| Purpose : Through a randomized double-blind controlled trial of traditional Chinese medicine intervention in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI),to observe the intervention effect of dissipating blood stasis and detoxifying Chinese medicine on the quality of life and cardiovascular events in patients with CHD after PCI,to observe the therapeutic effect and clinical safety of dissipating blood stasis and detoxifying Chinese medicine and dissipating blood stasis,detoxifying,opening depression and dispersing knot therapy on chest pain,blood stasis and stagnation syndrome.The correlation between traditional Chinese medicine intervention,TCM syndrome score,Seattle angina score,GRACE score and various risk factors and the occurrence of cardiovascular events after PCI of coronary heart disease was analyzedMaterial and Method: From December 2020 to December 2021,76 Patients with coronary heart disease after Percutaneous coronary intervention(PCI)were selected from the expert outpatient clinic of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.The general information of the Patients was recorded,the relevant questionnaires and rating scales were asked and filled out,and the relevant clinical and laboratory examinations were Performed.Then the data were input into the central randomized system(technical support Provided by Zhejiang Provincial Hospital of Traditional Chinese Medicine).On the basis of conventional western medicine treatment after PCI,the dissipating blood stasis and detoxifying Chinese medicine medication and the control medication were given respectively for 12 weeks,and the amount of Chinese medicine was 1month each time.The medication was randomly numbered by the drug system,and the treatment medication was distributed in three times.Relevant clinical and laboratory examinations were Performed,and the annual incidence of adverse cardiovascular and cerebrovascular events was recorded in detail,and the results were statistically analyzed.Results:1.There was no significant difference in general condition data between the two groups(P>0.05).There were no significant differences in past medical history and risk factors between the two groups(P>0.05).There were no significant differences in disease type,number of coronary artery lesions,number of stents and number of stents between the two groups(P>0.05).There were no significant differences in the related laboratory indexes such as troponin,liver function,high-sensitivity C-reactive protein,and renal function between the two groups(P>0.05),and the baseline data were all comparable.2.The left ventricular ejection fraction(LVEF)measured by color Doppler ultrasound in the two groups was significantly different after intervention in the experimental group(P<0.05).The levels of NT-pro BNP in the two groups were significantly decreased after intervention(P<0.01),and the difference between the two groups was statistically significant(P<0.01).The difference of Hs-CRP between the two groups after intervention was significant(P<0.01),the difference after treatment period was significant(P<0.01),the difference after follow-up period was statistically significant(P<0.05),the experimental group was better than the control group.3.The TCM syndrome scores of the experimental group and the control group were significantly different after intervention and before intervention(P<0.01),and there was a significant difference between the two groups(P<0.01),the experimental group was better than the control group;The effective rate of traditional Chinese medicine in the experimental group was 86.1% after 12 weeks of treatment;The control group was 74.3%,the difference between the two groups was statistically significant(P<0.05).After 6 months of follow-up,the experimental group was 91.7%;The control group was 80.0%,There was a significant difference between the two groups(P<0.01),and the experimental group was better than the control group.4.There were significant differences in the five items of Seattle strangulation score including angina attack(AF),angina stable state(AS),physical activity limitation(PL),disease cognition(DS)and treatment satisfaction(TS)between the two groups after intervention and before intervention(P<0.01).There was a significant difference between the two groups(P<0.01),and the experimental group was better than the control group.5.The comparison of quality of life CQQC scores between the two groups,including physical condition,disease condition,psychological status,general life,medical condition and working condition,after intervention compared with before intervention,there were significant differences between the two groups(P<0.01),and the experimental group was better than the control group(P<0.01).There was a significant difference in the total score of quality of life between the two groups after intervention(P<0.01).There was a significant difference in the difference between the two groups after intervention(P<0.01),and the experimental group was better than the control group.6.There were significant differences in GRACE scores between the experimental group and the control group before and after intervention(P<0.01),and there were significant differences in GRACE scores between the two groups(P<0.01),and the experimental group was better than the control group.Comparison of GRACE score risk classification between the two groups: there were statistically significant differences between the two groups before and after intervention(P<0.01),and there were statistically significant differences between the two groups after intervention(P<0.01),and the experimental group was better than the control group.7.The incidence of major adverse cardiovascular events in the two groups was as follows: in the experimental group,there was 1 case of readmission due to unstable angina pectoris attack,and 1 case of MACE occurred,with an incidence of 2.78%;In the control group,5 Patients were re-hospitalized due to unstable angina pectoris,1 Patient was re-hospitalized due to myocardial infarction,2 Patients had heart failure,and 8 Patients had MACE,with an incidence of 22.86%.The difference between the two groups was statistically significant(P<0.05),and the control group was significantly higher than the experimental group.8.By single factor correlation analysis,TCM intervention(r= 0.302,P=0.011<0.05),GRACE risk classification(r= 0.271,P=0.022<0.05),TCM syndrome score(r=0.303,P=0.010<0.05),age(r=0.237,P=0.047<0.05)were correlated with the occurrence of MACE.TCM syndrome score(r=0.311,P=0.008<0.01),serum NT-pro BNP level(r=0.403,P <0.001),serum Hs-CRP value(r=0.317,P=0.007<0.01)were significantly correlated with the occurrence of MACE.9.Binary Logistic regression analysis showed that the increase of NT-pro BNP value was a promoting factor for cardiovascular events,P=0.037<0.05,with statistical difference,OR=1.888(1.039-3.431);The increase of Hs-CRP value was a promoting factor for cardiovascular events,P=0.023<0.05,with statistical difference,OR=1.981(1.232-17.673).Conclusion:1.For patients with stasis and toxin stasis syndrome after PCI of coronary heart disease,on the basis of conventional western medicine treatment,dissipating blood stasis and detoxifying Chinese medicine intervention can improve the symptoms of TCM stasis and toxin stasis syndrome,improve the stable state of angina pectoris,angina pectoris attack,and the degree of physical activity limitation,so as to achieve the therapeutic effect.2.For patients with chest pain,blood stasis and toxin stasis syndrome after PCI,on the basis of conventional western medicine treatment,the intervention of dissipating blood stasis and detoxifying Chinese medicine Chinese medicine can improve cardiac function and increase left ventricular ejection fraction,resist inflammatory reaction,protect myocardial cells,and significantly reduce NT-pro BNP value and Hs-CRP value.3.For patients with stasis and toxin stagnation syndrome of coronary heart disease after PCI,on the basis of conventional western medicine treatment,the intervention of dissipating blood stasis and detoxifying Chinese medicine can significantly improve the quality of life from the physical health dimension,mental health dimension,and social life dimension.4.For patients with stasis and stagnation syndrome of coronary heart disease after PCI,traditional Chinese medicine intervention,GRACE risk classification,traditional Chinese medicine syndrome score,age value and NT-pro BNP level are related to the occurrence of MACE.The increase of serum NT-pro BNP and Hs-CRP values is a promoting factor for the occurrence of cardiovascular events after PCI.5.For patients with chest bi,blood stasis and toxin stagnation syndrome after PCI of coronary heart disease,on the basis of conventional western medicine treatment,the intervention of dissipating blood stasis and detoxifying Chinese medicine can reduce the risk and incidence of cardiovascular events by improving clinical symptoms,improving cardiac function,fighting inflammatory reaction and protecting myocardial cells. |
PDF Full Text Request