| Objective: The effect of Yixin Tongbi Decoction on the incidence of cardiovascular adverse events in patients with non-obstructive coronary microvascular disease(Qi deficiency and blood stasis,phlegm block syndrome),the changes of coronary flow reserve before and after drug use,the curative effect of TCM syndrome,TCM syndrome score and the improvement of quality of life were analyzed in order to evaluate the interest of the patients.Tongbi Decoction is effective and safe in treating this disease.Method: In the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from June 2016 to April 2017,the symptoms of angina pectoris were obvious.There was no obvious abnormal coronary angiography and normal left ventricular ejection fraction.The coronary flow reserve(CFR)was reduced by transthoracic ultrasound coronary flow imaging,and Qi deficiency and blood stasis was found in TCM syndrome differentiation.The patients with phlegm turbidity blocking syndrome were selected after inclusion and exclusion criteria.A total of 56 cases were enrolled,including 18 males and 38 females.The basic data of the patients' clinical baseline and hospitalization were recorded.All cases were given the routine treatment of oral and basic diseases of nicorandil.The treatment group was divided into the treatment group(30 cases,the average age of 60 ± 7.37 years)and the control group(28 cases,the average age 58.44 ±7.43 years old).Comparing two groups of patients with cardiovascular adverse events in January,March and June(including cardiac death,non fatal myocardial infarction,non fatal stroke /TIA,angina pectoris readmission,and heart failure rehospitalization),and calculated the incidence of time and number of cases,and compared the incidence of two groups before and after treatment.The changes of coronary blood flow reserve,TCM syndrome,TCM syndrome and adverse reactions were measured by SPSS for Windows19.0 software package.Results: A total of 56 patients were included in the study and 54 were actuallycompleted(1 case was removed and 1 case was excluded).Treatment group: 29 cases were actually completed(one case was eliminated by self-administered combination of other traditional Chinese medicines for activating blood circulation and removing stasis);the control group: 25 cases were actually completed(one case of headache withdrawal due to incompetence due to nicorandil).1.Efficacy evaluation: Efficacy and prognosis of cardiovascular adverse vents were evaluated.In the treatment group,3 patients were hospitalized or heart failure,1 was admitted to hospital by TIA,and the incidence of ardiovascular adverse events was 10.2%;3 patients in the control group ere hospitalized for heart failure.One patient was admitted to hospital with hest pain,and the incidence of cardiovascular adverse events was 12.0%. here was no significant difference between the two groups(P>0.05).The FR values measured by transthoracic echocardiography in both groups were igher than those before treatment.The CFR of the treatment group was .62±0.36,and the CFR of the control group was 2.37±0.26.The CFR value f the treatment group improved more significantly.Statistical significance P=0.020<0.05).There was no statistical difference between the two groups f patients before and after treatment in terms of their awareness of the isease(P>0.05).In addition,compared with the control group,the treatment roup had the efficacy of TCM syndromes,TCM syndrome scores,and the mount of angina in Seattle.The improvement in the quality of life of the valuation of the table was more significant and the difference was tatistically significant(P<0.05).2.Safety evaluation: Yixin Tongbi Decoction did not appear obvious adverse eactions,while the control group had 1 cases of abscission due to nicorandil nduced headache.Conclusion: The TCM syndrome differentiation of non-obstructive coronary arteria microvascular disease belongs to the syndrome of qi deficiency and blood stasis and phlegm block syndrome.Yixin Tongbi Decoction and nicorandil only give nicorandil the incidence of cardiovascular adverse events,but the former has moreclinical benefit,which is CF measured by transthoracic ultrasound coronary flow imaging.The R value increased.The quality of life in TCM syndrome,TCM syndrome score and quality of life assessed by Seattle angina scale improved more.In addition,the Yi Xin Tong Bi decoction has good curative effect,safety and universality,and the population of nicorandil intolerance in clinical or use Yixin Tongbi Decoction alone in the treatment of non-obstructive coronary arteria microvascular disease.For patients with clinically suspected coronary arteria microangiopathy,if there are more risk factors for women and cardiovascular disease,early intervention with CFR to identify microvascular lesions may benefit more from early intervention. |
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