| Objective: To evaluate the effect of Tongyang Xuanbi Decoction established by Guangxi famous Chinese medicine professor Lu Jianqi on sputum-stasis-associated coronary heart disease stable angina pectoris and vascular endothelial function.Experience in diagnosis and treatment,and provide reference for further research in clinical and basic fields.Methods: From From November 2018 to December 2019,108 patients with clear diagnosis of SAP(classified as "grade ?",and "grade ?")who were treated in the cardiology department of the First Affiliated Hospital of XXX University of Traditional Chinese Medicine were selected.Chinese medicine Patients with syndrome differentiation of phlegm and blood stasis as the research object were randomly divided into the control group and the treatment group according to the method of rolling dice.The control group(n=54 cases)was treated with conventional western medicine and the treatment group(n=54 cases).Tongyang Xuanbi Decoction was added on the basis of conventional western medicine treatment,and the course of treatment was 4 weeks.Comparison of vascular endothelial functions such as flow mediated dilation,plasma nitric oxide,and endothelin-1 in the brachial artery before and after treatment between the two groups Important indicators and TCM syndrome scores,TCM syndrome efficacy,total effective rate for improving angina pectoris,Seattle score(SAQ).Statistical analysis was performed using SPSS 23.0 statistical software.In counting data,rank data is used for rank sum test,and disorder data is used for chi-square test.Measurement data are expressed as "?x±s".After homogeneity of variance test and normality test,paired T test is used for comparison before and after self-treatment in each group,and independent sample T test is used for comparison between two groups before and after treatment.Homogeneity distribution or variance,using non-parametric tests.Result:1.Comparison of gender,age,course of disease,angina pectoris classification,underlying diseases,important indicators of vascular endothelial function(FMD,NO,ET-1),angina pectoris score,TCM syndrome score,and Seattle five groups in the two groups There was no statistical difference(P>0.05),all were comparable;2.Comparison of the total effective rate of angina pectoris after treatment in two groups of subjects:The degree of angina pectoris in both groups improved after treatment(P<0.05),but by comparison,the total effective rate of 90.38% in the treatment group was significantly higher than the control73.08%,there was a statistical difference(P<0.05);3.Comparison of FMD before and after treatment in the two groups of subjects:After treatment,the levels of FMD in the two groups of subjects were higher than before(P<0.05),but the level of elevation in the treatment group was more significant(P<0.05);4.Comparison of NO and ET-1 levels before and after treatment in two groups of subjects:two groups of subjects after treatment The level of serum NO was higher than that before treatment(P<0.05),but the increase was more significant in the treatment group(P<0.05).After treatment,the level of ET-1in both groups was lower than before(P<0.05),but The reduction was more pronounced in the treatment group(P<0.05);5.Comparison of TCM syndrome scores between the two groups ofsubjects before and after treatment:The TCM syndrome scores of the two groups of subjects decreased after treatment(P<0.05),but the degree of reduction in the treatment group was more significant(P<0.05));6.Comparison of the efficacy of TCM syndromes after treatment in the two groups of subjects:The efficacy of TCM syndromes in the two groups of subjects improved after treatment(P<0.05),but the total effective rate of the treatment group was 84.91% higher than that of the control group at63.46 %,The difference is statistically significant(P<0.05);7.Comparison of SAQ scores between the two groups of subjects after treatment:The scores of each group in the SAQ content of the two groups of subjects improved after treatment(P<0.05),but the Seattle content of the treatment group was limited by physical activity limitation Except(P<0.05),the improvement of other scores was better than that of the control group,and the difference was statistically significant(P<0.05);8.The 105 subjects who completed the randomized controlled trial study had stable vital signs.There were no obvious abnormalities in the safety indicators of the two groups of subjects during the study,and no adverse events occurred.Conclusion:1.Adding Tongyang Xuanbi Decoction on the basis of conventional western medicine treatment can effectively improve angina pectoris and vascular endothelial function in patients with sputum-stasis interstitial SAP,relieve clinical symptoms and improve quality of life.Western medicine conventional treatment),and no obvious Adverse reactions were seen,and the safety and effectiveness have been verified,which is worthy of clinical recommendation.2.Based on bibliometric content,it has been found that the use oftraditional Chinese medicine to intervene in vascular endothelial function to treat SAP has been a hot spot in clinical research for nearly 30 years,and the proprietary Chinese medicines and treatment methods to improve vascular endothelial function have mostly involved aroma warming,nourishing qi and activating blood.The composition and rule of the traditional Chinese medicine to some extent verify the scientificity of this research.3.Using network pharmacology to analyze the action mechanism of Tongyang Xuanbi Decoction in the treatment of SAP,it was found that stigmasterol,?-sitosterol,isorhamnetin,carvedin,8-isoprenyl mountain in Tongyang Xuanbi Decoction Chemical components such as naphthol can improve the function of vascular endothelial cells.At the same time,the key core targets of VEGFA,PPARG,CAT,TP53,and SOD1,which are closely related to SAP disease,were discovered through topology analysis.The center,multi-sample advanced clinical research and basic research provide a certain theoretical reference. |
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