Liu Hua-wei’s Academic Thoughts And Clinical Research On The Treatment Of Angina Pectoris With Kai Jiang Fen Xiao Tang Caused By Arteries And Veins Obstruction Due To Phlegm And Blood Stasis

Professor Liu Hua-wei is one of the mentors of the fourth and fifth generation for training qualified Tradition Chinese Medicine (TCM) doctors to carry on the experience of national well-known and senior TCM experts, practicing medicine for 40 years in Shaanxi Province Hospital of Traditional Chinese medicine, with rich clinical experience, is adept in treatment of internal diseases, especially on coronary heart disease, hypertension, arrhythmia and other diseases, has a unique academic ideas and clinical experience of his own, studying and summarizing the tutor’s academic characteristics and clinical experience, to inherit and carry forward the traditional Chinese medicine.1 A study on the academic ideas and clinical experience of Professor Liu Hua-weiProfessor Liu Hua-wei is well versed in classic, paying attention of Neijing, treatise on febrile diseases, synopsis of prescriptions of the golden chamber, seasonal febrile disease of the classic clinical expertise in syndrome differentiation, put emphasis on the spleen and stomach, liver and gallbladder, advocating the concept of the double ninth Festival academic. Summary of academic ideas of Professor Liu Hua-wei include:emphasis on the overall concept; adhere to the disease differentiation and syndrome differentiation combined; paying attention to the viscera gas gasification; emphasizing the spleen and stomach, attach importance to the hepatobiliary; commonly used in clinical "adjusting activity of Qi, promoting gasification"philosophy of prescription; pay attention to the Qi and Yang; adhering to the "junior fire supporting vital QI"idea,be good at using FuZi in clinical;give full play to the advantage, reflecting the overall thinking.Liu Hua-wei, a clinical professor of unauthorized treatment of internal diseases, with their own characteristics for the treatment of cardiovascular diseases and summarize the clinical experience of Professor Liu Hua-wei:"Kai jiang fen xiao tang" is made based on the "Theory of Opening with Acrid Agents and Descending with Bitter Agents" Decoction for the treatment of coronary heart disease and angina pectoris (arteries and veins obstruction due to phlegm and blood stasis).By syndrome differentiation of ZangFu to the viscera gas gasification philosophy guiding arrhythmia, hypertension, lung cancer, esophageal cancer, chronic gastritis and cirrhosis of the liver disease treatment.New views:(1) Kai jiang fen xiao tang is made based on the "Theory of Opening with Acrid Agents and Descending with Bitter Agents", evolved from Wendan Decoction and Wuling powder, which has the function of Resolving Phlegm and descending the turbid to achieve the effect of regulating Qi, promoting qi transformation, reflecting the concept of traditional Chinese medicine as a whole. (2) the decoction can improve the clinical symptoms and blood lipid, serum fibrinogen level, to provide new ideas and methods for the treatment of angina pectoris induced by coronary heart disease.(3)By using "viscera gas gasifiction"philosophy to interpret pathogenesis and treatment of angina pectoris induced by coronary heart disease. Systematically summarizing professor Liu Hua-Wei’s academic origins and academic thoughts for the first time. To inherit and promote the experience of professor Liu Hua-Wei has the very vital significance.2.Clinical research on "Kai jiang fen xiao tang" for the treatment of coronary heart disease and angina pectoris (arteries and veins obstruction due to phlegm and blood stasis).Angina pectoris induced by coronary heart disease share the same symptoms of" Chest Fullness", "heartache"," true heart pain" in the traditional Chinese medicine. In recent years, with the change of the life style and diet structure, the incidence of angina pectoris induced by coronary heart disease rate showed an upward trend and age of onset tends to younger, which has become a serious and common threat to people’s life and health nowadays. A complete system of TCM has been established in syndrome research, pathogenesis and treatment of coronary heart disease. Therefore, it is imperative to explore the way of preventing and treating coronary heart disease from Chinese medicine. Professor Liu Hua-wei summarize other schools of the cause and pathogenesis of coronary heart disease (CHD), followed the pathogenesis of "YinYang micro-string" from Synopsis of the Golden Chamber, and that coronary heart disease is due to the viscera Qi disorders, gasification, resulting in phlegm, dampness and water, phlegm and blood stasis in the pathology of metabolites stop, Bizu Xinmaitong caused, and phlegm stagnation is the main pathogenesis of coronary heart disease, heart sick, involving the liver, spleen, kidney, but relations with the gallbladder and spleen (stomach) are closely related. The clinical use of "acrid opening and bitter descending method" for leading the creation of open down consumer Decoction on patients with coronary heart disease of clinical curative effect and the level of blood lipid and serum fibrin and other clinical observation and research, to explore reduce the cancellation of the clinical effect and mechanism of Decoction in the treatment of coronary heart disease, so as to further summarize and develop academic experience of famous veteran doctors of traditional Chinese medicine (TCM).Objective:(1) To summarize,inherit and carry forward the academic thoughts and clinical experience of professor Liu Hua-Wei. (2)To observe influence and discuss the possible mechanism of the"Kai jiang fen xiao tang" made based on the "Theory of Opening with Acrid Agents and Descending with Bitter Agents" on ECG, blood lipid, serum fibrinogen level before and after treatment of the patients with angina pectoris induced by coronary heart disease (arteries and veins obstruction due to phlegm and blood stasis), and discuss the unique advantages of treating angina pectoris induced by coronary heart disease (CHD).Methods:(1)Learn and investigate the published papers and books of professor Liu Hua-Wei,Systemized his academic thoughts.(2)In the learning process with the teacher, by copying the prescription and giving instruction, record the characteristics of prescription medication and treatment based on syndrome differentiation,to summarize the clinical experience of professor Liu.(3)Clinical study:A random-control method was designed,120 cases of coronary heart disease with stable angina were selected by the method of parallel control. All patients are randomly allocated into two groups of western medicine group (control group) and combined treatment group (treatment group) with each group 60 patients.Western medicine group were treated with isosorbide mononitrate tablets, aspirin tablets and atorvastatin tablets.Combination of Chinese and Western medicine group take oral administration of the decoction, a total of 4 weeks on the basis of treatment of Western Medicine Group.All the patients were assessed with clinical severity score and ECG before and after treatment of 4th week; and the serum total cholesterol, triglyceride, high and low density lipoprotein and serum fiber protein original level, all of which were operated for between-group comparison and within-group comparison.The measurement data were analyzed by t-test and analysis of variance and independent samples t test is applied for between-group comparison, while the paired samples t-test applied for within-group comparison. The count data and the rate were analyzed by chi-square test; Data level iscompared with Riddit analysis.Results:(1) Within-group comparison before and after treatment, symptom of angina pectoris and TCM symptom were significantly improved (P<0.05) in both of the two groups; angina pectoris, electrocardiogram curative effect, and total efficiency of TCM syndrome has different degree of improvement have been improved in different ways. Before and after treatment, the treatment group was significantly better than the control group in terms of angina pectoris, ECG and traditional Chinese Medicine symptoms(P<0.01).(2) As for blood lipids compared to control group, the control group has no significant difference in TG, TC, LDL-C,HDL-C before and after treatment(P>0.05); TC, LDL-C decreased significantly in treatment group (P<0.05), HDL-C increased significantly in treatment group (P<0.01), TG before and after treatment has no significant difference (P>0.05), indicating that TC、LDL-C decreased significantly,HDL-C increased significantly in treatment group. As for blood lipids within-group comparison after treatment, LDL-C decreased and HDL-C increased better in treatment group than in control group(P<0.05). (3) As for serum fibrin fibrinogen (FIB) within-group comparison before and after treatment,the control group:P> 0.05,the difference was not significant;the treatment group:P<0.05, the difference was significant,indicating that FIB decreased significantly in treatment group.Before and after treatment,FIB decreased significantly better in treatment group than in control group(P<0.01).Conclusion:Studies have shown that Kai jiang fen xiao tang, in the treatment of coronary heart disease angina pectoris (arteries and veins obstruction due to phlegm and blood stasis) patients, can improve the symptoms of angina pectoris, and electrocardiogram (ECG) and TCM syndrome effect, and reduce the serum TC, LDL-C and increase the serum HDL-C, and serum fibrin original level. So that arteries and veins obstruction due to phlegm and blood stasis is one of the important pathogenesis of angina pectoris induced by coronary heart disease. It is speculated that the Phlegm-and Dampness-relieving, Adjusting Activity of Qi and promote qi-transformation based on theory of Opening with Acrid Agents and Descending with Bitter Agents to regulate blood lipid, serum fibrin fibrinogen level may be one of the mechanisms of relieve angina pectoris induced by coronary heart disease.The integrated Traditional Chinese and Western medicine combined treatment that Kai jiang fen xiao tang combined with isosorbide mononitrate, worship, aspirin and atorvastatin atorvastatin calcium, can significantly improve the angina pectoris and blood lipids, serum fibrin original level. This study provides a scientific and objective evidence for the treatment of the patients with angina pectoris induced by coronary heart disease (arteries and veins obstruction due to phlegm and blood stasis), which lays a foundation for further study on the mechanism of the action.