Research On The Mechanism And Curative Effect Of Shuqing Decoction On The Syndromes Of Post-PCI In Patients With Unstable Angina Pectoris

Objective:Percutaneous coronary intervention(PCI)greatly reduces the mortality of coronary heart disease.However,many patients after PCI still have symptoms such as chest tightness,chest pain,palpitation,shortness of breath,fatigue,anxiety,depression,etc.,which seriously affect the quality of life of patients."Post-PCI syndrome"were putted forward to conclude that phenomenon,which have been indepth researched on its pathogenesis,and the treatment are constantly updated,but the re-hospitalization rate and disability rate of the disease are still at a high level.To systematically sort out the various etiology and pathogenesis of postoperative PCI syndrome in patients with unstable angina pectoris,we compare the differences of postoperative and preoperative of PCI in syndromes,mechanism and treatments.Observe and explore the curative effect of shuqing decoction for patients with Post-PCI syndrome.Methods:The ancient and modern literatures of traditional Chinese medicine were systematically sorted out,and the related records of Post-PCI syndrome were sorted out and summarized.The etiology and pathogenesis of Post-PCI syndrome in patients with unstable angina pectoris were summarized.To further verify shuqing decoction are effective on Post-PCI syndrome,66 patients with unstable angina pectoris after PCI were randomly divided into control group and Chinese medicine treatment group.The control group was treated with standardized western medicine,and the patients in Chinese medicine treatment group were additional treated by shuqing decoction.After 14 days of intervention,the clinical and laboratory indicators were analyzed,including 6-minute walk test,TCM symptom score,ECG changes,LVEF,Seattle angina quality of life score,serum creatinine and urea nitrogen,blood alanine aminotransferase and total bilirubin changes,as well as plasma neurohumoral factors PRA,AngⅡ,ALD,ET,NT-ProBNP.Results:Intermingled deficiency and excess is the predominantly feature of patients with Post-PCI syndrome.The syndrome of iatrogenic injury caused by PCI surgery itself and intensivetreatment of medicine before and after surgery should be attributed to external factors.The pathological products include blood stasis,damp hot and phlegm heat.The results of clinical observation of the effect of shuqing decoction on patients with Post-PCI syndrome,show that compared with the control group,TCM symptom scores were significant decreased in the shuqing decoction treatment group(obvious effective rate 39.4,66.7,%),cardiac function grading improved significantly(obvious effective rate 33.3,57.6,%),ECG efficacy rate was significant higher in shuqing decoction treatment group(obvious effective rate 36.4,54.6,%)(P<0.05);The scores of the 6 minutes walk were significantly improved after treatment by shuqing decoction(P<0.05),the LVEF,LVESD and LVEDD were significantly improved as well(P<0.05).After treatment with shuqing decoction,the neurohumoral factors were significantly lower than those before treatment(P<0.01).Compared with the control group,ALD,ET(P<0.01),PRA,AngII,NT-ProBNP decreased(P<0.05).There were no significant adverse reactions after treatment in the two groups,and there were no statistically significant differences(P>0.05).Conclusions:Intermingled deficiency and excess is still an important pathogenesis of patients with Post-PCI syndrome.Compared with standard medicine,shuqing decoction combined with standard medicine can significantly improve symptoms,improve cardiac function and prevent ventricular remodeling in patients with Post-PCI syndrome.And its curative effect may be related to the decrease and inhibition of neurohumoral factors such as ALD,ET,PRA,AngII,NT-ProBNP.