| Study 1 Theoretical discussionThe "blood-vessel-heart-spirit" theory discusses stable angina pectoris from four dimensions: blood,pulse,heart and soul,covering multiple stages of disease onset,evolution and prognosis.Combining the characteristics of elderly patients and the changes in the four aspects of blood,pulse,heart and spirit,it is believed that deficiency of spleen and kidney is the core pathogenesis of the disease,and that damage to the heart is the key to the disease,and the treatment should be based on the method of benefiting the kidneys and strengthening the spleen throughout.Study 2 Clinical Studies ObjectiveTo investigate the clinical efficacy and mechanism of efficacy of the formula for butian decoction in the treatment of elderly patients with stable angina pectoris of spleen-kidney deficiency under the guidance of the "blood-vessel-heart-spirit" theory,so as to provide more ideas for clinical treatment.MethodsA total of 122 elderly patients with stable angina pectoris of spleen-kidney deficiency were included in this study,including 61 cases in the control group and 61 cases in the experimental group.Both groups were given conventional medicine treatment,and the experimental group was given the formula of butian decoction superimposed on this.Clinical data and venous blood serum were collected from the two groups at 0 and 4 weeks.The differences in efficacy between the two groups were compared in terms of angina score,TCM syndrome score and quality of life,and the possible mechanism of efficacy was explored from the perspective of vascular endothelial injury.Result1 The baseline data of the control group and the experimental group were statistically analyzed without significant differences and were comparable.2 Comparison of the efficacy of the control group and the experimental group in terms of angina pectoris score and TCM symptom score.2.1 The angina points in both groups decreased after treatment than those before treatment(P<0.05).Compared between groups,at 4 weeks of treatment,the experimental group was better than the control group in terms of improving angina pain points(P<0.05).2.2 The TCM main,secondary and total syndrome scores of both groups decreased after treatment than those before treatment(P<0.05).Compared between groups,at 4 weeks of treatment,the experimental group was better than the control group in terms of improving the TCM main and total syndrome scores(P<0.05).2.3 The chest tightness,palpitations and chest pain scores in both groups decreased after treatment than those before treatment(P<0.05).Compared between groups,at 4 weeks of treatment,the experimental group was better than the control group in terms of improving chest pain scores(P<0.05).2.4 The loss of appetite and weakness of the lumbar and knees scores in the experimental group decreased after treatment than those before treatment(P<0.05),and the relief of the lumbar and knee weakness symptoms was more obvious(P<0.05).3.Comparison between the control group and the experimental group on the Seattle Angina questionnaire and Short Form-36 before and after treatment.3.1 Seattle Angina questionnaire: The degree of limitation of physical activity,stability of angina,angina attacks,treatment satisfaction and disease awareness scores increased in both groups after treatment than those before treatment(P<0.05).Compared between groups,at 4weeks of treatment,the experimental group outperformed the control group in terms of improvement of angina attacks(P<0.05).3.2 Short Form-36: physiological function,physical function,somatic pain,general health,social function,mental health,energy and health change scores increased in both groups after treatment compared to before treatment(P<0.05);for emotional function,the scores of this dimension tended to increase in the control group after treatment compared to before treatment,but the difference was not statistically significant(P>0.05),while the experimental group had significantly higher scores on this dimension after treatment compared to before treatment(P< 0.05).Compared between groups,at 4 weeks of treatment,the experimental group outperformed the control group in terms of improved general health,social functioning,energy,and changes in health(P<0.05).4 Comparison of serological indicators between the two groups.4.1 Klotho: The Klotho level in the experimental group increased after treatment than those before treatment(P<0.05),while the Klotho level in the control group tended to increase after treatment than those before treatment,but the difference was not statistically significant(P>0.05).Compared between groups,at 4 weeks of treatment,the Klotho level in the experimental group was higher than that in the control group(P<0.05).4.2 NOS3: The NOS3 level increased in both groups after treatment than those before treatment(P<0.05).Compared between groups,there was no statistically significant difference in NOS3 levels between the two groups before and after treatment(P>0.05).4.3 Nrf2: The Nrf2 level in both groups tended to increase after treatment than those before treatment,but the difference was not statistically significant(P>0.05).Compared between groups,there was no statistically significant difference in Nrf2 levels between the two groups before and after treatment(P>0.05).ConclusionThe "blood-vessel-heart-spirit" has rich theoretical connotations,and the butian decoction guided by this view has good clinical efficacy in treating elderly patients with stable angina pectoris of spleen-kidney deficiency.It has significant advantages in alleviating angina,TCM symptoms points and improving quality of life,and its mechanism of action may be related to improving vascular endothelial damage by affecting Klotho and NOS3 expression. |
