The Clinical Study On YishenhuoxueJieDu Decoction For Geriatric Angina Pectoris Of Coronary Heart Disease And Its Effects On Blood Lipids、vWF、P-selection And Hcy

Objective:To observe the changes of blood lipids,vWF,P-selectin,Hcy and hsCRP in senilepatients with angina pectoris of coronary heart disease and clinical efficacy withtreatment of the method YishenhuoxueJieDu-decoction combined with routinewestern medicine.In order to evaluate the efficacy and influence on the relative indexof YishenhuoxueieDu-decoction and further explore its possible mechanism of action.Methods:According to the diagnostic criteria of coronary heart disease angina andTCM syndrome,60patients with coronary heart disease angina were randomlydivided into two groups equally.The control group(30cases)was treated by conventional theray(aspirin0.1per os,qd;isosorbide mononitrate20mg per os,bid;atorvastatin20mg per os,qd;metoprolol12.5～25mg per os,bid;perindopril2～4mg peros,qd).The patients with unstable angina pectoris would received additionalparnaparin4000u in subcutaneous injection for five days.On angina pectoris attacks,the two groups both received sublingual nitroglycerin0.5mg each time,repeat it every5minutes until the pain was relieved. And the study group (30cases) were added withYishenhuoxueieDu-decoction therapy besides conventional therapy,course oftreatment both lasts for6weeks in the two groups.Observing the condition of anginapectoris,TCM syndrome,efficacy of TIB,testing the changes of blood lipids,vWF,P-selectin,Hcy and hsCRP before and after treatment.All data were analyzed bySPSS17.0statistical software.Results:1.The improvement rates of TCM syndrome,angina,electrocardiogram and efficacy ofTIB in study Group are higher than that in the control group (P <0.05).2.After treatment,TC,TG and LDL-C levels lowered significantly,HDL-C increasedsignificantly in the two groups,there was obvious difference comparing with thosebefore treatment（P <0.05）.Comparison between the two groups after treatment, the decrease of TC,TG and LDL-C were superior to that in control group（P<0.05）;HDL-C increased slightly and with no statistical significance（P>0.05）.3.After treatment,vWF,P-selectin,Hcy and hsCRP levels in the two groups decreasedsignificantly,there was significant difference comparing with those before treatment（P <0.05）.Comparison between the two groups after treatment, the decrease of vWF,P-selectin, Hcy and hsCRP levels was superior to that in control group（P<0.05）.4. Before and after treatment, the changes of blood routine(WBC,RBC,PLT), liver andkidney functions and coagulation indicator between the two groups had no statisticaldifference（P>0.05）.And there was no hemorrhage reaction in the patients.Conclusion:In treatment of senile patients with coronary heart disease angina,the methodYishenhuoxueieDu-decoction combined with routine western medicine are superior toonly routine western medicine,it could significantly improve clinicalefficacy,improving the levels of blood lipids,vWF,P-selectin,Hcy and hsCRP,whichprompts us that it would be better to treat coronary heart disease angina by integratedtcm-wm.The possible mechanism:1.It would rectify the derangement in lipid metabolism, prevent lipids deposition of aorta intima,delay atherosclerosis effectively.2.It wouldreduce vascular inflammation,have effect on plaque stabilization, improve endothelialfunction,protect the integrality of vessel endthangium.3.It would inhibit activation ofplatelet activating factor,improve prothrombotic state,reduce the incidence ofthromboembolic events.