Clinical Study Based On Psycho-cardiacology Model To Explore Shutiao Decoction On Stable Coronary Artery Disease With Anxiety And Depression

Objective:Based on the psycho-cardiacology model,applying the academic thought of Zhang Zhen,a master of Chinese medicine,and using Shutiao decoction to treat the patients with stable coronary artery disease accompanied by anxiety and depression(qi stagnation and blood stasis type),and further summarizes the academic experience of famous old Chinese medicine,explores its etiology,pathogenesis and mechanism of action,and provides new ideas for Chinese medicine to prevent and treat psycho-cardiacology disease.Method:64 patients with stable coronary artery disease accompanied by anxiety and depression who were eligible for inclusion and belonged to TCM qi stagnation and blood stasis type were randomly divided into two groups,32 in the control group and 32 in the treatment group.The control group received conventional Western medicine treatment of coronary heart disease + psychological intervention treatment,and the treatment group received conventional western medicine treatment of coronary heart disease +psychological intervention treatment + Shutiao decoction,and the course of treatment in both groups was 28 days.TCM syndrome scores,Seattle Angina Questionnaiire(SAQ)scores,Generalized Anxiety Disorder Scale(GAD-7)scores,and Patient Health Questionnaire Depression Scale(PHQ-9)score,Hamilton Anxiety Scale(HAMA)score,Hamilton Depression Scale(HAMD)score,lipid-related indicatorsand and ECG changes of the two groups of patients were recorded before and after treatment.While recording the relevant safety indicators of the two groups during treatment.SPSS 26.0 statistical software was used for statistical processing to assess its clinical efficacy and safety.Result:1.Comparison of baseline : There was no significant difference in baseline data between the two groups(P>0.05),and the two groups were comparable.2.Comparison of efficacy of TCM syndromes: in terms of TCM syndrome points,both groups can improve the TCM syndrome points of patients(P<0.01),and the treatment group improved more significantly(P<0.01).In the aspect of single TCM syndrome score,the treatment group can improve all single TCM syndrome scores of patients(P<0.01),and the control group can improve patients’ chest pain,chest tightness,emotional restlessness,heart palpitations syndrome score(P<0.01)and chest tightness and bloating syndrome score(P<0.05),however,there was no statistically significant difference in improving the scores of insomnia,sigh,and abdominal fullness compared with before treatment(P>0.05),and the improvement in the treatment group was more significant(P<0.01).In terms of the total effective rate of TCM syndromes,the total effective rate of the treatment group was 90%,which of the control group was 73.33%,and the treatment group had a better effect(P<0.01).3.Comparison of SAQ scale score: The treatment group can improve the five SAQ scores(P<0.01),and the control group can improve the scores of treatment satisfaction,disease cognition(P<0.01),and the scores of physical activity limitation,angina pectoris stability,angina pectoris attacks(P<0.05).In addition,the treatment group was superior to the control group in improving the patient’s physical activity limitation(P<0.05),and also superior to the control group in angina pectoris stability,angina pectoris attacks,and treatment satisfaction(P<0.01).And there was no statistically significant difference in improving disease cognition compared with the control group(P>0.05).4.Comparison of GAD-7 scale: In terms of GAD-7 score,both groups can reduce GAD-7 score of patients(P<0.01),and the treatment group decreased even more(P<0.05).In terms of the total effective rate of GAD-7,the total effective rate of the treatment group was 86.67%,which of the control group was 73.33%,and the treatment group had a better effect(P<0.05).5.Comparison of PHQ-9 scale: In terms of PHQ-9 score,both groups can reduce the PHQ-9 score of patients(P<0.01),and the treatment group decreased even more(P<0.05).In terms of the total effective rate of PHQ-9,the total effective rate of the treatment group was 90%,which of the control group was 73.33%,and the treatment group had a better effect(P<0.05).6.Comparison of HAMA scale: In terms of HAMA score,both groups can reduce HAMA score(P<0.01),and the treatment group decreased even more(P<0.05).In terms of the total effective rate of HAMA,the total effective rate of the treatment group was 83.33%,which of the control group was 70%,and the treatment group had a better effect(P<0.05).7.Comparison of HAMD scale: In terms of HAMD score,both groups can reduce the HAMD score(P<0.01),and the treatment group decreased even more(P<0.05).In terms of the total effective rate of HAMD,the total effective rate of the treatment group was 86.67%,which of the control group was 70%,and the treatment group had a better effect(P<0.05).8.Comparison of blood lipids: In terms of blood lipid-related indicators,the treatment group can reduce TC,TG,LDL-C levels(P<0.01),can increase HDL-C levels(P<0.01),the control group can reduce TC,LDL-C level(P<0.05)and TG level(P<0.01),can increase HDL-C level(P<0.01),but there was no statistical significance between the two groups in improving TC,TG,HDL-C,LDL-C(P>0.05);in terms of total blood lipid efficiency,the total effective rate of blood lipid was 26.67% in the treatment group,20% in the control group,and the difference between the two groups was not statistically significant(P>0.05).9.ECG efficacy comparison: the total effective rate of the treatment group was 53.33%,which of the control group was 46.67%,and the treatment group had a slightly better effect,and the difference between the two groups was not statistically significant(P>0.05).10.Safety comparison: There were no significant abnormalities in the safety index examinations before and after treatment in the two groups.During the treatment,there were slight adverse reactions in the two groups.The incidence of adverse reactions in the treatment group was 3.33% and that in the control group was 6.67%.There are fewer adverse reactions in the treatment group,and the difference between the two groups was not statistically significant(P>0.05).Conclusion:1.Shu Tiao Decoction is effective in treating patients of qi stagnation and blood stasis type of stable coronary artery disease with anxiety and depression,which can effectively improve the TCM syndromes of patients.2.Shu Tiao Tang can effectively reduce the number and frequency of angina attacks,and also improve the patient’s physical activity.3.Shu Tiao Decoction can effectively improve the anxiety and depression of patients.4.Shutiao decoction can reduce the patient’s blood lipid index level,but there is no statistically significant difference with the Western medicine.5.Shu Tiao Decoction has fewer adverse reactions in the treatment of patients with stable coronary artery disease and anxiety and depression,and its clinical application is safe and reliable.