Addition and Subtraction Therapy of Zhishi Xiebai Guizhitang and Lizhongtang for Stable Angina and Effect on Inflammatory Factors and Endothelial Function / 中国实验方剂学杂志

ABSTRACT

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.