| ObjectiveCurrently,coronary heart disease(CHD)has become the leading killer of human health.The emergency of percutaneous coronary intervention(PCI)has saved many CHD patients’life.However,the postoperative recovery of patients undergoing PCI is not satisfying.Domestic and foreign researches have shown that among the elderly patients with CHD and elderly patients undergoing coronary stent implantation,the incidence of sleep disorder is up to 50%-64.7%.Modern medicine often treats insomnia with tranquillisers and sleeping pills,but most of Chinese people refuse to take them in fear of the side effects and dependency of tranquillisers and sleeping pills.Meanwhile,many studies have shown that traditional Chinese medicine(TCM)therapy has proven to be effective in treating insomnia.For that reason,in this study we carried out TCM intervention and management on insomnia patients undergoing coronary stent implantation.The influence of Yiqi Huoxue Anshenfang(prescription for supplementing qi,activating blood circulation and mind-calming)on the sleep of CHD patients was observed,and the effect of Chinese traditional medicine on the sleeping state of CHD patients undergoing coronary stent implantation was explored.To provide the clinical evidence for TCM-involved sleep management of heart rehabilitation,the efficacy of Yiqi Huoxue Anshenfang for CHD patients undergoing coronary stent implantation was observed.MethodsThis study was designed to be a randomized controlled trial.CHD patients treated or hospitalized in Dongzhimen Hospital Beijing University of Chinese Medicine from January 2016 to January 2017 were observed.The subjects were included based on the diagnostic criteria for CHD,insomnia,TCM syndrome and the quantified grading standards for TCM syndromes.A total of 52 patients were enrolled and randomly divided into experiment group and control group.On the basis of the standardized treatment guideline,Yiqi Huoxue Anshenfang,which was prescribed by Professor Guo Weiqin,was given to the experiment group,while the western medicine group received standardized guideline treatment and estazolam(diazepam).Controlled experiment statistics were carried out on their general Information,insomnia status,TCM symptom score,anxiety and depression score,Pittsburgh sleep quality index(PSQI),life quality etc.,and databases were built.The TCM symptoms,PSQI scores,anxiety and depression scores and life qualities of the patients before and after treatment as well as the improvements of their quality of life were analyzed.Results1.Basic information:The ages of these subjects were between 60 to 69 years old,and the percentages of men and women were similar:28 men(53.8%)and 24 women(46.2%).Their educational levels were mainly at the junior and senior middle school level,and only 9.6%of them had bachelor degree or above.Among the 52 patients with CHD following PCI treatment and insomnia,the patients with concurrent hypertension had the highest risk factor(n=42,80.8%),and the patients with hyperlipidaemia and diabetes accounted for 69.2%and 61.5%.Most of patients had quit smoking and alcohol after PCI.but their weight management was poor.The BMI of these patients mostly ranged from 24 to 27.9.2.Insomnia:major insomnia types:trouble in falling asleep,shallow sleep and easy to wake up,hard to falling back to sleep after awake,and all the frequencies were above 65%.During inquiry,the reasons for insomnia mainly included over thinking(n=34,65.4%),household affairs distracting(n=21,40.4%),and 14 patients complained about the affects of coronary heart disease,like chest congestion,dyspnea and other symptoms.Most of the patients(n=35,67.3%)had medical treatment of insomnia,of which 10 patients(19.2%)had taken traditional Chinese medicine,19 patients(36.5%)had taken western medicine,and 1 patient(1.9%)had received acupuncture therapy.As for the influence of PCI on insomnia,most of the patients(n=35,67.3%)thought there was no significant difference before and after PCI.3.TCM symptoms:repetitive measure analysis of variance was applied in evaluating TCM symptoms.Statistical analysis showed that no statistical difference(P>0.05)in TCM symptom score was found between experiment group and control group;but there were statistical difference(P<0.05)in TCM symptom scores at different time points before and after treatment;there were no interactions between grouping and time(P>0.05).suggesting that TCM symptoms of patients in both groups showed improvement after the treatment.4.PSI:Compared with the control group receiving estazolam treatment,Yiqi Huoxue Anshenfang had more advantages in improving the subjective sleep feeling of patients.There were no significant differences in improving sleep latency,efficiency,duration and sleep disorder between the experiment group and control group,but sigrnficant differences were found in both groups before and after treatment.There were significant differences in the total score between different groups,and there were statistical difference in sleep improvement(score-reducing rate)between the two groups(P<0.05).The percentage of patients with better sleep improvement and significant progresses in the experiment group were higher than those of the control group.5.Anxiety and depression score:The study showed that most of the subjects enrolled had mild anxiety and mild to medium depression.After taking Yiqi Huoxue Ansheng prescription based on conventional treatment,the experiment group had improved the anxiety and depression score,which was better than the control group.Furthermore,the grading of depression was also improved after taking the medicine.6.Life quality score:Irn terms of quality of life,the exper:imental group and control group showed no obvious differences in physical strength before and after treatment.These two groups showed no significant differences in the scores pathogenic condition,medical service condition,general life,social and psychological conditions,but they had significant differences in these indicators at different time points before and after treatment,suggesting that Yiqi Huoxue Ansheng prescription based on the medication of western medicine has a certain effect in improving the quality of life of patients with CHD following PCI and insomnia.Conclusions1.Based on the medication of western medicine,Yiqi Huoxue Ansheng prescription can improve the TCM symptoms of patients with CHD following PCI and insomnia.2.Yiqi Huoxue Ansheng prescription is better than western medicine estazolam in treating patients with CHD following PCI and:insomnia in terms of their subjective feeling of insomnia and the general condition of insomnia.3.Yiqi Huoxue Ansheng prescription has certain curative effect for the anxiety and depression conditions and quality of life of patients with CHD following PCI and insomnia. |
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