| ObjectiveThe feasibility and advantages of the " Blood – Vessel-Heart-Spirit " integral concept in distinguishing stable coronary heart disease combined with diabetes mellitus were analyzed through literature curation and comparison of clinical efficacy.The mechanism of syndrome differentiation treatment from two ends of cold and heat on patients with stable coronary heart disease combined with diabetes mellitus was also explored,in order to provide a theoretical basis for the clinical application of Wen Yang Tong Luo and Huo Xue Jie Du method in the treatment of patients with stable coronary heart disease combined with diabetes mellitus.Method1.Referring to Literature at home and abroad,we made clear the progress in the treatment of stable coronary heart disease complicated with diabetes,and discussed the theoretical basis of applying the hypothesis of the " Blood – Vessel-Heart-Spirit " integral concept to guide the treatment of stable coronary heart disease combined with diabetes.2.132 eligible patients with stable coronary heart disease combined with diabetes were included.Among them,66 cases in the treatment group and 66 cases in the control group.Two groups were treated with conventional medicine therapy.On this basis,the treatment group was superimposed with Wen Yang Tong Luo or Huo Xue Jie Du prescriptions under the guidance of syndrome differentiation,directed by " Blood – Vessel-Heart-Spirit " integral concept.At 0 and 4 weeks as the observation point,the serum and scale data of the two groups were collected to evaluate the changes of serum indexes and the improvement of quality of life.The possible mechanism was also explored from the perspectives of inflammation,vascular endothelial function and lipid metabolism.Result1.There is no significant difference in baseline data between the treatment group and the control group before treatment.2.Comparison of angina score,TCM syndrome score and quality of life between the treatment group and the control group before and after treatment2.1 Angina scores were significantly lower after 4 weeks of treatment in both groups compared with those before treatment,with significant differences between scores before and after treatment(P < 0.05).There was no statistical difference in the scores between the two groups(P > 0.05).2.2 After 4 weeks of treatment,compared with those before,TCM total syndrome scores,TCM major syndrome scores,and TCM secondary syndrome scores in the two groups were decreased and the change in the scores was statistically significant(P < 0.05).The TCM major syndrome scores and the chest pain symptoms scores were decreased more significantly in the treatment group than those in the control group,and the differences were significant(P <0.05).The TCM secondary syndrome scores in the treatment group showed a decreasing trend compared with the control group,but there was no statistical difference compared with the control group(P > 0.05).2.3 After 4 weeks of treatment,in both groups,Seattle scale scores were increased compared to week 0,with statistical difference(P < 0.05).The degree of physical activity limitation,angina pectoris stabilization,and satisfaction with treatment scores were increased more in the treatment group compared to the control group(P < 0.05),and the SF-36 scale scores increased in both groups compared to week 0(P < 0.05).The increase in the physical functioning,energy,and social functioning degrees was more pronounced in the treatment group than in the control group(P < 0.05).3.Comparison of serological indicators between the two groups3.1 s VCAM-1: After 4 weeks of treatment,serum s VCAM-1 decreased in both groups which was statistically different from that before treatment(P < 0.05).It decreased more in the treatment group superimposed on TCM syndrome differentiation treatment than in the control group,which was statistically significant(P < 0.05).3.2 AGEs: After 4 weeks of treatment,serum AGEs increased in both groups with a significant difference(P < 0.05),and AGEs increased less in the treatment group than in the control group,although there was no statistical difference between the two groups(P > 0.05).3.3 s RAGE: After 4 weeks of treatment,serum s RAGE increased between the treatment group and the control group,and the difference was statistically significant(P < 0.05).The increase rate of the treatment group was similar to that of the treatment group(P > 0.05).After 4 weeks of treatment,serum s RAGE increased significantly compared to week 0,(P < 0.05),and there were comparable changes between the treatment and control groups(P >0.05).3.4 IL-6: After 4 weeks of treatment,serum IL-6 was decreased in both groups,which was statistically different from that before treatment(P < 0.05),and the reduction in the treatment group was comparable to that in the control group(P > 0.05).3.5 CETP: After 4 weeks of treatment,serum CETP was decreased in both groups with a significant difference(P < 0.05),and the reduction in the treatment group was comparable to that in the control group(P > 0.05).Conclusion1.The " Blood-Vessel-Heart-Spirit " integral concept is based on the theoretical foundation of TCM and is consistent with the modern scientific connotation.The clinical verification is effective.The concept can dynamically expound the mechanism and evolution process of stable coronary heart disease complicated with diabetes.It is scientific,reasonable and clinically informative,and could elaborate the etiology and pathogenesis of stable coronary heart disease combined with diabetes based on the multilevel system such as tissue and cell.2.Under the guidance of the "Blood-Vessel-Heart-Spirit " integral view,the method of Wen Yang Tong Luo and Huo Xue Jie Du method has obvious effect on improving angina pectoris and the main symptoms of traditional Chinese medicine,and the effect is better than that of conventional western medicine treatment group.The method of Wen Yang Tong Luo and Huo Xue Jie Du under the guidance of the " Blood –Vessel-Heart-Spirit " integral concept are effective in improving angina pectoris symptoms and the chest pain symptoms in TCM major symptoms,and the curative effect is better than that of conventional medicine therapy group.The evaluation of quality of life also proves that after the treatment of TCM syndrome differentiation,the rehabilitation of patients’ physiological function and social function will get a positive effect.It is proved that the method of Wen Yang Tong Luo and Huo Xue Jie Du can improve the psychosomatic symptoms of patients,stabilize the development of chronic diseases,and coordinate blood,vessel,heart and spirit.3.The mechanism of Wen Yang Tong Luo and Huo Xue Jie Du method in treating stable coronary heart disease combined with diabetes has relationship with endothelial adhesion,glycosylation and inflammation.It may produce an anti-inflammatory and anti glycosylated vascular protective effect through regulating AGE/RAGE axis and decreasing VCAM-1 and IL-6. |
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