A Chinese medicine composition for auxiliary treatment of coronary artery blood supply insufficiency and phlegm and blood stasis syndrome

Abstract

The present invention belongs to a Chinese medicine composition for clinical auxiliary treatment of phlegm and blood stasis syndrome of coronary artery insufficiency and its preparation and specific usage. The technical scheme of the present invention is: 30 parts of Trichosanthes peel, 30 parts of Asarum, 10 parts of Cinnamon bark, 10 parts of Santalum album, 10 parts of Olibanum, and 3 parts of Borneol are ground into fine powder, and vinegar is added to blend into a paste, which is a Chinese medicine patch for treating ischemic angina pectoris. The present invention uses the Chinese medicine composition to apply Xinshu acupoint and Shenmen acupoint in a specific time period to warm and transform phlegm and fluid, promote blood circulation and dredge collaterals, and achieve the purpose of relieving chest pain. The Chinese medicine prepared by the prescription has small toxic and side effects, and is more effective when used in conjunction with the classic acupoint matching method of traditional Chinese medicine, Nazhi method.

Description

Technical Field

[0001] The invention relates to a preparation method of a Chinese medicine composition for application and the technical field of treating coronary artery insufficiency, and more specifically to a Chinese medicine composition for treating coronary artery insufficiency and phlegm and blood stasis syndrome. Background Art

[0002] Coronary artery insufficiency is a clinical syndrome of paroxysmal chest pain caused by insufficient blood supply to the myocardium due to coronary atherosclerosis. Epidemiological surveys have found that the prevalence of patients with coronary artery insufficiency in my country is currently showing a gradual upward trend. If patients with coronary artery insufficiency are not treated in time, they may further develop acute myocardial infarction, and even develop serious complications such as heart failure and arrhythmia, which will affect the patient's prognosis.

[0003] At present, the main clinical treatments for coronary artery insufficiency are drugs such as antiplatelet aggregation, anticoagulation, lipid regulation to stabilize plaques, reduce myocardial oxygen consumption, and dilate coronary arteries. However, long-term use of such Western medicines may lead to varying degrees of drug resistance and easily cause adverse reactions such as headaches, hypotension, liver damage, and gastrointestinal discomfort. Traditional Chinese medicine treatment mainly relies on oral decoctions of Chinese medicines. Although it can effectively relieve patients' chest pain symptoms, has fewer toxic and side effects, and is safe for long-term use, most oral Chinese medicine preparations have strong flavors and are difficult for some patients to tolerate, resulting in poor compliance for long-term use.

[0004] The Chinese medicine application method originated from the meridian theory of traditional Chinese medicine. This theory believes that the meridian circulation route of the human body is the key part of the occurrence and reflection of disease symptoms. When each meridian and its internal organs are diseased, the meridian will reflect symptoms and signs through the relevant parts or organs it is connected to. Therefore, stimulating the meridian qi of specific acupoints and unblocking the blocked meridians can achieve the therapeutic purpose of adjusting the body's qi and blood and balancing the yin and yang functions of the internal organs. Acupoint application therapy is a non-invasive external treatment auxiliary method. It is more easily accepted by patients in clinical use. In addition, it has a direct effect, definite efficacy, and is easy to promote. It can be used as an alternative treatment to oral Chinese medicine. Summary of the invention

[0005] The technical problem solved by the present invention is to solve the shortcomings in the current treatment of coronary artery insufficiency, and the present invention provides a Chinese medicine preparation method for auxiliary treatment of coronary artery insufficiency with phlegm and blood stasis syndrome. Another object of the present invention is to provide a group of Chinese medicine acupoints and application methods for treating angina pectoris with phlegm and blood stasis.

[0006] To achieve the above purpose, the technical solution adopted by the present invention is as follows:

[0007] A Chinese medicine composition for assisting the treatment of coronary artery insufficiency of phlegm and blood stasis type, comprising the following parts by weight:

[0008] 30 parts of Fructus Trichosanthis peels, 30 parts of Asarum, 10 parts of Cortex Cinnamomi, 10 parts of Santalum Albizia, 10 parts of Olibanum, 3 parts of Borneolum Syntheticum.

[0009] In the present invention, 30 parts of Trichosanthes peel, 30 parts of Asarum, 10 parts of cinnamon bark, 10 parts of sandalwood, 10 parts of frankincense and 3 parts of borneol are uniformly mixed and ground into fine powder, and 10 ml of edible vinegar is added to mix into a paste. When used, the sterile auxiliary material containing the ingredients is applied to the acupuncture points.

[0010] The mechanism of the technical solution adopted in the present invention is: during the ischemic period of myocardial infarction in coronary heart disease, complex carbohydrates and lipids accumulate in the vascular intima, a large amount of connective tissues such as elastic fibers and collagen fibers form a matrix, and calcium deposition aggravates the formation of plaques. Although there is no disease name of coronary artery insufficiency in traditional Chinese medicine, it can be classified into the category of "chest pain" in traditional Chinese medicine according to its onset characteristics and clinical manifestations. Traditional medicine believes that chest pain is a syndrome of deficiency in the root and excess in the superficial. The deficiency in the root is mainly deficiency of qi, blood, yin and yang, and the superficial excess is qi stagnation, phlegm turbidity, cold coagulation, blood stasis, etc. With the development of society, the pathogenesis of coronary heart disease has also evolved. In recent years, more and more scholars have conducted a large number of studies on the etiology and pathogenesis, objective indicators and syndrome differentiation and treatment of the syndrome of phlegm and blood stasis in coronary heart disease, and have obtained more experience and results.

[0011] From the perspective of traditional Chinese medicine, as people's living standards continue to improve, many people nowadays are greedy for alcohol and drink, and eat too much fatty and greasy food. Over time, this will damage the spleen and stomach, causing the spleen to lose its healthy function and dampness and phlegm stagnation. Phlegm is sticky and greasy, which can easily block the yang energy and blood circulation, and stay in the heart and chest, causing phlegm and dampness to block the disease. As Zhu Gong said in "The Book of Classification and Saving People": "The pain of the (heart) pericardium is caused by the stagnation of phlegm and saliva, which is blocked and painful." Chinese medicine scholars believe that atherosclerosis and elevated blood lipids are manifestations of "phlegm", and myocardial ischemia and changes in blood rheology are manifestations of "stasis". Therefore, coronary heart disease is more prone to pathological factors such as phlegm and stasis. Phlegm and stasis syndrome has been considered an important pathogenesis of coronary heart disease and runs through it throughout. Treatment based on phlegm and stasis has become a common treatment method for coronary heart disease. Its main clinical manifestations are chest tightness and pain, pain in a fixed place, especially at night, phlegm and fat body, poor appetite, abdominal distension, purple tongue, greasy fur, and stringy pulse. Therefore, the treatment of this syndrome should utilize the methods of warming and resolving phlegm and fluid, and promoting blood circulation and unblocking collaterals.

[0012] The invention has the following beneficial effects: the present invention uses the peel of Trichosanthes as the main drug, which is bitter and cold in nature, and enters the lung and stomach meridians, and has the functions of promoting qi, resolving phlegm and relieving numbness. This product can resolve phlegm and promote qi, and is an important drug for treating chest pain and chest pain. Cinnamon and Asarum are both ministerial drugs, and Cinnamon is pungent and sweet in nature, and enters the heart, liver, kidney and spleen meridians, and has the functions of dispersing cold and relieving pain, promoting blood circulation and dredge meridians, guiding fire back to its source, and replenishing fire and assisting yang. It is commonly used to treat cold pain in the chest, cold arthralgia and the like. The peel of Trichosanthes and Cinnamon are combined, one cold and one warm, one lung and one heart, and complement each other, and have the effects of strengthening the heart and assisting yang, promoting qi and resolving phlegm, and warming the meridians and dredge the blood vessels. Asarum is warm and pungent in nature, enters the heart, lung and kidney meridians, and has the functions of clearing the orifices and relieving pain, warming and transforming phlegm and fluid, and can be used for various types of phlegm and fluid, arthralgia and pain. Sandalwood and frankincense are adjuvant drugs. Sandalwood is pungent and warm in nature. It enters the spleen, stomach, heart and lung meridians, and has the merits of promoting qi and warming the middle, appetizing and relieving pain. It is clinically used to treat angina pectoris caused by turbid phlegm and cold coagulation. Frankincense is pungent, bitter and warm in nature. It enters the heart, liver and spleen meridians, and has the merits of regulating qi and activating blood circulation, and relieving pain. It is mainly used to treat stagnation of qi and blood, pain caused by blood stasis in the heart and chest, etc. "Rihuazi Bencao": "Stop cholera, heart and stomach pain. Decoction of ointment relieves pain and grows flesh." There is also "Zhenzhu Nang" cloud: "Determine the pain of various meridians." Borneol enters the heart meridian, is warm and bitter in nature, has the merits of opening all orifices, dispersing stagnation fire, improving eyesight and relieving pain. The fragrance of borneol is used in the prescription, because it can "lead a group of medicines to open knots and stagnate, directly reach the diseased area, and remove the disease." When the present invention is used, it must follow the "Nazhi method" to apply Shenmen acupoint from 11 to 13 o'clock and Xinshu from 15 to 17 o'clock in sequence. "Nazhi method" is a branch of the ancient classic acupuncture acupoint matching prescription "Ziwu Liuzhu method". It is a special acupoint treatment method based on the order of meridian qi flow in 12 hours. This method points out that at noon (11:00 to 13:00), qi and blood flow to the hand Shaoyin heart meridian, which is beneficial to blood circulation throughout the body; at Shenshi (15:00 to 17:00), the bladder meridian is prosperous, which once again strengthens the power of the heart, and the heart fire generates stomach earth, which is beneficial to the transportation and transformation of phlegm and fluid. Shenmen acupoint is one of the acupoints of the Shaoyin heart meridian. It is located on the wrist, at the ulnar end of the palmar transverse line of the wrist, and in the radial depression of the ulnar flexor tendon. This acupoint is mainly used to treat chest pain, palpitations, asthenia, forgetfulness, insomnia and other diseases. Xinshu belongs to the foot-sun bladder meridian. It is on the back, 1.5 inches below the spinous process of the 5th thoracic vertebra. It is mainly used to treat chest pain, insomnia, palpitations, forgetfulness, irritability, arrhythmia and other diseases. According to the pathogenesis characteristics of coronary artery insufficiency caused by phlegm and blood stasis, this method of stimulating specific acupoints of the Shaoyin Heart Meridian and the Taiyang Bladder Meridian can warm the phlegm and fluid, promote blood circulation and dredge the meridians, and achieve twice the result with half the effort in treating this disease. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1Comparison of the treatment group before and after intervention, including: a: comparison of TCM syndrome scores; QTJF: TCM score before treatment, HTJF: TCM score after treatment; b: number of angina attacks per week; QTXJT: number of angina attacks before treatment, HTXJT: number of angina attacks after treatment; c: time of angina attack; QTT: time of angina attack before treatment, HTT: time of angina attack before treatment; ★: P < 0.05; ★★: P < 0.01.

[0014] Figure 2 Comparison of the control group before and after intervention, including: a: comparison of TCM syndrome scores; QCJF: TCM score before treatment, HCJF: TCM score after treatment; b: number of angina attacks per week; QCXJT: number of angina attacks before treatment, HCXJT: number of angina attacks after treatment; c: angina attack time; QCT: angina attack time before treatment, HCT: angina attack time before treatment; ★: P < 0.05; ★★: P < 0.01.

[0015] Figure 3 Comparison between the two groups after intervention, including: a: comparison of TCM syndrome scores; TJF: TCM score before treatment, CJF: TCM score after treatment; b: number of angina attacks per week; TXJT: number of angina attacks before treatment, CXJT: number of angina attacks after treatment; c: time of angina attack; TT: time of angina attack before treatment, CT: time of angina attack before treatment; ★: P < 0.05; ★★: P < 0.01. DETAILED DESCRIPTION

[0016] General Information:

[0017] Research subjects: From November 2022 to March 2023, 30 patients with coronary artery insufficiency hospitalized in the Department of Cardiology of Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine were selected. They were randomly divided into a treatment group and a control group, with 15 cases in each group. There was no significant statistical difference in age, gender, and underlying diseases between the two groups (P>0.05).

[0018] Diagnostic criteria:

[0019] Refer to the diagnostic criteria for coronary artery insufficiency in the "2014 ACC / AHA Guidelines for the Treatment of Ischemic Angina / Non-ST-Elevation Myocardial Infarction" developed by the American College of Cardiology / American Heart Association.

[0020] Inclusion criteria:

[0021] 1. Meet the diagnostic criteria for coronary artery insufficiency of coronary heart disease, confirmed by coronary angiography or coronary artery CTA; 2. Aged 30 to 85 years old; 3. Sign informed consent.

[0022] Exclusion criteria:

[0023] 1. Those aged <30 or >85 years old; 2. Those with severe cardiopulmonary insufficiency, blood system diseases, liver and kidney insufficiency, cerebrovascular diseases, and immune system diseases; 3. Patients with mental disorders; 4. Pregnant or lactating women; 5. Those with acute myocardial infarction and non-ST-segment elevation acute myocardial infarction who need emergency interventional treatment; 6. Those with severe allergic reactions or intolerance to traditional Chinese medicine treatments.

[0024] method:

[0025] 1. Drug ingredients: 30 parts of Trichosanthes peel, 30 parts of Asarum, 10 parts of cinnamon, 10 parts of sandalwood, 10 parts of frankincense, and 3 parts of borneol.

[0026] 2. Treatment method: Grind 30g of Trichosanthes peel, 30g of Asarum, 10g of Cinnamon, 10g of Sandalwood, 10g of Frankincense, and 3g of Borneol into fine powder, add vinegar to make a paste. When using, apply the sterile auxiliary material containing this substance to the acupuncture point.

[0027] 3. Observation indicators: 1. Clinical efficacy of coronary artery insufficiency: record the number of angina attacks and the duration of each attack; 2. Nitroglycerin discontinuation rate: the standard is discontinuation (no need to take nitroglycerin sublingually after treatment); reduction (the daily dosage of nitroglycerin is reduced by more than 50% compared with the previous dosage); unchanged (the daily dosage of nitroglycerin is reduced by less than 50% or the dosage is increased). Discontinuation rate = number of cases of discontinuation after treatment / number of cases of medication before treatment × 100%; 3. Quantitative scoring of TCM symptoms in accordance with the "Guidelines for Clinical Research of New Chinese Medicines" using the symptom score scale of phlegm and blood stasis syndrome, the main symptoms are chest tightness and chest pain, which are divided into none, mild, moderate and severe levels according to the symptoms, corresponding to 0, 2, 4 and 6 points respectively. Secondary symptoms: including body fatigue, obesity, phlegm, dark complexion, turbid and greasy tongue coating or slippery, slippery or astringent pulse, according to the classification of none and yes, corresponding to 0 and 1 points respectively. Tongue and pulse: score according to whether there is turbid or slippery tongue coating, slippery or astringent pulse, 0 points if there is no turbid or slippery tongue coating, 1 point if there is turbid or slippery pulse, and record them before and after treatment. After treatment, the total score of symptoms is reduced by ≥70%, which is considered to be markedly effective; after treatment, the total score of symptoms is reduced by ≥30% but <70%, which is considered to be effective; if there is no significant improvement in symptoms such as dizziness, headache, palpitations and insomnia, or even if the symptoms are aggravated, the score of symptoms is reduced by <30%, which is considered to be ineffective.

[0028] Statistical methods:

[0029] SPSS 21 statistical software was used for statistical analysis of the data. If the measurement data conformed to the normal distribution, they were expressed as mean ± standard deviation (x ± s). Paired sample t test was used for intra-group comparison, and independent sample t test was used for inter-group comparison. Count data were expressed as rate and composition ratio, and the chi-square test was used. P < 0.05 was considered statistically significant.

[0030] result

[0031] 1.1 Comparison of the two groups before and after treatment

[0032] Table 1 Comparison of TCM symptom scores between the two groups before and after treatment

[0033]

[0034] Figure 1 Comparison of the treatment group before and after intervention, including: a: comparison of TCM syndrome scores; QTJF: TCM score before treatment, HTJF: TCM score after treatment; b: number of angina attacks per week; QTXJT: number of angina attacks before treatment, HTXJT: number of angina attacks after treatment; c: time of angina attack; QTT: time of angina attack before treatment, HTT: time of angina attack before treatment; ★: P < 0.05; ★★: P < 0.01.

[0035] Comparison of clinical efficacy between the two groups

[0036] Table 2 Comparison of clinical efficacy between the two groups

[0037]

[0038] Figure 2 Comparison of the control group before and after intervention, including: a: comparison of TCM syndrome scores; QCJF: TCM score before treatment, HCJF: TCM score after treatment; b: number of angina attacks per week; QCXJT: number of angina attacks before treatment, HCXJT: number of angina attacks after treatment; c: angina attack time; QCT: angina attack time before treatment, HCT: angina attack time before treatment; ★: P < 0.05; ★★: P < 0.01.

[0039] Comparison of angina pectoris attack frequency and duration between the two groups

[0040] Table 3 Comparison of angina pectoris attack frequency and attack time between the two groups

[0041]

[0042] Figure 3 Comparison between the two groups after intervention, including: a: comparison of TCM syndrome scores; TJF: TCM score before treatment, CJF: TCM score after treatment; b: number of angina attacks per week; TXJT: number of angina attacks before treatment, CXJT: number of angina attacks after treatment; c: time of angina attack; TT: time of angina attack before treatment, CT: time of angina attack before treatment; ★: P < 0.05; ★★: P < 0.01.

[0043] Typical medical cases

[0044] Case 1: Zhang, male, 76 years old. Date of first visit: December 16, 2022. Chief complaint: recurrent chest pain for more than 1 year, aggravated for 1 month. The patient had a coronary angiography due to chest pain one year ago, which showed a 60-70% stenosis of the anterior descending branch. At that time, the patient did not undergo coronary artery stent implantation, and only took oral nitroglycerin and other drugs to relieve symptoms. In the past month, the patient was furious once because of trivial matters in life. After his emotions stabilized, he felt that his chest pain attacks increased significantly, and the pain symptoms were worse than before. The patient refused to undergo coronary angiography again this time and only accepted drug treatment. Based on the original treatment plan, the "Nazhi method" was applied to the Shenmen and Xinshu points in turn. After one week of treatment, the patient's chest pain symptoms improved significantly, and the frequency of attacks also decreased significantly. Follow-up has improved so far, and chest pain symptoms occasionally occur once a few months, and the condition is stable.

[0045] Case 2: Huang, female, 68 years old. Date of first visit: January 20, 2023. Chief complaint: repeated chest pain for several years, aggravated for 1 month. One year ago, the patient had a coronary artery CTA due to chest pain, which showed a 50% stenosis of the left circumflex branch. After long-term medication treatment, chest pain symptoms occasionally occurred. One month ago, the patient had a respiratory virus infection. After recovery, he felt that his chest pain symptoms were more frequent than before, the pain was needle-like, and the pain was significantly aggravated than before, and he needed to take nitroglycerin frequently to relieve the symptoms. The patient refused to undergo further coronary angiography this time, so Chinese medicine was added to the patient's original drug treatment plan. The patient's chest pain attacks were significantly reduced after 1 week of treatment, the pain was relieved, and the number of times he took nitroglycerin also decreased significantly. The patient is still receiving regular Chinese medicine patch treatment in the outpatient clinic, and his condition has been stable so far during follow-up.

[0046] in conclusion

[0047] According to clinical observation, we found that the TCM syndrome score, weekly angina attack frequency, and angina attack time of the treatment group were significantly improved compared with those before treatment (P < 0.01). Compared with the control group, the TCM syndrome score, weekly angina attack frequency, and angina attack time of the treatment group after intervention were more significantly improved (P < 0.01), and the nitroglycerin reduction rate of the treatment group was lower than that of the control group (P < 0.05). Therefore, the above clinical observation results can be used to confirm that the Chinese medicine composition of the present invention has a clinical effect of assisting the treatment of coronary artery insufficiency and phlegm and blood stasis syndrome.

Claims

1. A Chinese medicine composition for assisting the treatment of coronary artery insufficiency and phlegm and blood stasis syndrome, characterized in that: The composition is as follows in parts by weight: 10-40 parts of Trichosanthes peel, 10-40 parts of Asarum, 3-20 parts of cinnamon bark, 3-20 parts of sandalwood, 3-20 parts of frankincense and 1-5 parts of borneol.

2. A Chinese medicine composition for assisting the treatment of coronary artery insufficiency and phlegm-stasis syndrome as claimed in claim 1, characterized in that: The specific weight portions are: 30 parts of Trichosanthes peel, 30 parts of Asarum, 10 parts of cinnamon bark, 10 parts of sandalwood, 10 parts of frankincense, and 3 parts of borneol.

3. A Chinese medicine composition for assisting the treatment of coronary artery insufficiency and phlegm-stasis syndrome as claimed in claim 1 or 2, characterized in that: Evenly mix the above components and grind them into fine powder, add edible vinegar to mix into a paste, and stick the sterile auxiliary material containing this substance on the acupuncture points when using.

4. A Chinese medicine composition for assisting the treatment of coronary artery insufficiency and phlegm-stasis syndrome as claimed in claim 3, characterized in that: The acupoints are Shenmen acupoint and Xinshu acupoint.

5. A Chinese medicine composition for assisting the treatment of coronary artery insufficiency and phlegm-stasis syndrome as claimed in claim 4, characterized in that: The time for applying the Shenmen acupoint is from 11:00 to 13:00, and the time for applying the Xinshu acupoint is from 15:00 to 17:00.

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