Clinical Observation On Treatment Of Non - ST - Segment Elevation Acute Myocardial Infarction By

Objective:1.To study the theory of "treatment heart and brain with same methods" on the basis of Traditional Chinese Medicine(TCM). To provide new theoretical guidance for Zhong-feng-xing-nao decoction in treatment of non-ST-segment elevation myocardial infarction.2. The study was Through clinical research to examine the effect of Zhong-feng-xing-nao decoction in treatment of NSTEMI and to provide scientific foundation for Zhongfengxingnao decoction in treatment of cardiovascular diseases.Methods:1. To study and research of theory:By adepting to the literatures, we analysised the physiological realations, the commom characters both of the brain and heart, and then we induced that the cerebral infarction and CAHD were different diseases but coming from the same source. At last we concluded the theories of treatment heart and brain with the same methods.2. Clinical studying methods:(1)A total of 84 patients who complied with a standard to be randomly divided into treatment group (n=43) and control group(n=41). The difference of base line for two group had not statistical significance.(2) Both groups were treated with Modern Medicine conventional therapy,but the treatment group added Zhong-feng-xing-nao decoction,the control group was not. The course of treatment was 14d.(3)To detect ECG、LP、CK-MB、cTnI、Angina attack frequency、Duration of angina pectoris、Dosage of analgesics、Echocardiogram(LVEF、E/A、WMSI) and so on at different times or durations. After the observation of the examination results were analyzed and compared.Results:1.the ancient physician had rich experience in treatment of "zhen xin tong"and other diseases whose similar AMI,and close to Modern Medicine theoretical viewpoint.The theory of TCM support "treatment heart and brain with same methods". Zhong-feng-xing-nao decoction in treatment of NSTEMI to accord with theory of TCM.2. Clinical research:(1) The cases of between groups were horizonon base line for two group, no statistical significance(P>0.05).(2) The ischemic graph of ECG in the two groups after treatment present ed improving trend,but the treatment group was more obvious. Compared with the same group on admission, the treatment group results show statistically significant differences at 24h(P<0.05) and the control group was at 72h(P<0.05). Results comparison between groups showeds that the treatment group better than the control group at 24h、48h(P<0.05).(3) The VLP of Both groups in the course had an improving trend, especially the treatment group is more obvious. Comparison between groups, the treatment group better than the control group at 1W\2W(P<0.05).(4) The cTnI and CK-MB value of two groups is on the decline after achieved peak, the downward trend of the treatment group than the control group is more apparent. The differences between groups is more outstanding at 48h,72h(P<0.01).(5) Attack frequency of two groups of patients with chest pain and duration are decline, the treatment group is more obvious.the data of in 25-48h period has significant difference (P< 0.05) between groups, but has no significant difference at the 7th day.(6) The results of analgesic dose for comparison between the two groups show that the treatment group in the time period were significantly lower than control group (P< 0.05).(7) Two groups in each period of LVEF、E/A、WMSI value tend to be better,and the treatment group is more obvious. In the 7th day and 14th day, WMSI value in treatment group were better than control group (P< 0.05), the LEVF value is better than that of control group (P< 0.05), but had no statistically difference between the two groups (P> 0.05) in the whole process on E/A.Conclusion:(1)It has a rich theoretical and practical basis that TCM to clinical diagnosis and treatment of diseases of similar to AMI. The theory of TCM support the point of "treatment heart and brain with same methods".(2) Zhong-feng-xing-nao decoction is suitable for clinical cardiovascular emergency treatment, the treatment of AMI meet in TCM theory of "treating different diseases with same method".(3) Zhong-feng-xing-nao decoction can significantly improve the ECG、VLP、CK-MB、cTnI、Angina attack frequency、Duration of angina pectoris、analgesics dosage、 LVEF、 E/A WMSI in patients with acute NSTEMI, and has obvious advantages than pure western medicine treatment.(4)It is Curative effect, safe and reliable, without adverse reaction that Zhong-feng-xing-nao decoction in treatment of NSTEMI.(5) Zhong-feng-xing-nao decoction is the effective prescription for the treatment of NSTEMI.