| Objective: To investigate the relationship between angina pectoris and myocardial bridge index in patients with myocardial bridge,and to observe the clinical effect of Tianxiangdan on angina pectoris of myocardial bridge.Methods:The subjects of this study were suspected coronary heart disease hospitalized in Xinjiang Uygur Autonomous region Hospital of traditional Chinese Medicine from January 2017 to December 2018.(CCTA)was diagnosed as myocardial bridge by coronary artery CT.(1)all the selected patients underwent exercise treadmill test.Whether chest pain was induced by exercise plate test and whether there were ischemic changes in exercise plate test were recorded.(2)the length and thickness of myocardial bridge were measured on CT,the muscle bridge index(length×thickness)was calculated,and the length and thickness of myocardial bridge were analyzed.The correlation between muscle bridge index(length×thickness),glycolipid metabolism,heart rate,blood pressure and chest pain induced by exercise plate test.(3)to analyze the correlation between the length and thickness of myocardial bridge,muscle bridge index(length × thickness),glucose and lipid metabolism,heart rate,blood pressure and ischemic changes in the results of plate test.(4)the patients with chest pain induced by exercise plate test were selected.According to the results of exercise plate test,they were divided into two groups:exercise plate test without ischemia group and exercise plate test with ischemia group,and exercise plate test without ischemia group was given lifestyle intervention Tianxiangdan granule.The ischemic group was divided into control group and experimental group.The control group was given lifestyle intervention metoprolol tartrate tablets,and the experimental group was given lifestyle intervention metoprolol tartrate tablets.Tianxiangdan granule was taken orally.(5)the attack of(AS),angina pectoris in Seattle angina pectoris scale(SAQ)was observed before and after treatment in the non-ischemicgroup.(AF),was observed in the stable state of(AS),angina pectoris with Seattle angina pectoris scale(Seattle angina pectoris)before and after treatment.Treatment satisfaction(TS),disease awareness(DP)five dimensions score and chest pain,chest tightness,shortness of breath,fatigue TCM syndrome score changes;On the basis of the observation indexes of the exercise plate test without ischemia group,the changes of the peak exercise heart rate,exercise time,metabolic equivalent and the worst ST level of the exercise plate test before and after treatment were observed in the exercise plate test group with ischemic exercise plate test.(6)the changes of exercise peak heart rate,exercise time,metabolic equivalent and the worst ST level were observed before and after treatment.At the end of the trial,MACE events were followed up for 1 month.Results:The main results were as follows:(1)the muscle bridge index of patients with chest pain was(27.09 ±2.00)mm2,which was significantly different from that of patients without chest pain(16.58 ±1.05)mm2.(2)there was no significant correlation between chest pain induced by exercise treadmill test and cardiovascular risk factors such as sex,age,glucose and lipid metabolism.(3)the ischemic changes in exercise treadmill test were not significantly related to the length and thickness of myocardial bridge(r ≤0.141,0.234,P > 0.05),but positively correlated with muscle bridge index,and the correlation coefficient was(r = 0.261,0.046,respectively).P < 0.05);(4)there was no significant difference in the length and thickness of myocardial bridge between patients with no ischemic change in treadmill test and those with ischemic change in treadmill test.Muscle bridge index(length × thickness)(21.15(20.10,34.36)mm2 in patients with ischemic changes in treadmill test and muscle bridge index(length × thickness)in patients with no ischemic change in treadmill test(13.30(12).94,23.10)(mm2comparison,There were statistical differences.(5)whether ischemic changes occur in exercise treadmill test and cardiovascular risk factors such as sex,age,glycolipid metabolism and so on.The correlation was not significant.(6)in the non-ischemic group,chest pain,chest tightness,shortness of breath and fatigue were significantly lower than those before treatment(P < 0.05).The scores of TCM syndromes of chest pain,chest tightness,shortness of breath and fatigue in the experimental group were lower than those in the control group after treatment.The difference was statistically significant(P < 0.05).(7).After treatment,the total score of TCM syndromes was significantly lower than that before treatment in the non-ischemic group(P < 0 05),and the total score of TCM syndromes was significantly lower than that before treatment(P < 0 05).Exercise plate test has ischemia group: before treatment,the experimental group was compared with thecontrol group,and the syndrome of traditional Chinese medicine(TCM)was compared with that of the control group.There was no significant difference in the total score(P >0.05),but the total score of TCM syndromes in the experimental group was lower than that in the control group after treatment,and the total score of TCM syndromes in the control group and the experimental group after treatment was significantly lower than that before treatment(P < 0.05).(8)exercise treadmill test without ischemia group: after treatment,the degree of(PL),angina pectoris was more stable than that before treatment,and the attack of(AS),angina pectoris was stable.(AF),treatment satisfaction was(TS),.The degree of disease awareness of(DP)was significantly improved(P < 0.05).Exercise plate test has ischemia group: before treatment,the control group compared with the experimental group,the above five There was no significant difference in dimension score(P > 0.05),but it was significantly higher in the control group and the experimental group after treatment than that before treatment(P < 0.05).In terms of treatment satisfaction,the score after treatment in the experimental group was significantly higher than that in the control group,and there was significant difference between the two groups(P < 0.05).In the other four dimensions,there was no significant difference in the score after treatment between the experimental group and the control group(P > 0.05).(9)in the group with ischemic exercise plate test,the average heart rate at the peak of exercise in the test group was(161.20±2.39)beats / min,which was higher than that in the control group(153.60±5.37)beats / min,the exercise duration of the test group(7.40±0.55)min,was higher than that of the control group(6.00±0.71)min;the average metabolic equivalent of the experimental group was(9.00 ± 0.71)METs,which was higher than that of the control group(7.80±0.84)METs.After treatment,the worst ST level in the test group(1.14±0.23)mm,was lower than that in the control group(1.54±0.31)mm,P < 0.05.(11)both the non-ischemic group and the ischemic group of the exercise plate test No MACE event occurred.Conclusion:1.The occurrence of angina pectoris in patients with myocardial bridge was related to the thickness and index of myocardial bridge,but not to the length of myocardial bridge and the risk factors of cardiovascular disease.2.The ischemic changes in myocardial bridge patients were related to muscle bridge index,but not to myocardial bridge length,thickness and cardiovascular risk factors.3.Tianxiangdan can effectively improve myocardial bridge angina pectoris. |
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