| Objective:Clinical observation of Zhishi Xiebai Guizhi Decoction on cold coagulation of phlegm and blood stasis qi stagnation syndrome of unstable angina pectoris(UA)patients and the treatment effect of plasma fibrinogen(FIB),two D-dimer(D-D)and serum homocysteine(Hcy),high sensitive C reactive protein(hs-CRP)level of influence.To evaluate the efficacy of Zhishi Xiebai Guizhi Decoction in the treatment of UA,and to explore its possible mechanism.Method:With qi stagnation,phlegm,blood stasis,cold coagulation syndrome UA patients were randomly divided into treatment group of 32 cases,30 cases in the control group,the control group were treated with routine treatment;the treatment group in the control group treatment based on the use of Zhishi Xiebai Guizhi Decoction.The two groups were treated for 2 weeks.Two groups of patients were observed before and after treatment of TCM symptoms,angina pectoris,angina pectoris(seizure frequency,duration,consumption of nitroglycerin),routine electrocardiogram,FIB,D-D,Hcy and hs-CRP.Result:1.The curative effect of TCM syndrome was compared:in the treatment group,the TCM syndromes were markedly effective in 9 cases,effective in 18 cases,the total effective rate was 84.4%,the control group was markedly effective in 4 cases,effective in 11 cases,and the total effective rate was 50%.There were statistical differences between the two groups(P<0.01).2.Comparison of angina pectoris:8 cases of angina pectoris in the treatment group,17 cases effective,the total effective rate of 78.1%,3 cases in the control group,13 effective cases,and the total effective rate of 53.3%.There were statistical differences between the two groups(P<0.05).3.Angina pectoris attack comparison:before treatment,there was no significant difference between two groups of patients with angina pectoris(frequency of attack,duration and dosage of nitroglycerin)(P>0.05).After treatment,the two groups of patients with angina pectoris were significantly improved,compared with before the treatment,the difference was statistically significant(P<0.01).After treatment,there were significant differences between the two groups of angina pectoris(P<0.05),and the improvement of angina pectoris in the treatment group was better than that of the control group.4.Electrocardiogram curative effect comparison:two groups of electrocardiogram curative effect,the treatment group total effective rate is 75%,the control group is 43.3%,P<0.05,has the statistical difference,the treatment group is obviously higher than the control group,especially for the ST segment depression and the T wave inversion improvement is especially obvious(P<0.05).5.The levels of plasma FIB and D-D before and after treatment in the two groups were compared:there was no statistical difference in the level of FIB and D-D in the two groups before treatment(P>0.05).After treatment,the level of FIB decreased significantly(P<0.05),and the decrease of D-D level was more significant(P<0.01).After treatment,there was a statistically significant difference in the level of FIB between the two groups(P<0.05).There was no significant difference in the D-D level between the two groups after treatment(P>0.05).6.The levels of serum Hcy and hs-CRP before and after treatment in the two groups were compared:there was no significant difference between the Hcy and hs-CRP levels in the two groups before treatment(P>0.05).After treatment,the level of Hcy in the treatment group decreased significantly(P<0.05),and there was a downward trend in the control group(P>0.05).There was a significant difference between the two groups(P<0.05).After treatment,the level of hs-CRP in the two groups was significantly decreased(P<0.05),and there was a difference between the two groups(P<0.05).7.Between the different TCM syndrome factors(Cold coagulation,phlegm,stasis and qi stagnation)of UA patients,compared the clinical efficacy of Zhishi Xiebai Guizhi Decoction,there was no statistically significant difference(P>0.05).Conclusion:1.Zhishi Xiebai Guizhi Decoction Combined with conventional western medicine treatment can further improve the cold coagulation of phlegm and blood stasis and qi stagnation syndrome curative effect,TCM syndrome curative effect in UA patients with angina,improvement of angina pectoris,and can promote the recovery of ischemic electrocardiographic changes.2.Zhishi Xiebai Guizhi Decoction can reduce cold coagulation of phlegm and blood stasis qi stagnation syndrome in UA patients with FIB,D-D and serum Hcy,hs-CRP levels,and that the intervention of UA possible mechanism for regulation of coagulation and fibrinolysis system dynamic balance,inhibit thrombosis,inhibit inflammatory reaction and vulnerable plaque.3.of Zhishi Xiebai Guizhi Decoction on the phlegm and blood stasis,qi stagnation,cold coagulation syndrome UA patients have a certain effect,the 4 solid element is syndrome of clinical curative effect. |
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