TCM symptoms of the two groups were similar (P>0.05). Observed two groups of patients after the TCM symptom scores before decreased, the application group, chest pain, chest tightness, shortness of breath, palpitation, fatigue, aversion to cold, Yaoxisuanruan symptoms were improved compared with the control group, the difference was statistically significant (P<0.05), but no significant difference between the two groups, no spontaneous sleep improvement situation (P>0.05); analysis of total score of clinical symptoms:after six months of follow-up, found that the total score of the two groups of patients with traditional Chinese medicine symptoms than decreased, but the application group decreased more significantly than the control group of TCM symptoms total score (P< 0.01); analysis of TCM symptoms curative effect: sticking group was 1 cases (0.90%), effective in 53 cases (48.18%); the control group was 0 cases (0%), effective in 14 cases (12.73%); sticking group total effective rate (49.08%) higher than the control group in the total efficiency (12.73%), the difference was statistically significant (P<0.01).4. The distribution characteristics of effective syndromes:The patients with angina pectoris of two groups with Yang deficiency and cold syndrome and non Yang deficiency cold coagulation syndrome were analyzed, results showed: sticking group and 59 cases of Yang deficiency syndrome patients,49 cases were effective,10 cases ineffective. Non Yang deficiency syndrome patients,25 cases were effective,26 cases ineffective, that application group, Yang deficiency cold coagulation syndrome in patients with angina pectoris in winter is better than that of patients with Yang deficiency syndrome, the difference was statistically significant (P< 0.05), while the control group of patients with angina pectoris Yang Deficiency cold coagulation syndrome and patients with non deficiency cold coagulation syndrome Yang had no significant difference (P> 0.05)5. Readmissions in winter:We compared with factors related to patients with coronary heart disease readmissions in the winter used binary regression analysis, the results showed that:Dog-days Paste is a protective factor for readmission in winter, [P< 0.01, RR=0.029,95%CI (0.003,0.312)], Dog-days Paste Treating Winter Diseases in Summer for reduce the occurrence of angina pectoris in patients with coronary heart disease in winter for readmission has certain protective effect.6. Related survey:The investigation results show that there are 75 patients (68.10%) that the Dog-days Paste can improve the frequency of angina pectoris; 74 patients (67.30%) think sticking can alleviate angina; think sticking group. Nearly half of the patients in Dog-days Paste think taking anti-anginal drugs reduced. In addition, the application group 67 cases (60.90%) of patients that fit perfectly Gina winter seasonal variation, the frequency of angina pectoris decreased;66.40% of patients with Dog-days Paste were satisfaction.7. Safety evaluation:During the application, no serious adverse events. A total of 5 patients after patching mild discomfort, skin flushing performance, mild itching and skin symptom. Patients can be tolerated, did not affect the application; another 1 cases due to tape allergies, stop sticking.Conclusions:1. Dog-days Paste Treating Winter Diseases in Summer for the Prevention and Treatment of Patients with Angina Pectoris, improve the attack of angina pectoris in winter, and the clinical symptoms of TCM has certain curative effect.2. The effect of Dog-days Paste for angina pectoris patients with Yang deficiency and cold syndrome was more better than patients with non Yang deficiency syndrome.3. Dog-days Paste to reduce in patients with coronary heart disease and angina pectoris in winter for readmission has a protective effect.4. people with high of Dog-days Paste the prevention and treatment of angina pectoris of satisfaction.5. During the sticking, no serious adverse events occurred, Dog-days Paste is in Good security.