Clinical Research Of Yiqi Detoxifying And Descending Turbid Tongbi Decoction Treating Diabetic Coronary Heart Disease

Purpose:By observing and comparing the clinical therapeutic effects of using the self-developed decoction medicine — Yiqi detoxifying and descending turbid Tongbi Decoction and using atorvastatin calcium tablets combined with aspirin enteric-coated tablets to treat diabetic coronary heart disease, to explore the efficacy of the Yiqi detoxifying and descending turbid Tongbi Decoction in treating this disease.Method:60 outpatients who visited the doctor in the Affiliated Hospital of Yanbian University and the Affiliated Hospital of Changchun Traditional Chinese Medical College (during October 2014 to February 2016) and were diagnosed as a diabetic coronary heart disease were chosen, and then were subgrouped into the decoction group and the control group randomly.All the patients were given the same alimentary control methods and diabetes education, given a diet rich in vitamin and good protein, in addition, different amounts of staple food and appropriate exercise schemes were made to them according to their different daily work and energy consumptions; At the same time, taking the fasting and postprandial blood glucose level of each patient into account sufficiently, the insulin therapy was suitable for each individual. The decoction group patients were given basic treatment plus Yiqi detoxifying and descending turbid Tongbi Decoction (made of ginseng, raw radix astragalis, tsaokoamomum fruit, ginger processed pinelli, mangnoliaofficinalis, cassia twig, coptischinensis from Sichuan of China, barbary wolfberry fruit, honeysuckle flower, forsythia suspensa, radix salviaemiltiorrhizae, ligusticichuanxiong, cyperirhizoma, mongoliansnakegourd, radix ophiopogonis, licorice root and so on) modified treatment. For patients with upper hyperactivity of liver yang, ginseng was replaced by panaxquinquefolium, and uncariarhynchophylla and gastrodiaelata were added; For patients with severe heart pain, frankincense and myrrh were added; For patients with blood stasis, safflower, angelica sinensis and panaxnotoginseng were added. After being decocted with water,300ml decoction was taken to be administered warmly by the patients before breakfast (for patients who got loose stools after medication the decoction can be administered 10 minutes after the breakfast) and 1 hour after the dinner each day. Meanwhile, the control group patients were given basic treatment plus oral atorvastatin calcium tablets 10mg (after dinner) combined with oral aspirin enteric-coated tablets 100mg (after breakfast), both 1 time a day; the two groups were observed for 2 courses of treatment at the same time, and each course was one month.The main observed and compared indexes of the patients in two groups before and after medication include:(1) The changes of traditional Chinese medical symptoms, fur of tongue and pulse manifestation; (2) The curative effect of angina pectoris; (3) The curative effect of electrocardiogram; (4) Fasting blood glucose, two-hours postprandial blood glucose; (5) Glycosylated hemoglobin; (6) Blood lipid (TC, TG, HDL); (7) Changes in hemorheology (high shear viscosity, low shear viscosity and fibrinogen); (8) Routine urine test, routine blood test; (9) Renal function, liver function.The result:1. After medication, the total effective rate of curative effect of traditional Chinese medical syndrome is respectively 83.3% and 63.3% in the decoction group and the control group; The total effective rate of electrocardiogram is respectively 70% and 43.3%. Comparisons between the two groups in the curative effect of traditional Chinese medical symptom and the electrocardiogram are both considered to have statistical difference (P<0.05).2. After medication, the indexes of FBG,2hPG and HbAlc in patients of the decoction group significantly decreased (P<0.01). After medication, the significant difference (P< 0.05, P< 0.01) is considered to exist when comparing the decoction group and the control group, which indicates that YiqiJieduHuazhuoTongbi Decoction is superior to atorvastatin tablets combined with aspirin enteric-coated tablets group in regulating glucose metabolism of the patients.3. After medication, indexes of TC, TG and HDL of patients in two groups all changed, but significant difference is not existing in the comparison between the groups (P> 0.05), which indicates that Yiqi detoxifying and descending turbid Tongbi Decoction has the same effect with the control group in regulating blood lipid of the patients.4. After medication, high shear viscosity, low shear viscosity and fibrinogen of patients in the two groups all significantly decreased compared with those before treatment (P< 0.01), and comparison between the result of decoction group and control group after treatment indicates that each index value of hemorheology of patients with Yiqi detoxifying and descending turbid Tongbi Decoction changed to a greater degree (P<0.05). This directs that the therapeutic efficacy of Yiqi detoxifying and descending turbid Tongbi Decoction is better than that of the control group in the improvement of hemorheology.Conclusion:Yiqi detoxifying and descending turbid Tongbi Decoction can effectively increase myocardial blood supply, improve clinical symptoms, regulate blood sugar, enhance the protection of cardiovascular function, reduce blood viscosity, promote blood circulation flow rate, increase blood flow and oxygen supply to ischemic myocardium and can effectively reduce the incidence of adverse reactions and toxic side effects due to medication.