| Background: At present, the high incidence and mortality of cardiovascular disease has heavily influenced the health of people. Coronary heart disease(CHD) is one of the most common cardiovascular disease. It has angina symptoms caused by myocardial ischemia and hypoxia. It belongs to “chest bi-syndrome” or “real pain in heart” in traditional Chinese medicine(TCM). The western medicine for treatment of CHD includes drugs and surgery. Drugs can improve myocardial ischemia, prevent myocardial infarction and make the prognosis better. What’s more, drugs have side effects, surgery treatment is expensive and the technique is uneven. Compared with western medicine, traditional Chinese medicine in treating obstruction has unique advantages, not only has rich theoretical foundation and clinical experience, also has scientific supports confirmed by physiology and pharmacology in recent years. In TCM, the treatment guided by the concept of holism combines the syndrome and symptom. With treatment combining TCM and western medicine, it can increase the curative effect, reduce the dosage, side effects and toxin, also can better improve the patients quality of life. With the development and evolution in TCM, treatment from spleen is accepted by more and more people.Purpose:Through clinical observation, to evaluate the clinical efficiency and explore the related mechanism in enteric nervous system(ENS).Methods: Patients who diagnosed as CHD with stable angina(syndrome of intermingled phlegm and spleen deficiency) are divided into test group1(80 cases) and control group(80 cases) by random. With the basic corresponding treatment, test group1 was treated with decoction which can invigorate qi and spleen and eliminate phlegm and turbidity, while control group gives decoction containing 10% herbs above as bland contrast, twice a day. The treatment lasted for 12 weeks. TCM symptom classification quantization table score, the usage of nitroglycerin were observed before and after treatment between the two groups toevaluate the clinical efficiency and through the content of GLP-1, ghrelin, VIP in serum and its content to explore the related mechanism in ENS.Results: 1.Comparison in TCM symptom classification quantization table score Two groups can both significantly improve in TCM symptom classification quantization table score after 4 weeks treatment and 12 weeks treatment(p<0.05), and there is no significant difference( p>0.05) between two groups before and after treatment. But by comparing the average, the improvement in test group after 12 weeks treatment is better than control group. 2.Comparison in the usage of nitroglycerin Compared with before treatment, test group can significantly improve in the usage of nitroglycerin after 12 weeks treatment(p<0.05), but control group have no improvement after 12 weeks treatment. And there is no significant difference( p>0.05) between two groups before and after treatment. 3. Comparison in the content of GLP-1, ghrelin, VIP in serum The content of GLP-1 in test group has significant difference after 4 weeks treatment and 12 weeks treatment(p<0.05). The content of GLP-1 in control group has significant difference after 4 weeks treatment but after 12 weeks treatment there is no significant difference.And the content of VIP and ghrelin in both two groups has no significant difference after 4 weeks treatment and 12 weeks treatment compared with before treatment. And there is no significant difference( p>0.05) between two groups before and after treatment in the content if GLP-1、VIP or ghrelin. 3.Correlation analysis Make spearman correlation analysis between the enteric nervous index(GLP-1,ghrelin, VIP)and each item in TCM symptom classification quantization table GLP-1 has correlation with item of chest pain, sallow complexion and having no appetite. Ghrelin has correlation with item of limbs heaviness、head heaviness、gasteremphraxis and loose stool. The correlation coefficient is not high. And make spearman correlation analysis between the enteric nervous index(GLP-1,ghrelin, VIP)and BMI, there is no correlation.6.Conclusion: 1. Treatment from spleen in CHD could significantly improve the patient’s clinical symptoms and the degree of angina pectoris attack, TCM symptom classification quantization table shows the treatment has improved the patients quality of life, 2. The blood index of GLP-1 in ENS has increased. 3. GLP-1 has positive correlation with the items of chest pain, sallow complexion and having no appetite in TCM symptom classification quantization table score. Ghrelin has positive correlation with the items of limbs heaviness、head heaviness、gasteremphraxis and loose stool. |
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