| ObjectiveThrough theoretical research to explore the mechanism of Xinkai Kujiang method,and the pathogenesis of Coronary atherosclerotic heart disease,and to mentor clinical e xperience on behalf of the party for the party,to observe the treatment of stable angin a pectoris with hot phlegm and blood stasis and the validity of the certificate for exte nding the application of Xinkai Kujiang method provides theoretical basis and for hot phlegm stasis and coronary heart disease stable angina clinical treatment to provide ne w train of thought.Method1 Theoretical research:By referring to ancient and modern literature,the origin and development of Xinka i Kujiang method are summarized,and its clinical application is summarized to reveal t he theoretical connotation of Xinkai Kujiang method.To explore the pathogenesis of th e syndrome of hot phlegm and stasis of stable angina pectoris,and to provide theoretic al basis for the treatment of the syndrome of hot phlegm and stasis of stable angina pectoris by adding or subtracting the representative prescription of Xinkai Kujiang met hod.2 Clinical studies:Patients meeting are randomly divided into the treatment group and the control gr oup.The two groups are treated with conventional western medicine basic treatment,and the treatment group is additionally treated with Banxia Xiexin Decoction and Xiaoxia ngxiong Decoction for continuous 4 weeks,a total of 28 days.Before and after treatme nt,the two groups filled in the general situation questionnaire,angina symptom quantitati ve evaluation table,TCM syndromes quantitative evaluation table,safety index monitorin g table;After 4 weeks,the improvement of clinical indicators is observed,and the clinica l efficacy and safety of Xinkai Kujiang method,which took Banxia Xiexin Decoction a nd Xiaoxiangxiong Decoction as representative prescriptions,in the treatment of stable angina pectoris with hot phlegm and blood stasis are evaluated.Result(1)Xinkai Kujiang method is to use the characteristics of spicy medicine and bitte r medicine to play a role:the spicy medicine to the liver,spleen,lung,stomach meridian,p owder line warm and run,the main rise on the main,warm Yang Qi,body fluid moist.T he bitter medicine returns to the heart,lung,stomach,liver,gallbladder and large intestine,dryness relives,firm Yin,main descending main descending,dryness and dampness clear heat and keep Yin lowering qi machine.(2)Xinkai Kujiang method is specific to the treatment of human diseases,relying on drug qi theory,human qi theory,spleen and stomach qi lifting,five viscera tonifying and reducing expression to play a role in clinical practice.(3)The theoretical basis for the treatment of coronary heart disease angina pectoris by the Xinkai Kujiang method:the core pathogenesis of coronary heart disease is the original deficiency and the real deficiency.The original deficiency is the damage of he art Yang and the deficiency of heart qi after a long time,and the other four viscera or gans appear abnormal vaporization.Standard is the pathological product of abnormal ga sification metabolism.Stable angina pectoris with hot phlegm and stasis as the main cli nical contradiction is the thermal standard stage of the development of coronary heart disease.Xin-kai ku-jie method for the treatment of stable angina pectoris with hot phle gm and stasis syndrome can promote the operation of the five viscera to restrain the mechanism,and the heart deficiency can be repaired.The normalization of hot phlegm a nd stasis can be eliminated with the adjustment of the qi theory recovery machine,and qi theory is an important target for Xinkai Kujiang drugs to play a role.(4)The results of the clinical study showed that there are 3 cases of shedding in the clinical observation,and a total of 86 patients are actually included in the statistica l analysis,including 43 cases in the treatment group and 43 cases in the control group.(1)Baseline data comparison:the general data of the two groups are comparable,inc luding age,gender,course of disease,smoking history,drinking history,previous history,angi na pectoris grade,four items of blood lipid,fib,TCM syndrome score,etc.(P>0.05).(2)Efficacy comparison of angina pectoris,electrocardiogram and nitroglycerin arrest rate:the improvement rate of angina pectoris in the treatment group is 81.4%,which is better than that of the control group(58.10%,P<0.05).The total effective rate of ECG i mprovement in the treatment group is 46.50%,which is significantly better than 11.60%in the control group(P<0.01).The stopping rate of nitroglycerin in the treatment grou p is 79.10%,and that in the control group is 60.50%(P<0.05).In the treatment group,the effective rate of angina pectoris,ECG and the rate of st opping nitroglycerin are 81.40%,46.50%and 79.10%,respectively,which are significantly better than that of the control group(58.10%,11.60%,11.60%).(P<0.05,P<0.01,P<0.05)(3)Comparison of four items of blood lipid and FIB:After treatment,the four lipide mia and FIB levels in the treatment group and the control group are significantly imp roved compared with before treatment(P<0.05).After comparison between the two group s after treatment,the improvement of HDL-C and LDL-C in the treatment group is bet ter than that in the control group(P<0.05),and there are no significant differences in T C,TG,FIB and other indexes between the two groups(P>0.05).(4)Comparison of TCM symptom scores:All TCM symptom indexes are improved in the treatment group before and after treatment(P<0.05);In the control group,chest pai n,chest tightness,body drowsiness,epigastrium puffiness and other indicators are improve d compared with those before treatment(P<0.05).In the control group,there are no signi ficant improvements in indicators such as insomnia,dreaminess,less food,palpitation,dry mouth and sticky mouth,cough,shortness of breath,yellow phlegm,body obesity and con stipation(P>0.05).After treatment,the improvement of each single symptom score in the treatment group is better than that in the control group(P<0.05).All TCM symptom indexes in the treatment group are improved after treatment(P<0.05),while those in the control group are improved after treatment(P<0.05),including chest pain,chest tightness,limb drowsiness,epigastric and abdominal puffiness,etc.Howeve r,there is no significant improvement in symptoms such as insomnia,dreaminess,lack of food,palpitation,dry mouth and sticky mouth,cough,shortness of breath,yellow phlegm,b ody fat and constipation(P<0.05).After treatment,the improvement of TCM symptom sc ores in the treatment group is better than that in the control group(P<0.05).(5)Comparison of the efficacy of TCM syndromes:the effective rate of TCM syndr omes in the treatment group is 95.35%;The effective rate of TCM syndromes in the c ontrol group is 32.56%.The clinical efficacy evaluation of the treatment group is better than that of the control group(P<0.01).The total effective rate of TCM syndromes in the treatment group is 95.35%,whic h is significantly better than 32.56%in the control group(P<0.01).(6)Comparison of redness and yellowish and greasy tongue:The distribution of red ness and yellowish and greasy tongue before and after treatment is statistically signific ant between the two groups(P<0.05).There is no significant difference in pulse slip nu mber or string slip(P<0.05).(5)In this clinical observation,no abnormal changes in the safety indicators and no serious adverse events are found in the patients during the treatment period.Therefore,the modified Banxia Xiexin Decoction combined with Xiaoxianxiong Decoction for the treatment of this disease has a better safety.ConclusionClinical trial results of this study show that with this decoction heart decoction a nd small chest soup for Xinkai Kujiang method on behalf of the prescription treatmen t hot phlegm stasis and stable angina pectoris curative effect,with basic western medici ne treatment can improve patients’ clinical symptoms and improve the symptoms of ang ina pectoris and electrocardiogram of ischemia,blood lipids play a regulatory role,comp rehensive improve the patients quality of life.Good safety,no obvious toxic side effects and adverse reactions. |
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