| Objective:To investigate the effect of Tongguan Capsule Combined with PCI on systolic function of left ventricle of coronary heart disease(CHD). Methods:Seventy patients treated with percutaneous coronary intervention (PCI) were randomized to two groups: group A (n=35, treated with Tongguan Capsule and conventional western medicine) and group B(n=35, treated with conventional western medicine). The clinical characteristics were evaluated. Also, the severity scale of coronary artery stenosis was quantitively assessed according to coronary angiography by Gensini sore. The whole systolic function of left ventricle: left ventricular eject fraction (LVEF), cardiac output(CO), systolic volume(SV) and regional systolic function: Wall Motion Score Index (WMSI) were scaled by GE-ViVid 7 color-doppler echocardiograph before PCI and 1 day, 30days, 90days after PCI respectively. The changes of syndromes of QI-deficiency and blood stasis were respectively evaluated through the measuring scales of Ql-deficiency and of blood stasis. Major adverse cardiac events (MACE) including death, nonfatal myocardial infarction(MI), target vessel revascularization(TVR) and new heart failure were followed in 6 months after PCI. Result:1.General conditions: 65 coronary artery was stenosis in Group A and 72 in Group B. The Gensini score of Group A was 23.92 ±10.64 and Group B was 23.52 ±15.62, and there was not statistics difference (P=0. 85). 3cases were missed in Group A and 2 cases in Group B and the total missing rate is 7.1%. 32 patients in Group all received with Tongguan Capsule in the whole follow-up 3 months and the compliance rate was 100%.2. Main Adverse Cardiac Events: At 6 month follow-up, there didn't exist statistics difference in the incidence of death, non-fatal MI and TVR between two groups. The incidence of new heart failure of Group A was statistically lower than Group B(5.7% vs 22.9%, P=0.04), thus, the incidence of MACE in Group A was statistically lower than Group B(11.4% vs 34.3%, P=0.022).3. The Whole Systolic Function of Left Ventricle: The levels of LVEF, CO, SV in the two groups before treatment revealed the same baseline. When compared in the same group, LVEF, SV, CO levels of 1 month after PCI in Group A and 3 months after PCI in two groups were higher statistically than those before PCI (P<0.05 or P<0.01). When compared between two groups, the levels of LVEF, SV of 3 months after PCI in Group A were higher significantly than Group B(P<0.05).4. The holistic WMSI: The holistic WMSI in the two groups before PCI revealed the same baseline (P=O.754) . The holistic WMSI of 1 in group A and 3 months in two groups after PCI was all significantly lower than before PCI when compared in the same group (P<0. 05orP<0. 01) . There was statistical difference of the holistic WMSI of 3 months after PCI between two groups (P=0. 041) .5. WMSI in the region of revascularization :The WMSI in the region of revascularization of two groups before treatment revealed the same baseline (P=0.84). The WMSI of 1 and 3 months in two groups after PCI was all statistically lower than before PCI when compared in the same group(P<0. 05 or P<0. 01) . There was statistical difference of WMSI in 3 months after PCI between two groups in the region of revascularization (P= 0. 030) .6. WMSI in the region of non-revascularization: The WMSI in the region of non-revascularization of two groups before treatment revealed the same baseline (P=0. 69) . There was no statistical difference when comparing the WMSI 3 months after PCI with WMSI before PCI in Group B (P>0. 05) , but there was statistical difference when comparing WMSI of 3 months after PCI with it before PCI in Group A (P=0. 03) and when comparing WMSI in 3months after PCI between two groups in the region of non-revascularization (P=0.026) .7. The Scores of the Measuring Scales of Ql-deficiency(MSQD): There weren't statistical difference between two groups in the scores of MSQD before PCI. And the same result was revealed when respectively comparing the scores of MSQD of 1 day after PCI with that before PCI in two groups, and when comparing the scores of MSQD of 1 month after PCI with the scores before PCI in Group B. However, there existed notable statistics sense when comparing the scores of MSQD of 1 and 3 months after PCI with the scores before PCI in Group A and when comparing the scores of MSQD of 3 months after PCI between two groups.8. The Scores of the Measuring Scales of Blood stasis(MSBS): There weren't statistical difference between two groups in the scores of MSBS before PCI(P>0.O5). However, there existed notable statistics sense when respectively comparing the scores of MSBS of 1 day/ 1 month/ 3 months after PCI with the scores before PCI in two group and when comparing the scores of MSQD of 3 months between two groups (P<0.05).Conclusion:1. PCI could greatly relieve the systole dysfunction of the whole and regional cardiac ventricle of patient with CHD, however, the recovery of systolic function of CHD after PCI is delayed.2. PCI could significantly relieve the syndromes of blood stasis of CHD in short term but could not effectively relieve the syndromes of QI-deficiency. So the patients after PCI should receive the treatment of supplementing Qi and activating blood circulation according to TCM.3. The therapy of the combination of Tongguan Capsule and PCI could relieve the systole dysfunction of the whole and regional cardiac ventricle of patient with CHD more than the therapy of only PCI. That suggests that Tongguan Capsule could protect ischemia myocardium and improve the systolic function of it.4. Tongguan Capsule exerts a better effect in improving the syndromes of TCM, especially in improving syndromes of Ql-deficiency and blood stasis than only PCI, which is related with the action of reinforcing QI and activating Blood.5. The combined therapy of Tongguan Capsule and PCI could reduce the... |
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