| Objective: Aiming at the model of coronary heart disease with heart-kidney yang deficiency, this project which is based on the western medicine routine treatment and nursing, is designed by comparing the curative effects among the septal aconite cake separated moxibustion combined with acupoint application method, septal aconite cake separated moxibustion method and acupoint application method. Further to explore the mechanism effect of the aconite cake separated moxibustion combined with acupoint application method on coronary heart disease with heart-kidney yang deficiency, and to provide a new theoretical basis for the treatment and nursing of coronary heart disease(CHD).Methods: This clinical study was taken with the method of randomized controlled trial, and 80 qualified subjects were assigned equally to the septal aconite cake separated moxibustion combined acupoint application group(group A), septal aconite cake separated moxibustion group(group B), acupoint application group(group C) and control group(group D) with the proportion of 1:1:1:1. The subjects in control group were treated by the conventional basal therapy, nursing and medical treatment. As for subjects in group A, B and C, the septal aconite cake separated moxibustion combined acupoint application, septal aconite cake separated moxibustion and acupoint application treatments are added, respectively, on the base of control group. After continuous treatment for 4 weeks, efficacy evaluation was made by observing the changes of some indexes in four groups, including short-term curative effect indexes(clinical symptoms, TCM score, ECG, blood fat, serum inflammatory cytokines, four coagulation tests) and long-term prevention indexes(the cases of readmission and the average hospitalization days).Result: 1.Clinical symptoms: After 4 weeks, the total effective rates of clinical symptoms are 85.0%, 80.0%,80%,60.0% respectively in group A, B, C, D.The total efficiency of four groups is compared with Kruskal-Wallis H test and the difference is statistically significant(P <0.05); After treatment, the clinical efficacy of four groups of patients was tested pairwise comparison by Wilcoxon test method. Compared with group D, the differences are all statistically significant(P <0.05) for group A, B and C. When group A is compared with group B and C, the total effective rate is higher, but the difference is not statistically significant(P> 0.05); 2.TCM Score :Before treatment, the differences of TCM Scores among four groups are not statistically significant(P> 0.05); after 4 weeks, when compared the TCM Scores of after treatment with before treatment in each group,the differences all is statistically significant(P <0.05); when compared with control group, the TCM Scores in group A,B and C are superior with statistical differences(P <0.05); 3.ECG monitoring: after 4 weeks, the total effective rates are75.0%, 60.0%, 65.0%, and 55.0% in group A, B, C, and D, respectively. Similar to clinical symptoms, the Kruskal-Wallis H test was used to compare the total efficiency of four groups, and the difference is statistically significant(P <0.05); After treatment, the ECG efficacy of four groups of patients was tested pairwise comparison by Wilcoxon test method.The total effective rate of group A is higher than group D, with statistically significant difference(P <0.05), and The total effective rate of group A is higher than group B and C, but without significant difference(P >0.05).the total effective rates of group B and C are higher than group D without statistically significant difference(P >0.05). The above results illustrate that the septal aconite cake separated moxibustion combined with acupoint application method has good treatment effect on coronary heart disease with heart-kidney yang deficiency; 4.By comparing the contents of plasma CRP, TNF-a, IL-18, IL-10, APN in each group before treatment, the difference is proved to be not statistically significant(P > 0.05); after 4 weeks, when compared with the results before treatment, the levels of TNF-a,IL-18 in each group, the levels of CRP in group B, D, and the levels of APN in group D, are all better than before treatment, but without significant difference(P >0.05). the levels of CRP in group A and C present significant differences(P <0.05),and the levels of IL-10,APN in four groups are rising, As for IL-10, the differences is statistically significant for four groups(P <0.05) when compared with the results before treatment, and the levels of APN in group D present no statistical difference,the result of APN in other three groups are same as the IL-10. After treatment, when compared with group B,D, the levels of CRP,IL-10,APN in group A and C are superior with statistical difference(P <0.05), when compared with the levels of IL-10,APN,CRP between group A and group C, the difference is not statistically significant(P > 0.05), While the differences between group A and group C are not statistically significant(P > 0.05); and the levels of IL-10,APN,CRP in group B is better than group D without statistically significant difference(P > 0.05); 5.Before treatment, the differences of TC, TG, HDL-C, LDL-C contents among four groups are not statistically significant(P > 0.05); after 4 weeks, when compared with the levels before treatment, TC?HDL-C?LDL-C in each group are better after treatment, but without significant difference(P >0.05); and the levels of TG, the differences are believed to be statistically significant(P <0.05) in group A, B and C when compared with the results before treatment, as for group D, the difference is not statistical significance(P > 0.05); After treatment, when compared with control group, the levels of TG in group A,Band C are superior with statistical difference(P <0.05), and the effects are similar in group A,Band C without significant difference(P >0.05); 6.Before treatment, the differences of PT, FIB, TT and APTT contents among four groups are not statistically significant(P > 0.05); after 4 weeks, when compared with the results before treatment, the TT in each group are all better than before treatment, but without significant difference(P >0.05); when compared with the results before treatment, the FIB,PT,APTT in group A, B and C present statistical differences(P <0.05); As for group D, the level of FIB is better after treatment with statistically significant difference(P <0.05); After treatment, when compared with control group, the FIB,PT,APTT in group A,B and C are superior with statistical differences(P <0.05), and the FIB,PT, APTT in group A and C are all better than group B, but the differences are not statistically significant(P > 0.05); 7.The differences of the cases of readmission in one month and three months after discharged among four groups are not statistically significant(P > 0.05); But when it comes to the average hospitalization days, the solution of the cases of readmission does not work anymore. Compared with the control group, the differences of the average hospitalization days in group A, B and C are statistically significant(P <0.05).Conclusion: 1. In this study, it presents markedly effects by taking the septal aconite cake separated moxibustion combined with acupoint application method to intervene the coronary heart disease with heart-kidney yang deficiency. 2. In conclusion, the septal aconite cake separated moxibustion combined with acupoint application method plays a part in improving the clinical symptoms and ECG, reducing the inverse effect of blood-lipid level, cholesterol, serum inflammatory cytokines and coagulation on coronary heart disease, and shortening the average of hospitalization days. 3. It is applied widely in clinic for it's simple, and easy to grasp, easy material availability, universally valid, effective, cheap and non-toxic. Furthermore, it plays a very important role on preventing and treating of coronary heart disease, and becomes necessary for era. |
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