Clinical Study on Tongmai Kaibi Decoction Combined with Compound Danshen Dropping Pills and Western Medicine for Stable Angina Pectoris of Coronary Heart Disease
Abstract: Objective: To observe the clinical effect of Tongmai Kaibi Decoction combined with Compound Danshen Dropping Pills and western medicine for stable angina pectoris of coronary heart disease of qi stagnation and blood stasis type. Methods:A total of 94 cases of patients with stable angina pectoris of coronary heart disease of qi stagnation and blood stasis type were randomly divided into the control group and the combination group,with 47 patients in each group. Both groups were treated with routine western medicines for antiplatelet and regulating lipid and Compound Danshen Dropping Pills,and the combination group was additionally treated with Tongmai Kaibi Decoction. Both groups were treated for 2 months. Before and after treatment,traditional Chinese medicine syndrome scores were assessed;angina pectoris attack frequency, angina pectoris duration, heart rates, blood pressure and ECG- related indexes of patients were recorded;left ventricular end-systolic volume index (LVESVI),left ventricular end-diastolic volume index (LVEDVI) and left ventricular ejection fraction (LVEF) were detected by Color Doppler Ultrasound System ; the levels of soluble intercellular adhesion molecule- 1 (sICAM-1) , interleukin- 18 (IL- 18) , interleukin- 6 (IL- 6) , glutathione peroxidase (GSH- Px) , myeloperoxidase (MPO) , high mobility group protein B1 (HMGB1), malondialdehyde (MDA), and superoxide dismutase (SOD) were detected. Results: After treatment, the total effective rate and the total clinical effective rate of electrocardiogram in the combination group were higher than those in the control group (P<0.05). The scores of chest pain,chest tightness,palpitation,shortness of breath,fatigue and lack of strength in the two groups were decreased when compared with those before treatment (P<0.05), and the scores of chest pain, chest tightness, palpitation, shortness of breath, fatigue and lack of strength in the combination group were lower than those in the control group (P<0.05). When compared with those before treatment, the frequency of angina pectoris attack in the two groups was decreased, the duration of angina pectoris was shortened, and the values of LVESVI and LVEDVI were decreased, and the LVEF values were increased,differences being significant (P<0.05). The frequency of angina pectoris attack in the combination group was lower than that in the control group,the duration of angina pectoris was shorter than that in the control group,the LVEF value was higher than that in the control group,and the values of LVESVI and LVEDVI were lower than those in the control group, differences being significant (P<0.05). Systolic blood pressure and diastolic blood pressure in the two groups were decreased when compared with those before treatment, heart rates were decreased when compared with those before treatment, the rise of ST segment and the change amplitude range of T-wave were increased when compared with those before treatment, differences being significant (P<0.05). The systolic blood pressure and diastolic blood pressure in the combination group were lower than those in the control group,the heart rate was less than that in the control group,and the rise of ST segment and the change of T-wave were more significant than those in the control group, differences being significant (P<0.05). The levels of sICAM-1, IL-18, and IL-6 in the two groups were decreased when compared with those before treatment (P<0.05), and the levels of sICAM-1,IL-18,and IL-6 in the combination group were lower than those in the control group (P<0.05). MDA levels in the two groups were decreased when compared with those before treatment, and the levels of SOD and GSH- Px were increased when compared with those before treatment, differences being significant (P<0.05). The MDA level in the combination group was lower than that in the control group,and the levels of SOD and GSH-Px were higher than those in the control group,differences being significant (P<0.05). The levels of MPO and HMGB1 in the two groups were decreased when compared with those before treatment (P<0.05),and the levels of MPO and HMGB1 in the combination group were lower than those in the control group (P<0.05). Conclusion:On the basis of routine western medicine and Compound Danshen Dropping Pills,the additional application of Tongmai Kaibi Decoction for patients with stable angina pectoris of coronary heart disease of qi stagnation and blood stasis type can effectively improve heart function, reduce inflammatory responses, inhibit oxidative stress and relieve clinical symptoms.