Clinical Research On The Treatment Of Unstable Angina Pectoris With Traditional Chinese Medicine Polygonum Cuspidatum And Hawthorn Based On TCM Theory Of Blood Stasis And Toxin

Objective:To observe the clinical efficacy of Chinese herbs for detoxification and activation of blood circulation(Polygonum cuspidatum combined with Hawthorn)based on TCM theory of blood stasis and toxin in the treatment of toxin and blood stasis type of unstable angina pectoris of coronary heart disease,and to explore its mechanism from the aspact of regulating the balance of pro-inflammatory and anti-inflammatory,so as to provide a certain basis for the application of the compatibility above in the treatment of coronary heart disease.Methods:According to the random number table method,sixty patients with heat toxin and blood stasis type of unstable angina pectoris were divided into control group and experimental group,who were hospitalized in the Cardiology Department of Guang'anmen Hospital from July 1,2017 to December 31,2017.30 cases in each group.The control group was given Western medicine routine therapy plan,while the experimental group was given Jiedu Huoxue formula granules on the basis of western medicine treatment,each formula granule containing 15g of Polygonum cuspidatum and 10g of hawthorn.Take one dose twice a day orally and the course of treatment is 4 weeks.The clinical efficacy,pro-inflammatory factors(hs-CRP,TNF-a,IL-6)level,anti-inflammatory factors(IL-10,Adiponectin)level,pro-inflammatory factors/anti-inflammatory factors ratio and the drug safety or adverse reactions in both groups before and after treatment were observed.Results:Regarding clinical efficacy,the angina symptom score,the SAQ score,the TCM syndrome score and the SF-36 score of the patients in both groups after treatment were allievated than those before treatment.In terms of improvement of the TCM syndrome score and the SF-36 core,the experimental group was superior to the control group,and the difference was statistically significant(P<0.01).With respect to pro-inflammatory factors.hs-CRP level in the experimental group after treatment was significantly decreased,and the difference was statistically significant(P?0.01).There was no statistically significant difference in hs-CRP level between the two groups.Compared with before treatment,TNF-a level in both groups after treatment was decreased and the difference was statistically significant(P<0.01).There was no statistically significant difference between the two groups.IL-6 decreased significantly after treatment in the control group,and the difference was statistically significant(P?0.01).IL-6 in the experimental group after treatment also showed a downward trend compared with before treatment,but the difference was not statistically significant.There was no significant difference in IL-6 level between both groups after treatment.In regard to anti-inflammatory factors,IL-10 level was significantly higher in the experimental group after treatment than before treatment,and the difference was statistically significant(P<0.05).IL-10 level in the control group was also slightly increased after treatment,but it was not statistically significant.There was no statistically significant difference in IL-10 level between both groups after treatment.There was no statistically significant difference in Adiponectin level between the two groups after treatment(P>0.05).however,the Adiponectin level in the experimental group after treatment was higher than that in the control group.The differences between both groups were statistically significant(P<0.05).With respect to pro-inflammatory/anti-inflammatory balance,IL-6/IL-10,hs-CRP/Adiponectin,and TNF-a/Adiponectin ratio decreased in the experimental group after treatment,and the difference was statistically significant(P<0.05).Furthermore,hs-CRP/IL-10,TNF-a/IL-10 and(hs-CRPx TNF-axIL-6)/(IL-lOxAdiponectin)decreased significantly in the experimental group after treatment and the difference was statistically significant(P<0.01).TNF-a/IL-10.IL-6/IL-10,TNF-?/Adiponectin.and(hs-CRP�TNF-?�IL-6)/(IL-10xAdiponectin)in the control group after treatment decreased significantly(P<0.01).Hs-CRP/Adiponectin increased slightly,and the difference was statistically significant(P<0.05).Hs-CRP/Adiponectin in the experimental group after treatment was significantly lower than that in the control group,and the difference was statistically significant(P<0.01).IL-6/Adiponectin after treatment in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).In terms of safety evaluation,one patient in the experimental group suffered diarrhea,and returned to normal by taking the drugs after meals instead.No adverse events occurred in either group during the study periodConclusion:Combined with conventional western medicine,the traditional Chinese medicine of detoxification and activation of blood including Polygonum cuspidatum and hawthorn can significantly improve the clinical symptoms of patients with unstable angina pectoris,reduce the TCM syndrome score,and have good safety.Its mechanism may be related to inhibition of pro-inflammatory factors and adjustment of the pro-inflammatory/anti-inflammatory balance.