| Objective: The purpose of this study was to observe the clinical efficacy of vasoactive agent shexiang tongxin dropping in the coronary slow flow phenomenon(CSFP) and provide basis for clinical treatment. Methods: Experiment 1. To evaluate the acute angiographic response to shexiang tongxin dropping. 22 patients with coronary slow flow phenomenon were participated by using Corrected Thrombolysis and Thrombin Inhibition in Myocardial Infarction Frame Count(CTFC) and the CTFC were calculated ≥ 27 frames. All the patients underwent angiography before and 5 min after 4# shexiang tongxin dropping through sublingual medicated. The CTFC were compared. 22 patients with normal coronary blood flow for the same period as the control group.and the CTFC were also calculated. Experiment 2. To evaluate the chronic antianginal efficacy of shexiang tongxin dropping. Selected 30 patients with CSFP, including 20 patients who participated the experiment 1. Recorded the result of the treadmill exercise testing and the Seattle angina score before they were randomly divided into two groups, one experimental(16 participants) and one control(14 participants). The experimental group patients were given Aspirin 100 mg every night and Atorvastatin calcium capsules 20 mg daily and shexiang tongxin dropping 3 times a day, once 2#. The control group patients were given Aspirin 100 mg every night and Atorvastatin calcium capsules 20 mg daily. After 3 months of treatment we measured the positive reaction of treadmill exercise testing and picked symptom score of The Seattle Angina Scale again. Compare the therapeutic effect of each group. Results Experiments 1: A total of 22 patients, 30 coronary vessels revealed slow flow phenomenon without obstructive epicardial coronary disease,16 cases for singlevessel slow flow, four for double-vessel and two for three, 15 for the left anterior descending antery(LAD) slow flow, 4 for left circumflex artery(LCX) and 11 for the right coronary artery. The mean CTFC of all the patients were 49.98±10.01 frames, the CTFC in LAD were 48.00±13.32 frames,59.00±4.69 frames in LCX,51.90±8.40 frames in RCA, The mean CTFC of all the normals were 22.61±1.65 frames, 23.24±2.84 frames in LAD, 22.18±2.99 frames in LCX, 22.45±2.59 frames in RCA,,The mean CTFC of all the patients after taking shexiang tongxin dropping were 40.42.±11.33 frames, the CTFC in LAD were 41.80±15.38 frames,50.00±9.04 frames in LCX,40.90±10.46 frames in RCA, all the CTFC in slow flow patients were higher than the normal coronary flow(P<0.05), there was also statistically significant different between CTFC before and 5 min after 4# shexiang tongxin dropping through sublingual medicated. TIMI frame counts were significantly higher in the CSFP after 4# shexiang tongxin dropping through sublingual medicated compared with the normal coronary flow in all coronary arteries. Experiment 2: The number of positive reaction with treadmill exercise testing in 30 patients was 11, account for 36.67%. In experimental group there was 5 patients(31.25%) with positive reaction while the control was 6(42.82%). There were no statistically significant difference in positive rate and the Seattle Angina Scale score before treated. The positive rate was 0 in the experimental group while the control was 28.57%(0/16 vs. 4/14, p<0.05). The positive reaction with treadmill exercise testing in experimental was significantly lower than before(5/16 vs 0/16, P<0.05) while the control was no(6/14 vs 4/14, P>0.05). Compared with before score, The Seattle Angina Scale score was significant difference in each group and the clinical efficacy in experimental group improved more than the control’s(P<0.05). Conclusions The study showed that CSFP had benefited from shexiang tongxin dropping that can significantly reduce CTFC in slow flow patients and lessen the frequency of angina pectoris, improve patient quality of life. It provided a new basis for proprietary Chinese medicine to treat angina caused by coronary slow flow. |
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