| Objective:By using the real world research method,by collecting the symptoms and signs of patients,the laboratory indexes of bleeding diagnosis were detected,and the patients with coronary heart disease after PCI were treated with western medicine antiplatelet therapy alone and on the basis of which the bleeding of activating blood and removing blood stasis therapy was combined.At the same time,the patients' symptoms,signs and quality of life were investigated,and the effects of activating blood and removing blood stasis on the syndrome and quality of life of patients after PCI were discussed.To provide better quality of treatment plan,in order to improve the outcome and quality of life of patients after PCI.Methods:This study used real world research methods.Observed patients were from the January to December 2017 in Beijing Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine.According to the diagnostic criteria of coronary heart disease,the diagnosis of chronic stable angina pectoris,the diagnosis of unstable angina pectoris,the diagnostic criteria of traditional Chinese medicine syndromes,and the classification and quantification criteria of traditional Chinese medicine symptoms were included in the study.In this study,a total of 49 samples were subjected to a period of 3 months of clinical observation and follow-up.The subjects were divided into western medicine observation group and western medicine combined treatment observation group.Using the "standard criteria for coronary heart disease after interventional intervention"(trial),the symptoms observed after the enrollment and the results of the examination were recorded.Establish a database,conduct trial design from general data,TCM symptom evaluation,related examinations,quality of life,etc.,analyze whether the study subjects have any changes in bleeding events,clinical symptoms,quality of life,cardiac function,etc.,and explore blood circulation.Effects of antimony drugs on bleeding events,syndromes and quality of life in patients after PCI.Results:1.the distribution of bleeding events in the dual-use drug group.(1)there were 10 cases of bleeding in the group,of which 3 cases of gastrointestinal bleeding,of which 7 cases were combined with the medication group,3 patients in the western medicine group,25 in the group of bleeding events,and 14 in the western medicine group.After statistical analysis,the distribution of bleeding patients in the two groups was not obvious,and there was no statistical difference.(P = 0.05).(2)the distribution of bleeding patients in all stages of rehabilitation.Of the 49 patients enrolled in this study,there were 9 patients in the 1 stage,2 in 8,3 in 32,and there were 10 cases of bleeding events.Among them,1 cases of rehabilitation(4-7 days after operation),1 cases,accounting for 14.3%,2 cases(7 days-6 months)2 cases,accounting for 14.3%,3 cases(6 months or more)7 cases,accounting for 7.There was no significant difference in the distribution state of bleeding patients in all stages of rehabilitation.(3)observation and analysis of coagulation parameters in patients with bleeding events.In the diagnosis of bleeding risk and bleeding,the detection of hemagglutination index is of certain significance.Therefore,this study conducted a hypothesis test for the patients with bleeding in the sample.The results show that in the cases of bleeding,the prothrombin time distribution is 11.3571 + 2.084S,and the value distribution of the national standardization ratio INR is 1.0314 + 0.188INR,the active partial thromboplastin time was 30.3857 + 3.856S,fibrinogen content was 3.3014 + 0.5996g/L,thrombin coagulating time was 15.4429 +1.1253S,and there was no statistical correlation between the changes of the bleeding cases and the above indexes(P value>0.1).2.A case study of the symptoms of anxiety and depression after PCI(1)the proportion of patients with anxiety and depression in syndrome types.In this study,the distribution of anxiety and depression in patients after stent placement was analyzed in different syndromes,and the hypothesis test was used to analyze the correlation between anxiety and depression after stenting.The results showed that there were 1 patients with anxiety and depression after PCI,1 in Qi deficiency and blood stasis syndrome type,7 in phlegm and blood stasis syndrome type and 0 in heart and blood stasis syndrome.The distribution of anxiety and depression in different syndromes is not statistically significant.(2)TCM symptom scores and quality of life scores of anxiety and depression patients.The purpose of this study is to compare the changes of the patients with anxiety and depression in the symptom score of Chinese medicine after PCI,and to analyze the correlation between the symptoms of anxiety and depression and the symptom score of TCM after the stenting.According to the statistical analysis,the TCM symptom score of the patients with anxiety and depressive symptoms was 35.889 + 13.448 points during the period of entry,and there was no statistical correlation between the TCM symptom score and the TCM symptom score(P>0.1).(3)the correlation between anxiety and depressive symptoms and chest pain,palpitation and insomnia.When the group was enrolled,the correlation coefficients between them were r=0.292,P=0.525>0.05.There was no correlation between anxiety and depression symptoms and chest pain symptoms in this sample volume.When the group was released,the correlation coefficient r=0.315 and P=0.491>0.05 were obtained.There was no correlation between anxiety and depression symptoms and chest pain symptoms in this sample volume.When the group was enrolled,the correlation coefficients between them were r=0.515,P=0.237>0.05.There was no correlation between anxiety and depression symptoms and palpitation symptoms in this sample volume.When the group was released,the correlation coefficient r=0.315,P=0.491>0.05,R<0.4.It is concluded that there is no correlation between anxiety and depressive symptoms and palpitation symptoms in this sample size.When the group was enrolled,the correlation coefficients between them were r=0.080,P=0.865>0.05,of which r<0.4,there was no correlation between anxiety and depression symptoms and insomnia symptoms in this sample volume.When the group was out of group,the correlation coefficient r=0.575 and P=0.177>0.05.3.The change of symptom score of two groups of Chinese Medicine.At the beginning of the group,the scores of TCM syndromes and the quality of life were counted,and the distribution of the patients in the medicine group was 38.969 + 11.064.The score of the patients in the pure western medicine group was 35.824 + 9.349.To analyze the case that TCM symptoms score between the two treatment group were not statistically significant(P = 0.05).After 3 months of observation,after 3 months of observation,the two use groups were compared between groups and in groups,and the difference of the difference between the two use groups and the beginning of the group.Using independent sample t test and paired sample t test,the statistical results showed that 3 months after the entry of the group,the difference between the TCM symptom score combined group and the western medicine group and the group was compared,the non parameter test and the independent sample t test were applied.The difference between the TCM Syndrome score of the two use medicine group and the group was not found.It has statistical significance.4.changes of quality of life.According to the statistics,the differences in the scores of the patients in the two use groups were not statistically different in physiological function,physical function,physical pain,general health,energy,social function,emotional function,mental health,physical condition,condition,medical state,general life,social psychological state,and working state.Significance,after 3 months of observation,the scores of the patients in the two use drug group were evaluated.The non parametric test and independent sample t test showed that there was no statistical difference between the rest of the life quality score and the difference of the group after 3 months of follow-up,except the physiological function.5.The curative effect of TCM symptoms.The combination group and the simple western medicine group were followed up to carry out the TCM symptom score,at the same time,the curative effect conversion was carried out according to the score.The reduction rate was equal to that of the nimodipine method(the pre treatment integral treatment integral)/the pre treatment integral x 100%.According to the TCM symptom score standard,the following results were obtained:recovery:the main and secondary symptoms disappeared completely,the total score of the syndromes after treatment was 0 or lower than 95%;the main and secondary symptoms were basically or completely disappeared,the total score of the syndrome after treatment was reduced more than 70%;effective:the total score of the syndrome after observation was reduced by 30%(including 30%)to 70%.Ineffective:after treatment,the total score of syndromes decreased by less than 30%.After 3 months of follow-up,the treatment effect of the combined group was 5%,effective 45%,invalid 50%,the western medicine group was 10.3%,effective 69%,and 20.7%.Analysis showed that the two treatment group in the treatment effect difference was not statistically significant(P = 0.05)The main syndrome type and dominant syndrome type of patients after.6.Main syndrome type and dominant syndrome type of patients after PCI(1)main syndromesThrough the collection and observation of clinical data,the distribution of syndrome types at the beginning of the group after the stent implantation and after 3 months of follow-up were statistically analyzed.At the beginning of the group,8 people,16.3%of qi deficiency and phlegm stasis type,7 of qi deficiency and blood stasis type,14.3%,26 of mutual obstruction of phlegm and blood stasis,53.1%,8 cases of heart blood stasis,16,3%and 3 After 5 months,the proportion of qi deficiency,phlegm and blood stasis in 14.3%cases,4 cases of qi deficiency and blood stasis,8.2%cases,21 cases of phlegm and blood stasis,53.1%cases,10 cases of heart blood stasis,accounting for 24.5%.It is concluded that in the range of sample size,the most common type of phlegm and blood stasis syndrome among PCI patients is the main syndrome type.(2)superiority syndrome typeBased on the statistical results of the 4.1 part,the syndromes with the lowest score of TCM syndrome were analyzed,and the symptom score,physiological function,physiological function,somatic pain,general health condition,energy,social function,emotional function,mental health,physical condition and disease were analyzed by single factor analysis of variance.The distribution of scores,including love,medical status,general life,social psychology and working conditions,is shown in the following table.It can be seen that in the four kinds of syndromes,the TCM symptom score of phlegm and blood stasis type is the lowest,which is consistent with the main syndromes of stenting after 4.1 statistics.7.The proportion of the two use drug groups and the rehabilitation stagingAccording to the statistics of 49 patients,the proportion of the combined group was 59.2%and the western medicine group was 40.8%.According to the rehabilitation stage,9 cases were recovered,including 3 cases(33.3%),6 cases of pure western medicine group and 66.7%.2 patients were recovered from 2 period,2 cases(28.6%),pure western medicine group and rehabilitation period disease.There were 33 cases in the group,24 cases in the combined group(72.7%),and 9 cases(27.3%)in the western medicine group alone,and the P value was less than 0.05,X2=7.711.The difference of the above distribution was statistically significant.8.distribution and change of smoking and alcohol addiction in syndrome type,quality of life and TCM syndromesThe smoking and alcohol addiction of the case was compared with age,TCM syndrome score,physiological function,physiological function,body pain,general health condition,energy,social function,emotional function,mental health,condition,medical condition,general life,social psychological state,and working state.The effects of alcohol on the above aspects are listed below.In all the above items,the P value is greater than 0.05,so there is no correlation between the smoking and drinking habits of patients and the above aspects.9.adhere to the TCM symptom score of rehabilitation exercise and its relationship with smoking and drinking habits and syndrome types(1)the symptom score of the patients in the rehabilitation exerciseAmong the 49 patients included,5 patients persisted in the rehabilitation exercise.Therefore,the TCM symptom score of the patients was statistically analyzed.The TCM symptom score of the patients in the rehabilitation exercise was 37.8 + 8.96 points,and the patients who did not do the rehabilitation exercise were distributed in 37.89.10.76 points,the P values of both are 0.986 and 0.985,which are all greater than 0.05,so there is no statistical significance.(2)relationship between rehabilitation exercise patients and smoking and drinking habits and syndrome typesThe results were as follows:2 cases of smoking and drinking,1 cases of non smoking drinking,and 2 cases of non smoking and non drinking.P is more than 0.05,not statistically significant.There were 0 cases of qi deficiency and phlegm stasis syndrome,1 cases of qi deficiency and blood stasis,3 cases of mutual obstruction syndrome of phlegm and blood stasis,1 cases of blood stasis syndrome of heart and blood,the P value of 0.769 and X2 1.133.It can be seen that there is no statistically significant difference in the distribution of syndromes between rehabilitation exercise patients.Conclusions:1.Effect of blood circulation and blood stasis drugs on bleeding events after PCIIn the clinical observation and work,many patients with different rehabilitation staging after stenting have found varying degrees of bleeding problems.Based on this,this study targeted three-month follow-up of patients undergoing stent implantation.The results showed that the traditional Chinese medicine treatment containing blood and blood stasis components did not have a negative impact on the patient's bleeding event in the prognosis of the patient after stenting.2.Main types and advantages of stent after surgeryAfter a period of 3 months of clinical investigation and observation,the statistical analysis was performed on the main types of syndromes among the patients who underwent PCI after this sample.The results showed that after entering the group and after the end of the observation period,the most widely distributed pattern was the interphagia resistance.Syndromes.According to statistics,within the sample size range,the syndrome type with the lowest TCM symptom score is also phlegm-resistance type,which is consistent with the main syndrome type.It provides some inspiration for the next related research and has reference significance.3.The patients in the combination group were significantly more than those in the simple double therapy group,and the patients in the 3 stage of rehabilitation were the mostIn this study,the distribution of 49 cases was analyzed,and the study concluded that the combined group was 32 people,accounting for 59.2%,and 17 in the western medicine group,accounting for 40.8%.According to the rehabilitation stages,9 cases were recovered in 1 period patients,including 3 cases(33.3%)in the combination group,6 in the pure western medicine group and 66.7%in the pure western medicine group.2 cases(28.6%)and 5 cases(71.4%)of pure western medicine group,33 cases in 3 stage patients,24 cases in combination group(72.7%)and 9 cases in western medicine group(27.3%),thus the conclusion was that the patients receiving Chinese medicine combined with double resistance with blood circulation and stasis after stenting were obviously more than those of mono pure dual anti therapy patients.Within the scope,according to the patient's condition development and compliance with the patient's own willingness to choose the patients with traditional Chinese medicine on the basis of double resistance,the patient has a positive attitude towards the curative effect of the patients with blood activating and removing stasis.4.comparison of simple dual antiplatelet therapy and Chinese medicine combined with double anti-treatment in improving patient's syndrome and quality of lifeThe sample size was divided into two groups according to the way of taking medicine.The group of simple double antiplatelet drugs and the combination of traditional Chinese medicine with activating blood and removing stasis combined with the antiplatelet drug treatment group were compared with the TCM symptom scores and CQCC and SF-36 scores of the two groups of patients and followed up for 3 months.The scores in the group and 3 months after the follow-up were not statistically significant except for one of the emotional functions.Thus,there was no obvious advantage in the combination of simple double antiplatelet therapy and the combination of Chinese and Western medicine.In the range of sample size included in this study,we can draw a conclusion that there is no significant difference in the symptoms and quality of life of the patients after the stent implantation,and the treatment can follow the patient's wishes and the specific condition of the disease and then choose the treatment plan. |
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