Observation On The Therapeutic Effect Of Guantong Decoction On Patients With Angina Pectoris With Qi Deficiency And Blood Stasis Type After PCI Of Coronary Heart Disease

Objective To observe the clinical effect of Guantong Decoction on patients with recurrent angina with qi deficiency and blood stasis typeafter after percutaneous coronary intervention(PCI),including the improvement of angina efficacy,TCM syndrome integral,electrocardiogram efficacy,inflammatory factors,blood lipid and Left ventricular ejection fraction(LVEF).To evaluate the efficacy and safety of Guantong Decoction on patients with recurrent angina with qi deficiency and phlegm and blood stasis typeafter after PCI.Methods In this study,60 patients were selected from the cardiology department and inpatient department of Ruikang Hospital of Guangxi University of TCM affiliated from March 2019 to February 2020 who were diagnosed with coronary heart disease after PCI and recurrent angina pectoris,and the TCM syndrome type was qi deficiency and blood stasis.The patients were divided into the control group and the guantongfang group with 30 cases each by the random number table method.The control group received conventional treatment,and the guantongfang group received guantong decoction on the basis of conventional treatment.Both groups were treated for 4 weeks.The curative effect of Guantong Decoction was comprehensively evaluated by comparing the improvement effect of angina pectoris,TCM syndrome score,electrocardiogram effect,hypersensitive c-reactive protein,interleukin-6,total cholesterol,triglyceride,low-density lipoproteincholesterol,high-density lipoprotein cholesterol and left ventricular ejection fraction of the two groups of patients after treatment,To evaluate the safety of Guantong Decoction by observing the three conventional methods,liver and kidney function and adverse reactions before and after treatment.Results 1.Basic data: there were no statistically significant differences in age,gender,disease course,Body Mass Index,previous history,common risk factors,vital signs,the diagnosis,the number of lesions and the number of stents placed during previous PCI between two groups(P>0.05).2.Efficacy indicators: the total effective rate of angina pectoris in the guantongfang group was 83.3%,significantly higher than that in the control group(60.0%),and the difference between the two was statistically significant(P <0.05).In terms of TCM syndromes,the symptoms of the main symptoms(chest pain,chest tightness)and secondary symptoms(Palpitations of the heart,shortness of breath,fatigue of the mind)in the guantongfang group decreased more significantly(p<0.05),thus significantly reducing the total score of TCM syndromes of the patients(p<0.05).The total effective rate of ECG treatment in the guantong group was 60.0% higher than that in the control group(53.3%),but there was no statistical difference(P>0.05),so there was no significant difference in ECG improvement between the two groups.The levels of hs-CRP and IL-6 were significantly decreased in both the guantongfang group and the control group,and the difference after treatment was statistically significant(p<0.05),that is,the levels of hs-CRP and IL-6 were significantly decreased in the guantongfang group.In terms of lipid reduction,except HDL-C(p>0.05),the differences of TC,TG and LDL-C in the other three groups after treatment were all statistically significant(p<0.05),that is,combined treatment with guantongfang could significantly reduce the levels of TC,TG and LDL-C.Although the LVEFvalue of patients in both groups was increased after treatment,the difference between the two groups was not statistically significant(p>0.05).3.Safety: no abnormalities were found in blood routine,urine routine,stool routine,kidney function indexes and vital signs of the patients in the 2 groups after treatmentand,and 1 patient in the control group had mild abnormal ALT.Compared with the control group(23.3%),the total incidence of adverse reactions in the guantongfang group(3.3%)was statistically different(p<0.05).Therefore,the safety of the combined treatment of guantongfang was better than that of western medicine alone.Conclusion: 1.For patients with angina pectoris syndrome of qi deficiency and blood stasis after PCI,the combined treatment with guantong prescription on the basis of conventional western medicine can achieve better anti-angina pectoris effect,but fail to improve the changes of ischemic electrocardiogram more significantly.2.For patients with angina pectoris syndrome of qi deficiency and blood stasis after PCI,although the combination of guantong prescription with conventional western medicine therapy failed to significantly increase the LVEF value,it significantly reduced the TCM syndrome score and significantly improved the symptoms of qi deficiency and blood stasis,including chest tightness,chest pain,Shortness of breath,etc.3.For patients with angina pectoris syndrome of qi deficiency and blood stasis after PCI,combined with guantong prescription on the basis of conventional western medicine treatment can significantly reduce the levels of serum lipids(TC,TG,LDL-C)and inflammatory factors(hs-CRP?IL-6),thereby regulating lipid plaques and inhibiting intra-vascular inflammation.4.For patients with angina pectoris syndrome of qi deficiency and blood stasis after PCI,combined treatment with guantong prescription on the basisof conventional western medicine can significantly reduce the occurrence of adverse reactions compared with western medicine alone,with good safety.