| The increasing number of patients with CHD and the wide application of PCI and CABG have created a large population of patients with CHD after revascularization,and the accompanying mental and psychological problems are important factors affecting the prognosis.MD are a group of diseases characterized by changes in mood or mood,accompanied by cognitive and behavioral changes,including all common abnormal mood in the department of psychiatry,such as anxiety,phobia,general mood high or low.This study systematically elaborated the clinical efficacy of the Ningxin Anshen method in the intervention of MD after CHD revascularization and the mining of risk factors for MD after the operation under the guidance of the integrated view of "Blood-Vessel-Heart-Spirit" from three aspects of theoretical discussion,clinical data review and clinical research.In addition,the possible mechanism of Ningxin Anshen Chinese medicine’s intervention on MD after revasularization was discussed from the perspective of regulating HPA axis and protecting vascular endothelium.Study 1: Based on the integrated view of "Blood,Vessel,Heart and Spirit",the theoretical study on the intervention of Ningxin Anshen on MD after revascularization of CHD was investigatedThe integrative view of "Blood-Vessel-Heart-Spirit" is an academic concept put forward under the guidance of the holistic view of traditional Chinese medicine,which is based on the research model of ischemic heart disease,based on the tangible material structure of "Blood","Vessel" and "Heart",and integrates the intangible function of "Spirit".Its core ideas include blood,vessel,heart,spirit,four during the course of the disease on the multidimensional nature of space and time sequential sex,and stressed that "the heart of spirit ","spirit one,highlighting the importance of "nerves" for treating cardiovascular disease,chronic cardiovascular disease should be advocated to the whole cycle regulating,attaches great importance to prevent and improve prognosis in the necessity of raising the quality of patients life.In terms of treatment strategies,it is believed that vascular dysfunction is the early basis of MD after vascular reconstruction,and the damage of the heart body and restless mental position are the fundamental pathogenesis.Therefore,it is advocated to use the method of calming the heart body and tranquilizing the mind,and considering vascular dysfunction as appropriate,so as to make the blood vessels fluent.Study 2: The clinical risk factors of MD after revascularization of CHDObjective: To identify the risk factors for MD after revascularization of CHD,and to provide help for early and rapid clinical identification of people prone to MD after revascularization.Methods: By the first affiliated hospital of Tianjin medical university hospital medical record system selection,row standard parallel PCI and CABG surgery patients with complete clinical data,and formulated the coronary reascularization MD in patients with risk factors questionnaire,collect patients basic information,medical history information,reascularization,NYHA grading and other clinical data,According to the obtained data and diagnostic criteria,the samples were divided into MD group and non-mood disorder group,which were input into Excel and established a database.Statistical software was used to compare the differences between the two groups,and then binary Logistic regression analysis was performed on the factors with differences,and finally the risk factors related to MD after hemorrhage reconstruction were obtained.Results: Sex,arrhythmia,type of medication,times of revascularization and emergency revascularization were associated with MD after revascularization in CHD.Conclusion: Gender,arrhythmia,type of medication,times of revascularization and emergency revascularization are the risk factors of MD after revascularization in CHD.Among them,the probability of MD in women after revascularization of CHD was 2.523 times higher than that in men,and the probability of MD in patients with arrhythmia was2.323 times higher than that in patients without arrhythmia.the probability of MD in patients undergoing emergency revascularization was 5.367 times higher than that in patients without revascularization.With the increase of the type of medication and the number of revascularization,the incidence of MD increased.Study 3 Clinical study on the method of Ningxin Anshen under the guidance of "Blood-Vessel-Heart-Spirit" in the intervention of MD after revascularization of CHDObjective: To explore the clinical efficacy and possible mechanism of traditional Chinese medicine in the treatment of MD after revascularization of CHD under the guidance of "Blood-Vessel-Heart-Spirit".It is scientifically answered that traditional Chinese medicine has the same effect of double heart.Methods: Patients with MD after revascularization of CHD were selected and divided into two groups: traditional Chinese medicine treatment group and western medicine control group.after 4 weeks of intervention,the curative effect of angina pectoris,TCM syndrome,quality of life and mood were observed in the two groups before and after treatment,and the serum of patients at 0 and 4 weeks were collected.To explore the effect of traditional Chinese medicine of calming heart and mind on HPA axis and vascular endothelial function.Results: The method of Ningxin Anshen is effective in the intervention of MD after revascularization of CHD.In the clinical efficacy,the scores of mood state,angina pectoris,TCM secondary symptoms,anxiety or depression in the traditional Chinese medicine treatment group were better than those in the western medicine control group,and the difference was statistically significant;in terms of serological indexes,the VEGF of the two groups after treatment had a rising trend,ACTH,NE had a downward trend,but there was no statistical difference;the content of CORT in the treatment group was significantly lower than that in the control group,and the difference was statistically significant.Conclusion: Under the guidance of the holistic concept of "Blood-Vessel-Heart-Spirit",the traditional Chinese medicine of calming the mind and mind can improve the mood state and somatic symptoms to a great extent,and has the effect of two-heart homology,and its mechanism may be related to the inhibition of the over-activation of HPA axis and the improvement of vascular endothelial function. |
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