RESUMO
Objective:To discuss the efficacy of addition and subtraction therapy of Zhishi Xiebai Guizhitang and Lizhongtang for stable angina (SAP) with syndrome of Yin-cold stagnation and investigate its effects on inflammatory factors and endothelial function. Method:One hundred and thirty- eight patients were randomly divided into control group (69 cases) and observation group (69 cases) by random number table. During the study period, there were 3 drop-out cases, 3 excluded cases, and 63 completed cases in the control group. There were 3 drop-out cases, 1 excluded case, and 65 completed cases in the observation group. Basic therapy was given in both groups. Patients in both groups got metoprolol tartrate tablets, 50 mg/time, 2 times/days. Aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Trimetazidine dihydrochloride tablets, 1 tablet/time, 3 times/days In case of angina pectoris attacks, nitroglycerin tablets under the tongue, 0.25-0.5 mg, for every 5 minutes until the angina is relieved. And they also got treatment to control blood glucose, lipids and blood pressure. Based on the above treatment, the patients in control group additionally received Guanxin Suhe pills, chewed for administration, 1 pill/time, twice a day. The patients in observation group additionally received addition and subtraction therapy of Zhishi Xiebai Guizhitang and Lizhongtang, 1 dose/day. The course of treatment was 12 weeks in both groups. One week before treatment and one week after treatment, the number of times and duration of anginal attacks and dosage of nitroglycerin were recorded. Before treatment and after treatment, electrocardiogram was checked, and scores of Seattle Angina Questionnaire (SAQ) and syndrome of Yin-cold stagnation were graded; levels of serum phospholipase A2 (Lp-PLA2), homocysteine (Hcy), D-dimer (D-D), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), nitric oxide (NO) and endothelin (ET-1) were detected. Result:The number of times of angina attacks and Nitroglycerin consumption in observation group were less than those in control group (P<0.01), and the duration of angina attacks was shorter than that in control group (P<0.01). Score of syndrome of Yin-cold stagnation in observation group was lower than that in control group (P<0.01), and score of SAQ was higher than that in control group (P<0.01). Levels of Lp-PLA2, D-D, Hcy, IL-6, hs-CRP, TNF-α and ET-1 in observation group were lower than those in control group (P<0.01), and level of NO was higher than that in control group (P<0.01). The efficacy shown in electrocardiogram was also better than that in control group (Z=2.043, P<0.05； Z=2.003, P<0.05). Conclusion:On the basis of routine treatment of western medicine, addition and subtraction therapy of Zhishi Xiebai Guizhitang and Lizhongtang can further alleviate symptoms, reduce ischemic attack, improve the quality of life in patients with SAP and syndrome of Yin-cold stagnation. It has anti-inflammatory effect and can improve the function of blood vessels and stabilize plaque, showing better clinical effects and electrocardiographic results than Western medicine alone.
RESUMO
Objective To analyze the clinical efficacy of modified Xiaoqinglong Decoction with bladder ginger treatment in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of external cold and internal fluid. Methods Totally 150 cases of AECOPD were divided into Western medicine group, integrated traditional Chinese and Western medicine group, and observation group, with 50 cases in each group. Western medicine group received routine treatment, such as controlled oxygen therapy, anti-infection, triple inhalation, relieve spasm and asthma, cough and phlegm, correct water and electrolyte balance. On the basis of routine treatment, integrated traditional Chinese and Western medicine group received modified Xiaoqinglong Decoction, one dosage per day, twice a day, orally. On the basis of integrated traditional Chinese and Western medicine group, observation group received scraping the bladder at the back of the Bladder Meridian of Foot-Taiyang, putting 20–30 g fresh mashed ginger, for 15–20 min. All treatment lasted for 14 d. TCM symptom scores, the main symptoms of remission time and lung function before and after treatment in the three groups were compared. Results The differences in main symptoms scores (cough, expectoration, wheezing, shortness of breath) and total scores of the observation group were higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). The main symptoms remission time of the observation group was much shorter than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Compared with before treatment, the FEV1,FEV1/FVC and MMEF of the three groups after treatment showed an upward trend (P<0.05). The FEV1, FEV1/FVC and MMEF in observation group were significantly higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Conclusion Modified Xiaoqinglong Decoction combined with bladder ginger for the treatment of AECOPD of external cold and internal fluid has definite curative effect, and can significantly improve TCM symptoms and pulmonary function.