The Clinical Study On Yishen Huoxue Jiedu Decoction For Senile With Unstable Angina Of Coronary Heart Disease And Its Effects On The Vascular Endothelial Function、IL-18、Copeptin

ObjectiveTo observe the clinical curative effect with treatment of Yishen Huoxue Jiedu Decoction for senile with unstable angina of coronary heart disease(the type of kidney deficiency and blood stasis),and the influence of vascular endothelial function, IL-18, copeptin and hs-CRP.And to explore its possible mechanism of action. MethodOn the basis of the diagnostic criteria of coronary heart disease unstable angina(the type of kidney deficiency and blood stasis) and TCM syndrome, according to the order to be hospitalized,40 patients with coronary heart disease unstable angina were randomly and equally divided into the research group and the control group(n=20). Results1. In this study, patients’ angina pectoris and electrocardiogram(ECG) of two groups were improved after treatment. Two groups of patients with angina pectoris curative effect comparison, the research group total effective rate(95%) higher than the control group( 80%). Resting ECG curative effect comparison, the research group total effective rate(80%) higher than the control group( 70%). But comparison between the two groups, there are no statistically significant difference(P﹥0.05).2. Two groups of patients with TCM symptom scores were significantly decreased after treatment, the difference are statistically significant(P<0.01). After treatment, TCM symptom scores were more obvious in the research group, the difference was statistically significant(P < 0.01).3.Patients with nitroglycerin consumption are reduced of two grops, the research group total stopping and reducing rate(90%) is higher than the control group(50%). The difference between the two groups have statistical significance(P<0.05), the research group is better than the control group.4 After treatment, NO and 6-keto-PGF1α levels increased, ET and TXB2 level decreased in the two groups, compared with those before treatment, their difference have statistically significant(P<0.01).Comparison between the two groups after treatment, the increased levels of NO and 6-keto-PGF1α of the research group were superior to the control group, the difference had statistical significance(P<0.05); the decreased levels of ET and TXB2 were superior to the control group, difference had statistical significance(P<0.05).5. The two groups after treatment, the decrease of IL- 18, copeptin and hs-CRP levels had statistical significance(P < 0.01).Comparison between the two groups after treatment, the research group of IL-18, copeptin and hs-CRP decreased levels were superior to the control group, difference had significant statistical significance(P<0.01). Conclusion1. In treatment of senile patients with unstable angina of coronary heart disease who are belong to the type of kidney deficiency and blood stasis,the method Yishen Huoxue Jiedu Decoction combined with routine western medicine are more precisely than only routine western medicine in the curative effect, and in improving the patients’ TCM symptoms and reduce the dosage of nitroglycerin are better than routine western medicine treatment. To improve symptoms in patients with angina pectoris and ECG in a certain degree, but there were no statistically significant difference between the two groups(P﹥0.05).2.Yishen Huoxue Jiedu Decoction combined with routine western medicine can significantly improve the levels of vascular endothelial function(increasing NO and 6-keto-PGF1α levels, decreasing ET and TXB2 levels), IL-18, copeptin and hs-CRP. Its possible mechanism is by improving vascular endothelial function in patients with coronary heart disease unstable angina, protecting vascular intima, inhibit inflammation, achieving the stability of vulnerable plaques and the treatment effect of unstable angina.