A Cohort Study On The Treatment Of NSTE-ACS Based On The "phlegm, Blood Stasis And Toxin Deficiency" Pathogenesis And Its Effect On Serum Lp-PLA2 And PIGF

Purpose:To explore the clinical effect of legislative prescription based on the pathogenesis of "phlegm-blood stasis-deficiency-toxin" on non-ST-segment elevation acute coronary syndrome(NSTE-ACS)and its influence on serum lipoprotein phospholipase A2(Lp-PLA2)and placental growth factor(PIGF),in order to provide theoretical basis for clinical treatment of NSTE-ACS.Material and method:In this study,NSTE-ACS patients were taken as the research object,and the clinical design of multi center and prospective cohort study was adopted.According to whether to use the traditional Chinese medicine granules of "removing blood stasis and eliminating phlegm,strengthening spleen and detoxifying" which was sent by the pathogenesis concept of "phlegm,blood stasis and toxin",the patients were divided into the western medicine cohort and the combination cohort of Chinese and Western medicine.The western medicine group was given the routine diagnosis and treatment plan of Western medicine,and the combination of Chinese and Western medicine group was added with the traditional Chinese medicine granules of "removing blood stasis and phlegm,strengthening spleen and detoxifying".The course of treatment in both groups was 24 weeks.The symptom degree,duration,attack frequency,the amount of nitroglycerin,as well as the changes of Lp-PLA2 and PIGF expression in serum were observed before and after treatment.SPSS software was used for statistical analysis.Results:In this study,224 NSTE-ACS patients were enrolled,including 115 in the western medicine cohort and 109 in the integrated Chinese and Western medicine cohort.After 24 weeks of intervention,the angina symptoms of the two groups were improved(P < 0.05).The score of angina attack times,the degree of pain and the degree of decrease of nitroglycerin dosage in the combination of traditional Chinese and Western medicine group were better than those in the western medicine group(P < 0.05).There was no difference between the two groups in the improvement of angina duration(P > 0.05).After 24 weeks of intervention,the levels of Lp-PLA2 and PIGF in the two groups were significantly lower than those in thewestern medicine group(P < 0.05).Conclusion:Based on the pathogenesis of "phlegm,blood stasis,deficiency and toxin",the legislative prescription for improving angina symptoms of NSTE-ACS patients has certain curative effect and good safety,and the combination of Chinese and Western medicine in reducing the degree of angina pain,the number of attacks and the amount of nitroglycerin,the effect trend is better than that of Western treatment alone.Based on the pathogenesis of "phlegm,blood stasis,deficiency and toxin",the legislative prescription can significantly improve the angina symptoms of NSTE-ACS patients,which may be related to the down-regulation of Lp-PLA2,PIGF expression level and the inhibition of inflammatory response.