Clinical Research And Effects On Inflammatory Factors Of Qishen Yiqi Drop Pill With Xinmaitong Patch In Patients With Unstable Angina After PCI

Coronary heart disease(CHD)is a common and frequent disease nowadays.Besides,its mortality is increasing,in 2014 Chinese cardiovascular death rate is still on the list of the disease and is higher than the tumor and other diseases,which damage people's physical and mental health seriously.the regular treatments of coronary heart disease are medication and surgical treatment.While PCI is just one of them,because of its instant and effective effects,people are very concerned.However,there are still many problems that people still can't solve even with PCI,such as the improvement of patients' quality of life after surgery,psychological state and the recurrence of angina,which are always disturbing problems for clinical doctors and patients.There have no specific words such as coronary heart disease or chest pain after PCI in Traditional Chinese Medicine(TCM).While it very similar to thoracic obstruction and cardiodynia according to the clinical symptoms.During the past thousands of years,Traditional Chinese Medicine saved countless lives.Nowadays,TCM which treat patients based on pattern identification and take people as a whole body has a lot of advantages compared with western medicine.So combine them together and learn from each other,we doctors can do more for the patients.Objective one:Investigate 160 unstable angina pectoris patients who have been done the PCI and whose pattern are all deficiency of Qi and blood stasis to find the clinical effects through the method of Qishen Yiqi Drop Pill with Xinmaitong patch for these patients.Methods:Divide these 160 patients into control group and treatment group(group A,B,C)randomly,each group has 40 patients.And all of these four groups receive regular medicine treatment,while group A take more with Xinmaitong patch;group B with Qishen Yiqi Drop Pill;group C with Qishen Yiqi Drop Pill(three times a day)and Xinmaitong patch.The treatment course is 4 weeks.Then we need to observe the clinical effects,the symptom integral,blood coagulation function(PT.APTT.TT.FIB),the levels of serum high sensitivity C-reactive protein(Hs-CRP),Myeloperoxidase(MPO),blood lipids(TC?LDL?LPA)and free fatty acid(FFA)and etc.Results:1.There have significant differences of the efficacy of angina pectoris and TCM syndrome score among the four groups(P<0.05).The treatment groups are all better than the control group,and group C is the best.2.The life quality among these four groups get improvement,and AS,AF,TS and DP also improve to a certain degree after the treatment(P<0.05,P<0.01),while AS,AF,TS and DP in the treatment group are all better than the control group at the same period after the treatment(P<0.05),and group C is better than group A and B(P<0.05).The electrocardiogram and dynamic electrocardiogram of the four groups patients were improved after treatment,with the treatment group better than the control group.There was no significant difference in the left ventricular size after treatment,but the LVEF of the treatment group was better than the control group.3.The blood coagulation function in the four groups get improvement,and PT,APTT and TT in the four groups all lengthen to a certain degree after the treatment,while there have no significant differences(P>0.05).And FIB in the four groups also get improvement in the four groups,it decrease to a certain degree,while the treatment group are all better than the control group at the same period after the treatment(P<0.05).,and group C is better than group A and B(P<0.05).4.The Hs-CRP and MPO decrease to a certain degree after the treatment in the four groups(P<0.05).And the level of Hs-CRP and MPO in the treatment group are all significantly lower than the control group,while group C is better than group A and B(P<0.05).After treatment,TC,LDL,LPA and FFA with the treatment of the combination of Chinese and Western medicine decrease more than the control group.Conclusion:Xinmaitong patch and Qishen Yiqi Drop Pill can not only improve the efficacy and pattern of patients with unstable angina after PCI,but also can improve the function of blood coagulation,decrease the level of blood lipids and unstable inflammatory factors(Hs-CRP?MPO),and enhance their life quality.So Xinmaitong patch and Qishen Yiqi Drop Pill are effective to unstable angina,and can stabilize the plaques and fight inflammation.Besides,they have less adverse reaction,so they deserve to be promoted in clinical practice.Objective Two:Explore the effect of Qishen Yiqi Drop Pill with Xinmaitong patch on the cardiac function,apoptosis and inflammatory factors in rats with ischemia reperfusion.Methods:By ligating the coronary arteries,then loose the thread,we can get the rats with ischemia reperfusion injury.After that,we group these rats and treat them with Qishen Yiqi Drop Pill and atorvastatin respectively for 4 weeks.At last,we need to monitor the echocardiography,hemodynamics,HE staining,NT-proBNP,CKMB,cTnI and inflammatory factors,such as Hs-CRP and MPO.Results:1.Compared with the model group,the LVEDD and LVESD in the rats of Qishen Yiqi Drop Pill with Xinmaitong patch group and Atorvastatin group decreased to different degrees(P<0.05),while EF,FS and SV increased(P<0.05).2.Compared with the model group,the MAP,LVDP,+dp/dtmax and-dp/dtmax in the rats of Qishen Yiqi Drop Pill with Xinmaitong patch group and Atorvastatin group increased significantly(P<0.05),while LVEDP and ST decreased significantly(P<0.05).3.The levels of NT-proBNP,Hs-CRP and MPO in model group,Qishenyiqi dripping pills with Xinmaitong patch group and atorvastatin group were significantly higher than those in sham operation group(P<0.01).Compared with the model group,the levels of serum NT-proBNP,Hs-CRP and MPO in the rats were significantly lower than those in the rats treated with Qishenyiqi pills with Xinmaitong patch group and atorvastatin group(P<0.05).