Traditional Chinese medicine composition for treating chronic coronary syndrome and fading coronary artery and carotid plaques as well as preparation method and application of traditional Chinese medicine composition

Abstract

The invention belongs to the field of medical science, and relates to a traditional Chinese medicine, in particular to a traditional Chinese medicine composition for treating chronic coronary syndrome and fading coronary artery and carotid plaques as well as a preparation method and application of the traditional Chinese medicine composition. The formula of the composition comprises 10 to 30 g of radix astragali, 10 to 18 g of salvia chinensis, 20 to 40 g of euphorbia lunulata, 6 to 15 g of rhizoma pinelliae preparata, 6 to 15 g of ginseng, 6 to 15 g of cassia twig, 6 to 15 g of radix puerariae, 6 to 15 g of dried ginger, 5 to 15 g of rhizoma cimicifugae, 5 to 15 g of radix bupleuri, 6 to 20 g of bighead atractylodes rhizome, 5 to 15 g of pericarpium citri reticulatae, 6 to 15 g of radix scutellariae, 12 to 30 g of cynanchum glaucescens, 5 to 15 g of angelica sinensis, 5 to 15 g of radix curcumae, 10 to 30 g of salvia miltiorrhiza, and 6 to 15 g of honey-fried licorice root. The composition provided by the invention treats the origin of the aggregation by tonifying qi, eliminating the aggregation, activating yang and removing stasis, and treats the source of the aggregation by tonifying spleen, reducing phlegm, promoting blood circulation to remove blood stasis and smoothing the vein, not only has an exact curative effect on improving the clinical symptoms of the chronic coronary syndrome, but also can prevent the progression of arteriosclerosis and subside coronary artery and carotid plaques, and not only has obvious curative effect on the clinical symptoms, but also has obvious curative effect on the coronary artery and carotid artery plaques. The basic pathological change of atherosclerosis can be improved, so that the chronic coronary syndrome is treated, the pathological progress of the chronic coronary syndrome is prevented and treated, the curative effect is remarkable, and the safety problem is few.

Description

Technical Field

[0001] The invention belongs to the field of traditional Chinese medicine, and relates to a traditional Chinese medicine composition for treating coronary heart disease and chronic coronary syndrome and eliminating coronary artery and carotid artery plaques, as well as a preparation method and application thereof. Background Art

[0002] Atherosclerotic plaques are the pathological basis of many arteriosclerotic vascular diseases. Stabilizing and regressing plaques are fundamental to treating atherosclerotic diseases and preventing and controlling acute cardiovascular and cerebrovascular events.

[0003] How to eliminate plaques has always been a hot topic of research at home and abroad. Many studies have confirmed that the use of statins to enhance lipid-lowering can stabilize plaques and promote the regression of plaques, but statins have large side effects and poor compliance. Therefore, although the research on plaque-reducing drugs has made great breakthroughs compared with the past, it still cannot completely block the formation and progression of plaques. The incidence of atherosclerotic diseases and the incidence of acute adverse cardiovascular and cerebrovascular events are still at a high level, and long-term use of Western medicine has great side effects on the human body. Therefore, the development of safe and effective plaque-reducing drugs is an urgent problem to be solved.

[0004] Traditional Chinese medicine has the characteristics of comprehensive and multi-target treatment of diseases. Currently, a few clinical studies have found that traditional Chinese medicine has the effect of reducing arterial plaques. For example, Chinese patent medicines include Yingxinning Capsules, Quyu Xiaoban Capsules, Tongxinluo Capsules, etc., among which the main treatment methods are to invigorate qi and strengthen the spleen, soothe the liver and regulate qi, and remove blood stasis and dredge the meridians. However, at present, traditional Chinese medicine treatment of atherosclerotic diseases, such as chronic coronary syndrome, mostly uses the treatment methods of invigorating qi and activating blood circulation, and removing phlegm and removing blood stasis, which cannot fundamentally solve such problems. Summary of the invention

[0005] In view of the shortcomings of the above-mentioned prior art, the present invention provides a traditional Chinese medicine composition for treating chronic coronary syndrome and eliminating arterial plaques. The composition has a definite therapeutic effect, can treat chronic coronary syndrome, and can eliminate arterial plaques at the same time.

[0006] The present invention also provides a method for preparing a Chinese medicinal composition for treating coronary heart disease and chronic coronary syndrome and eliminating coronary artery and carotid artery plaques.

[0007] The technical solution adopted by the present invention to achieve the above-mentioned purpose is:

[0008] The invention provides a traditional Chinese medicine composition for treating chronic coronary syndrome and relieving coronary artery and carotid artery plaques. The composition comprises the following raw materials by weight: 10-30g of astragalus, 10-18g of celery, 20-40g of cat's eye grass, 6-15g of pinellia, 6-15g of ginseng, 6-15g of cassia twig, 6-15g of kudzu root, 6-15g of dried ginger, 5-15g of cimicifuga, 5-15g of bupleurum, 6-20g of atractylodes, 5-15g of tangerine peel, 6-15g of scutellaria, 12-30g of radix scutellariae, 5-15g of angelica, 5-15g of curcuma, 10-30g of salvia miltiorrhiza and 6-15g of preparatory liquorice.

[0009] Preferably, the raw materials include the following components by weight: 15g of Astragalus, 12g of Lithospermum officinale, 24g of Cat's Eye Grass, 9g of Pinellia ternata, 9g of Ginseng, 9g of Cinnamon Twig, 9g of Pueraria lobata, 9g of Dry Ginger, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes macrocephala, 6g of Tangerine Peel, 9g of Scutellaria baicalensis, 12g of Radix Phellodendri, 6g of Angelica sinensis, 9g of Curcuma aromatica, 12g of Salvia miltiorrhiza, and 9g of Radix Glycyrrhizae Preparata.

[0010] Preferably, the raw material medicine also includes: 10-20g of cat's claw.

[0011] The present invention also provides a method for preparing the above-mentioned Chinese medicine composition, comprising the following steps: weighing the raw medicine for each dose of medicine by weight, soaking it in warm water for 180-360 minutes, adding water to cover the raw medicine by about 1-2 cm, first decocting cat's eye grass for 60 minutes, and then decocting it twice with other raw medicines, the first decoction is boiled for 60-90 minutes, and the second decoction is boiled for 60 minutes, and the two medicinal liquids are combined.

[0012] Another object of the present invention is to provide the use of the above-mentioned Chinese medicine composition in the preparation of medicines for treating chronic coronary syndrome and eliminating coronary artery and carotid artery plaques.

[0013] The idea of ​​using traditional Chinese medicine to eliminate plaques in the present invention is different from previous studies. The present invention believes that the pathological nature of arterial plaques is vascular symptom knots. The generation of symptom knots is initially due to spleen deficiency, which is unable to transport and transform body fluids. Body fluids gather moisture to form phlegm, which accumulates in the body, and then blocks the circulation of qi and blood, which is unfavorable to the blood, and blood stasis is generated internally. Phlegm and blood stasis are mutually bound, and the blood vessels are stagnant to form a solid body, and symptom knots are formed. After a long time, the heat is turned into toxicity, and the heat, toxicity, phlegm and blood stasis are mutually bound. The symptom knots are further aggravated and solid, resulting in a complicated and dangerous condition. For arteriosclerotic plaques, the inventors believe that its pathological mechanism is: qi deficiency symptom knots, heat, toxicity, phlegm and blood stasis are mutually bound. For the treatment of arteriosclerotic plaques, the treatment method of the present invention is: invigorating qi to eliminate symptoms, unblocking yang and dispersing knots to treat the root of symptoms, strengthening the spleen and resolving phlegm, promoting blood circulation and removing blood stasis, and unblocking the meridians to treat the source of symptoms.

[0014] Compared with the prior art, the present invention has significant advantages:

[0015] The present invention is mainly aimed at the regression of arterial plaques to treat chronic coronary syndrome of coronary heart disease. For atherosclerotic plaques, the inventor believes that its pathological mechanism is: Qi deficiency syndrome, heat toxins, phlegm and blood stasis. The treatment method of the present invention is: replenishing Qi and eliminating symptoms, promoting Yang and dispersing knots to treat the root of the syndrome, strengthening the spleen and resolving phlegm, promoting blood circulation and removing blood stasis, unblocking the meridians to treat the source of the syndrome, and preventing the progression of arteriosclerosis. Among the Chinese patent medicines currently used for the treatment of coronary heart disease, most of them use replenishing Qi and promoting blood circulation as the treatment method, which is different from the intention and composition of this prescription.

[0016] (I) Formula analysis:

[0017] Main medicine: Astragalus 15g, Lithospermum officinale 12g, Cat's eye grass 24g, Pinellia 9g (to replenish qi and eliminate symptoms)

[0018] The present invention believes that the pathological mechanism of arterial plaque is qi deficiency and stagnation, so the fundamental treatment should be to invigorate qi and eliminate symptoms, promote yang and disperse stagnation. Therefore, the Chinese medicine composition of the present invention adds astragalus, lichen plantain, cat's eye herb, and pinellia tuber as the main medicine to exert the effect of invigorating qi and eliminating symptoms.

[0019] Astragalus is sweet, slightly warm, and enters the spleen and lung meridians. Astragalus replenishes vital energy, nourishes the five internal organs, regulates blood vessels without hindering stagnation, and can also support toxins and discharge pus. "Compendium of Materia Medica" says: "Astragalus... is the best of all qi-tonifying medicines, and is known as the best." "Compendium of Materia Medica" says: "It is a medicine that nourishes the lungs and spleen, protects the body from sweating, and drives away wind and poison." Lithospermum officinale tastes pungent and bitter, is slightly cold, and has the effects of clearing away heat and detoxifying, dispersing carbuncle and reducing swelling. "Shennong's Materia Medica" says: "It is mainly used for accumulation in the heart and abdomen, cold and hot evil spirits, and opens the nine orifices." "Compendium of Materia Medica" says: "It treats blood accumulation in the intestines, carbuncle and various sores." "Changsha Yaojie" says: "It eliminates chest lumps and stops pain in the lungs." Cat's eye grass tastes bitter, is slightly cold, and enters the lung, bladder, and liver meridians. It has the effects of removing phlegm and dispersing lumps, expelling water and removing toxins. "Shandong Chinese Herbal Medicine Handbook" says: "It expels water, detoxifies and disperses lumps." Pinellia is pungent in taste and warm in nature. It enters the spleen, stomach and lung meridians and has the effects of drying dampness and resolving phlegm, descending adverse qi and stopping vomiting, and eliminating lumps and dispersing masses. "Ming Yi Bie Lu" states: "It is mainly used to eliminate phlegm and heat in the heart, chest and diaphragm, acute pain and hard masses under the heart, vomiting and nausea due to seasonal qi, and eliminate carbuncle and swelling." "De Pei Ben Cao" states: "It can benefit the orifices and harmonize the stomach, and connect yin and yang. It is a holy medicine for removing dampness, resolving phlegm, relieving depression and stopping vomiting, removing goiter, eliminating lumps and masses, treating palpitations and stopping malaria." The present invention uses four medicines, namely, Radix Astragali, Herba Lithospermi, Herba Cat's Eyes and Herba Pinelliae as the main ingredients. Radix Astragali is mainly used to replenish qi and tonify deficiency, while Herba Lithospermi, Herba Cat's Eyes and Herba Pinelliae are mainly used to clear away heat and resolve phlegm, dispersing masses and eliminating symptoms.

[0020] Assistant drugs: ginseng 9g, cinnamon twig 9g, kudzu root 9g, dried ginger 9g, cimicifuga 6g, bupleurum 6g (to promote yang and detoxify)

[0021] The invention adds ginseng, cinnamon twig, kudzu root, dried ginger, cimicifuga and bupleurum as ministerial drugs to exert the effect of promoting yang and detoxifying. Ginseng, cinnamon twig, kudzu root and dried ginger warm yang, invigorate qi and promote yang, while cimicifuga and bupleurum can detoxify and promote yang.

[0022] Ginseng tastes sweet and slightly bitter, is slightly warm in nature, and enters the spleen and lung meridians. It has the effects of greatly replenishing vital energy, replenishing the spleen and lungs, strengthening qi and strength, unblocking blood vessels, and breaking up hard masses. "Shennong's Herbal Classic": "It mainly replenishes the five internal organs, calms the spirit, stabilizes the soul, stops panic, removes evil spirits, improves eyesight, and makes people happy and intelligent." "Bencao Jing Jizhu": "It treats coldness in the stomach and intestines, heart and abdominal pain, chest and flank fullness, cholera vomiting, regulates the middle, stops thirst, unblocks blood vessels, and breaks up hard masses." Cinnamon twig tastes spicy and sweet, is warm in nature, and enters the heart, lung, and bladder meridians. It has the effects of harmonizing the Ying and Wei, warming the meridians and promoting yang. "Shennong's Herbal Classic": "It is used to treat cough and reverse breathing, throat numbness caused by qi stagnation, vomiting and inhalation, benefits joints, replenishes the middle and replenishes qi." "Famous Doctors' Records": "It mainly treats heart pain, flank wind, flank pain, warms the tendons and unblocks the meridians, stops restlessness, and sweats." "Changsha Yaojie": "It can raise the clear yang and dislodge the depression, lower the turbid yin and reverse the reverse, relax the acute contraction of tendons and veins, relieve the obstruction of joints, enter the liver and gallbladder to disperse the depression, extremely stop pain, open the meridians and relieve the numbness, and even remove dampness and cold". Pueraria root tastes sweet and pungent, is cool in nature, and belongs to the spleen and stomach meridians. It has the effects of raising yang and clearing rashes, detoxifying and dredging the meridians. "Shennong's Herbal Classic": "It can cure thirst, fever, vomiting, all kinds of numbness, raise yin qi, and relieve all kinds of poisons". "Changsha Yaojie": "It can relieve the obstruction of meridian qi, clear the dryness and heat of the stomach, reach depression and stop diarrhea, lower the reverse and calm asthma". Dried ginger tastes pungent and is hot in nature. It belongs to the spleen, stomach, heart, and lung meridians. It has the effects of warming yang and dispersing cold, opening knots and relieving pain. "Famous Doctors' Records": "It is mainly used to treat cold abdominal pain, nausea, cholera, fullness, wind evil poison, and gas between the skin". "Depei Materia Medica": "It is used to treat phlegm and food stagnation, vomiting, diarrhea, cholera, convulsions, pains caused by cold and dampness, abdominal distension, yin and cold poisons, and blood stasis."

[0023] Cimicifuga is pungent and sweet in taste, slightly cold in nature, and enters the lung, spleen, large intestine, and stomach meridians. It has the effects of clearing away heat and detoxifying, and raising yang and clearing rashes. "Shennong's Herbal Classic": "It is mainly used to detoxify all kinds of poisons, kill all kinds of old things and evil spirits, and ward off febrile diseases and evil poisons." "Changsha Yaojie": "It is good for the throat and relieves pain, reduces swelling and toxins, and discharges pus and blood." "Depei Materia Medica": "It eliminates sores and carbuncles, and detoxifies all kinds of poisons." Bupleurum is bitter and pungent in taste, slightly cold in nature, and enters the pericardium, liver, triple burner, and gallbladder meridians. It has the effects of soothing the liver and relieving depression, and raising yang energy. "Shennong's Herbal Classic": "It is used to treat the heart and abdomen, remove gas in the stomach and intestines, food accumulation, cold and heat evil spirits." "Mingyi Bielu": "It is mainly used to eliminate typhoid fever, heart irritability, phlegm and heat, evil in the chest, wandering qi between the five internal organs, water swelling in the large intestine, and dampness and stiffness." "Depei Materia Medica": "It promotes the flow of qi and blood, disperses depression and regulates menstruation, raises yang energy, and balances the fire."

[0024] Auxiliary drugs: Atractylodes macrocephala 9g, dried orange peel 6g (strengthening spleen qi), Scutellaria baicalensis 9g, Radix Phellodendri 12g (lowering lung qi), Angelica sinensis 6g, Curcuma aromatica 9g, Salvia miltiorrhiza 12g (promoting blood circulation and removing blood stasis, unblocking meridians)

[0025] The present invention adds Atractylodes macrocephala, dried orange peel, Scutellaria baicalensis, Radix Paeoniae Alba, Angelicae Sinensis, Curcuma Radix, and Salviae Miltiorrhizae as adjuvants to dissipate phlegm and remove blood stasis, and unclog the meridians to treat the source of the symptoms. Atractylodes macrocephala and dried orange peel are used together to strengthen the spleen qi, Scutellaria baicalensis and Radix Paeoniae Alba lower the lung qi, and Angelicae Sinensis, Curcuma Radix, and Salviae Miltiorrhizae are used to promote blood circulation and remove blood stasis, and unclog the meridians.

[0026] Atractylodes macrocephala tastes bitter and sweet, is warm in nature, and belongs to the spleen and stomach meridians. It has the effects of replenishing qi and strengthening the spleen, resolving phlegm and removing dampness. "Compendium of Materia Medica" says: "It can eliminate the urgent fullness under the heart, cholera, and vomiting and diarrhea, benefit the blood between the waist and navel, benefit body fluids, warm the stomach, digest food, and make people eat more." "Leigong Paoyao Yaoxing Jie" says: "It can remove dampness and benefit the water channel, and strengthen the spleen and stomach after eating." Tangerine peel tastes pungent and bitter, is warm in nature, and belongs to the spleen and lung meridians. It has the effects of regulating qi, regulating the middle, and removing dampness and resolving phlegm. "Compendium of Materia Medica" says: "It is mainly used to treat chest heat and reverse qi, benefit water and food, lower qi, stop vomiting and coughing, remove bladder heat, lower water retention, five stranguria, and promote urination. It is mainly used to treat spleen inability to digest food, vomiting and reversal of qi in the chest, cholera, stop diarrhea, and remove inch white." "Depei Materia Medica" says: "It can guide stagnation and eliminate phlegm, regulate the middle and fast diaphragm, move stomach qi, benefit water and food, stop vomiting and reversal, clear five stranguria, remove bladder heat, remove inch white worm poison, and resolve fish smell poison."

[0027] Scutellaria baicalensis is bitter in taste and cold in nature. It enters the lung, gallbladder, stomach and large intestine meridians and has the effects of clearing away heat and dampness, purging fire and detoxifying. "Ming Yi Bie Lu" states: "It is mainly used to treat phlegm heat, heat in the stomach, colic in the lower abdomen, digestion of food, benefiting the small intestine, blood retention, stranguria, bleeding in women, and abdominal pain in children." "De Pei Materia Medica" states: "It purges the triple-burner fire, removes evil heat on the skin surface, benefits qi stagnation, eliminates phlegm in the diaphragm, relieves throat fishy smell, dissolves rashes, treats sores, clears intestinal stasis, stops heat and pain, cools blood and stabilizes pregnancy." Bai Qian tastes pungent and sweet, is neutral in nature, enters the lung meridian, and has the effects of descending qi and removing phlegm. "Bencao Jing Jizhu" states: "It tastes sweet, slightly warm, and non-toxic. It is mainly used to treat chest and flank reversal of qi, cough and shortness of breath." "Changsha Yao Jie" states: "It tastes sweet and pungent, and enters the Taiyin lung meridian of the hand. It descends the reversal of qi and stops cough, breaks up obstructions and clears phlegm."

[0028] Angelica sinensis is sweet and spicy, warm in nature, and enters the liver, heart, and spleen meridians. It has the effects of nourishing blood, activating blood circulation, reducing swelling and relieving pain.

[0029] "Famous Doctors' Records": "It tastes spicy, warm, and non-toxic. It warms the middle, relieves pain, removes the blockage of foreign blood, treats stroke, sweating, dampness, nausea, foreign qi deficiency and coldness, replenishes the five internal organs, and regenerates muscles." "Depei Materia Medica": "It promotes blood circulation and regulates blood, nourishes the body and regulates qi, removes wind and dispels cold, treats malaria, dysentery, pox, carbuncle, sores, and ulcers, relieves headaches, and pains in the heart, abdomen, waist, spine, limbs, tendons and bones. All of them have the effect of promoting blood circulation." Curcuma is spicy and bitter, and cold in nature. It has the effects of promoting blood circulation and relieving pain, promoting qi and relieving depression. "Ben Cao Jing Jie": "It has cold qi, spicy taste, and is non-toxic. It mainly treats blood stagnation, descends qi, regenerates muscles and stops bleeding, breaks bad blood, blood stranguria, hematuria, and wounds." "Depei Materia Medica": "It cools the heart, dispels depression, breaks blood and descends qi. It treats blood and qi pains in the heart and abdomen, retrograde meridians in women, vomiting blood and bleeding, postpartum blood rushing to the heart, insanity, phlegm blocking the mind, pox poison entering the heart, and picking out poisonous poison." Danshen tastes bitter and is slightly cold in nature. It enters the heart, pericardium, and liver meridians and has the effects of promoting blood circulation and removing blood stasis, cooling blood and eliminating carbuncle. "Shennong's Herbal Classic": "It tastes bitter and is slightly cold. It treats evil qi in the heart and abdomen, rumbling in the intestines like running water, cold and heat accumulation, breaks up tumors and removes masses, stops restlessness and fullness, and replenishes qi." "Bencao Jingjie": "It has a slightly cold air, bitter taste, and is non-toxic. It treats evil qi in the heart and abdomen, rumbling in the intestines like running water, cold and heat accumulation, breaks up tumors and removes masses, stops restlessness and fullness, and replenishes qi."

[0030] Adjuvant drug: Roasted Licorice

[0031] Roasted licorice root: sweet and mild in taste, it enters the heart, lung, spleen and stomach meridians. It can nourish the heart qi, replenish qi and restore the pulse. At the same time, it is good at entering the middle burner, replenishing the spleen and replenishing qi. "Bencao Zheng" says: "It helps ginseng and Astragalus to achieve the effect of qi deficiency."

[0032] The whole prescription uses Astragalus, Lithospermum officinale, Herba Cat's Eyes, and Pinellia as the main ingredients to invigorate the spleen and replenish Qi, eliminate symptoms and resolve knots; Ginseng, Cinnamon Twig, Pueraria lobata, Dry Ginger, Cimicifuga heracleifolia, and Radix Bupleuri as the assistant ingredients to invigorate Qi, promote Yang, resolve toxins, and resolve knots; Atractylodes macrocephala, Tangerine peel, Scutellaria baicalensis, Radix Paeoniae Alba, Angelica sinensis, Curcuma aromatica, and Salvia miltiorrhiza as the auxiliary ingredients to dry out dampness and resolve blood stasis, and activate blood circulation to remove the source of symptoms and knots; Licorice is the messenger to harmonize the various herbs. The whole prescription focuses on invigorating Qi, eliminating symptoms, promoting Yang and resolving knots in order to fundamentally resolve plaques, while adding phlegm-resolving, blood-clearing, and blood-activating herbs to treat the source of symptoms and knots, which is different from the compatibility of conventional prescriptions and herbs.

[0033] (II) Modern pharmacological research

[0034] (1) Astragalus

[0035] Modern pharmacological studies have found that Astragalus has anti-inflammatory and antioxidant effects, reduces myocardial fibrosis, inhibits cell apoptosis, and maintains the relaxation and contraction of myocardial cells by reducing sarcoplasmic reticulum Ca2+ overload. Astragalus can improve hyperlipidemia by regulating lipid metabolism. Astragalus can significantly reduce lipogenesis, improve lipolysis and the β-oxidation process of lipids in liver tissue, significantly reduce serum TG, TC, and low-density lipoprotein cholesterol levels, and increase serum high-density lipoprotein cholesterol levels.

[0036] (2) Ishimizu

[0037] Modern pharmacological research has found that Lithospermum officinale has an antioxidant effect, which can enhance the antioxidant capacity of tissues, reduce lipid peroxidation, and protect cell membranes from damage. The polysaccharide components in Lithospermum officinale have anti-tumor effects and can inhibit the growth of cancer cells.

[0038] (3) Cat's eye grass

[0039] Modern pharmacological research has found that cat's eye grass has antioxidant, antibacterial and anti-tumor effects. Its anti-tumor effect is related to inducing tumor cell apoptosis and inhibiting tumor cell proliferation.

[0040] (4) Pinellia

[0041] Modern pharmacological studies have found that Pinellia has anti-inflammatory, antioxidant and anti-tumor effects, and its anti-inflammatory mechanism may be related to the inhibition of inflammatory factors such as TNF-α, 5-hydroxytryptophan (5-HT) and prostaglandin (PG) E2. Pinellia can scavenge superoxide anion free radicals, hydroxyl free radicals and DPPH. Pinellia acidic polysaccharides can induce dose-dependent apoptosis of Hep G2 cells through S phase arrest. The fat-soluble extract of Pinellia can significantly increase the apoptosis and necrosis percentage of HPV+TC-1 cells in vitro, and can directly inhibit tumor growth and resistance to ischemic necrosis in vivo.

[0042] (5) Ginseng

[0043] Modern pharmacological research has found that the effective active ingredients of ginseng have a protective effect on cardiovascular and cerebrovascular diseases, among which ginsenosides are the main components. Ginsenosides have a significant protective and improving effect on cerebral perfusion re-ischemia, Alzheimer's disease memory loss, etc., and have pharmacological effects such as promoting neuronal regeneration and angiogenesis. At the same time, ginsenosides have pharmacological effects such as regulating arrhythmias and improving myocardial ischemia. Ginseng also has a variety of effects such as delaying aging, lowering blood lipids, anti-fatigue, anti-oxidative stress, anti-inflammatory, anti-viral, and protecting the liver.

[0044] (6) Cassia twig

[0045] Modern pharmacological research has found that cinnamon twigs have anti-inflammatory, vasodilation-promoting, diuretic and other pharmacological effects. Cinnamon twig volatile oil has a significant inhibitory effect on chronic and acute inflammatory diseases. Cinnamon twigs can improve cardiovascular function, and cinnamon twig ethanol extract and cinnamaldehyde have the pharmacological effect of promoting vasodilation.

[0046] (7) Pueraria root

[0047] Modern pharmacological studies have found that the main active ingredients of Pueraria root have myocardial protection, reduce insulin resistance, scavenge oxygen free radicals, anti-tumor, neuroprotection, anti-inflammatory, promote osteoblastogenesis and protect the liver. Puerarin can lower blood pressure, prevent myocardial hypertrophy, restore the role of myocardial cell autophagy, delay the progression of myocardial hypertrophy, inhibit myocardial cell apoptosis, stabilize the electrophysiological characteristics of hypertrophic myocardial cells, and relieve arrhythmias. Pueraria root total flavonoids can inhibit the proliferation of vascular smooth muscle cells (VSMC) stimulated by oxidized low-density lipoprotein (ox-LDL) and recombinant human platelet-derived growth factor-BB (PDGF-BB), and can also weaken the osteoblast differentiation of VSMC, thereby reducing AS calcification.

[0048] (8) Dried ginger

[0049] Modern pharmacological studies have found that dried ginger has the function of protecting myocardial cells. Substances such as 6-gingerol and 10-gingerol in dried ginger can repair and protect myocardial cell damage by increasing SERCA activity and myocardial cell vitality. Studies have found that turmeric ketones have the ability to inhibit bioactive anti-factor Xa levels and anti-platelet aggregation activity.

[0050] (9) Cimicifuga

[0051] Modern pharmacological studies have found that the active ingredients in Cimicifuga can increase the activity of superoxide dismutase and reduce the NO content, thereby inhibiting the secretion of inflammatory factors such as interferon-γ and interleukin-6. The active ingredients in Cimicifuga can selectively act on tumor cells, inhibiting the levels of cyclin B1 and dependent protein kinase 1, causing cycle arrest during division, inhibiting the expression of cyclooxygenase-2, and inducing the occurrence of apoptosis, or by damaging mitochondria to reduce membrane potential, triggering a Caspase cascade reaction to induce endogenous cell apoptosis.

[0052] (10) Bupleurum

[0053] The active ingredients of Bupleurum can protect the heart by regulating apoptosis signaling pathways and oxidative stress responses. Isorhamnetin can reduce the apoptosis rate of rat cardiomyocytes, improve cell viability, regulate the expression of cardiomyocyte autophagy and apoptosis pathways, and thus reduce myocardial damage. Isorhamnetin can also reduce reactive oxygen species, prevent myocardial hypertrophy and myocardial fibrosis. Quercetin has a protective effect on myocardial toxicity, and its mechanism of action may be related to inhibiting mitochondrial autophagy, reducing mitochondrial ROS production, and promoting ATP synthesis. Bupleurum saponin a can prevent and treat thrombus formation by inhibiting thrombin activity and inhibiting α1 adrenergic receptors, thereby reducing the generation of insoluble fibrin and vasodilation. It can also improve endothelial viability, inhibit endothelial cell oxidative stress and ferroptosis, and thus prevent and treat the occurrence and development of atherosclerosis.

[0054] (11) Atractylodes macrocephala

[0055] Modern pharmacological studies have found that atractylodes lactone, an extract of Atractylodes macrocephala, can inhibit the expression of inflammatory mediators and inflammatory factors, effectively exert anti-inflammatory activity, and reduce the body's inflammatory response. The active ingredients of Atractylodes macrocephala also have anti-tumor effects. Atractylodes lactone II can inhibit the expression of p-PI3K in macrophages, promote the polarization of M1 macrophages, regulate the tumor microenvironment, and inhibit further proliferation and changes of cancer cells. Atractylodes macrocephala can also effectively regulate the body's immune function and maintain the stability of the body's internal environment. Atractylodes macrocephala polysaccharides can significantly reduce the expression levels of thymus tissue-related inflammatory factors IL-1β, TNF-α, IL-6, and IL-10, and increase the relative expression levels of SOD and CAT mRNA and the relative expression levels of Bcl-2 protein.

[0056] (12) Tangerine peel

[0057] Modern pharmacological studies have found that tangerine peel and its extracts have the effect of regulating blood vessels. Nobiletin can inhibit PE-induced endothelial stripping rat aorta contraction by activating cGC and opening KATP channels through cGMP-independent pathways to increase intracellular cGMP content. Tangerine peel extracts and monomers hesperidin, naringenin, hesperidin and their derivatives can regulate blood vessels through platelet aggregation, anticoagulation and other pathways. Among them, hesperidin can inhibit arachidonic acid-induced serotonin secretion to achieve anti-platelet aggregation. Tangerine peel active ingredients hesperidin, nobiletin, baicalin, scutellariae tetramethyl ether, and sweet orange have anti-angiogenic effects.

[0058] (13) Scutellaria baicalensis

[0059] Modern pharmacological studies have found that Scutellaria baicalensis has anti-inflammatory, antibacterial, antioxidant and anti-tumor effects. Baicalin can inhibit the expression of tumor necrosis factor-α, interleukin-β, and interleukin-6, and play an anti-inflammatory role. Baicalin can damage the cell membrane of Escherichia coli, increase the permeability of the cell membrane, and cause the substances in the bacteria to extravasate and the bacterial DNA to escape, thereby playing an antibacterial role. Baicalin not only has an inhibitory effect on xanthine oxidase, but also can directly scavenge oxygen free radicals, and is a good antioxidant. The flavonoids in Scutellaria baicalensis achieve anti-tumor effects by regulating the cyclooxygenase pathway and lipoxygenase pathway related to the arachidonic acid system.

[0060] (14)Bai Qian

[0061] Modern pharmacological studies have found that whitehead has anti-inflammatory, analgesic, anti-tumor, and anti-thrombotic pharmacological effects. The ethanol extract of whitehead can significantly prolong the latency of the tail-flick reaction to thermal pain stimulation, reduce the number of twisting reactions caused by acetic acid, and inhibit ear swelling caused by xylene and plantar swelling caused by carrageenan. The active ingredients of whitehead can induce G1 phase arrest to upregulate the expression levels of Caspase-3, Caspase-9, and Bax, and downregulate the expression level of Bcl-2, thereby exerting an anti-tumor effect.

[0062] (15) Angelica

[0063] Modern pharmacological studies have found that angelica has pharmacological effects such as anticoagulation, angiogenesis regulation, anti-inflammatory, anti-oxidation, antihypertensive, and anti-atherosclerotic. Ferulic acid, the active ingredient of angelica, has a significant antithrombotic effect, and its antithrombotic effect may be related to improving coagulation function and platelet aggregation and adhesion function. Angelica extract can promote angiogenesis by promoting the expression of vascular endothelial growth factor, p38 and c-Jun amino-terminal kinase 1 / 2. Angelica mainly inhibits the release of inflammatory mediators by blocking the expression of related proteins and genes in the inflammatory signaling pathway and nuclear translocation, and reduces the immune activity of immune cells to exert anti-inflammatory effects. Angelica can exert antioxidant effects by inhibiting and scavenging free radicals and increasing the activity of antioxidant enzymes.

[0064] (16) Turmeric

[0065] Modern pharmacological studies have found that the active ingredients of Curcuma can inhibit platelet aggregation in the body, improve blood circulation, regulate lipid metabolism, plasma lipoproteins, platelet activation, oxidative stress, and apoptosis to regulate cardiovascular function. β-elemene in Curcuma extract can regulate transcription factors NF-κB and STAT3, thereby inhibiting the further development of inflammation and tumors. Curcuma ethyl acetate extract has significant anti-inflammatory and analgesic effects on acute inflammation, and has a certain dose-related effect. Its mechanism of action is related to the inhibition of TNF-α.

[0066] (17) Salvia miltiorrhiza

[0067] Modern pharmacological studies have found that salvianolic acid A, the active ingredient of Danshen, can reduce the activity of HMGCR, achieve HMGCR ubiquitination, inhibit the level of inflammation, and thus reduce the formation of AS. Tanshinone I protects against oxidative stress and oxidative stress-induced cardiomyocyte apoptosis in vivo and in vitro by activating Nrf2 and inhibiting MAPK signaling. Tanshinone II A can induce the synthesis of H2S synthase cystathionine γ-lyase (CES) by activating the estrogen receptor (ER) and cAMP signaling pathways, stimulate the production of endogenous H2S, and reduce acrolein-induced endothelial cell damage. Salvianolic acid B can inhibit adenosine diphosphate (ADP)-induced platelet aggregation, significantly prolong prothrombin time (PT) and activated partial thromboplastin time (APTT), produce an in vitro anticoagulant effect, and inhibit thrombus formation through the NF-κB / JNK / p38MAPK signaling pathway.

[0068] The beneficial effects of a traditional Chinese medicine composition for treating chronic coronary syndrome and eliminating coronary artery and carotid artery plaques provided by the present invention are:

[0069] The present invention mainly aims at the regression of plaques and is the fundamental method for treating plaques and coronary heart disease. It treats the root of symptoms by invigorating Qi and eliminating symptoms, promoting Yang and dispersing nodules, and treats the source of symptoms by invigorating the spleen and resolving phlegm, promoting blood circulation and removing blood stasis, and unblocking meridians. It is suitable for patients with coronary artery plaques and carotid artery plaques. DETAILED DESCRIPTION

[0070] The beneficial effects of the Chinese medicine composition of the present invention are further illustrated below through clinical trial data and specific examples.

[0071] Clinical study on Tongyang Sanjie Decoction in treating coronary heart disease and regressing coronary and carotid artery plaques

[0072] This study observed 40 patients with coronary atherosclerotic heart disease and carotid atherosclerosis. On the basis of conventional Western medicine treatment, they were treated with Tongyang Sanjie Decoction with modifications. The treatment effects were followed up clinically and the results were compared.

[0073] 1. Diagnostic Criteria

[0074] 1. TCM diagnostic criteria

[0075] TCM diagnostic criteria: formulated in accordance with the "Guidelines for Clinical Research of New Chinese Medicines". Syndrome differentiation criteria for chest pain, qi deficiency syndrome, heat toxicity, phlegm and blood stasis syndrome:

[0076] Main symptoms: chest tightness, chest pain; Secondary symptoms: palpitations, shortness of breath, fatigue, heaviness, sputum; Tongue: dark purple tongue, greasy coating; Pulse: deep and slippery pulse or deep and astringent pulse. The diagnosis can be made if one of the two main symptoms is met and ≥ 2 of the secondary symptoms are met, and the tongue and pulse are consistent.

[0077] (II) Western medicine diagnostic criteria

[0078] Western medicine diagnostic criteria: formulated with reference to the "Guidelines for the Diagnosis and Treatment of Stable Coronary Heart Disease" and "Guidelines for the Diagnosis and Treatment of Carotid Artery Stenosis" issued by the Chinese Medical Association's Cardiology Branch in 2018:

[0079] 1. Chest discomfort caused by myocardial ischemia is usually located behind the sternum, and can spread to the precordial area, with a palm-sized area, or even across the chest, with unclear boundaries. It often radiates to the left shoulder, the inner side of the left arm, the ring finger and little finger, or to the neck, pharynx or mandible.

[0080] 2. Chest pain often feels like oppression, stuffiness, tightness, or heaviness in the chest, sometimes described as a stranglehold on the neck or a burning sensation behind the sternum, but not like sharp pain like pins and needles or a knife. It may be accompanied by dyspnea, as well as nonspecific symptoms such as fatigue or weakness, dizziness, nausea, restlessness, or a sense of impending death. Dyspnea may be the only clinical manifestation of SCAD, and it is sometimes difficult to distinguish from shortness of breath caused by lung disease. When chest pain occurs, patients are often forced to stop ongoing activities until the symptoms are relieved.

[0081] 3. It usually lasts from a few minutes to more than 10 minutes, 3-5 minutes in most cases, and rarely exceeds 30 minutes. If the symptoms only last for a few seconds, it is likely not related to angina pectoris.

[0082] 4. An important feature of angina pectoris is that it is associated with fatigue or emotional excitement. Angina pectoris is often induced when the load increases, such as walking on a slope, walking against the wind, after a full meal, or when the weather turns cold. The pain often occurs when one is tired or excited, rather than after the fatigue. Sublingual nitrates can often relieve angina pectoris within minutes.

[0083] 5. Electrocardiogram showing ischemic changes or positive exercise stress test or confirmed by coronary CTA or coronary angiography.

[0084] 6. Carotid atherosclerosis was diagnosed by measuring carotid intima-media thickness, plaque size, systolic peak velocity, peak velocity ratio between the lesion site and the proximal end of the lesion, pulsatility index and other hemodynamic parameters through ultrasound.

[0085] The diagnosis can be made based on the above clinical symptoms and auxiliary examinations.

[0086] 2. Symptom Quantification Standards

[0087] (I) TCM symptom scoring criteria

[0088] TCM single symptom efficacy score and TCM syndrome efficacy assessment standard: formulated in reference to the "Guidelines for Clinical Research of New Chinese Medicines for the Treatment of Chest Pain (Angina Pectoris due to Coronary Heart Disease)" and the "Guidelines for Clinical Research of New Chinese Medicines".

[0089] The TCM symptom efficacy score is 0, 2, 4, or 6 for the main symptoms and 0, 1, 2, or 3 for the secondary symptoms.

[0090] 1. Chest tightness:

[0091] 0 points: None.

[0092] 2 points: Occasionally feel chest tightness, the symptoms are mild and can be relieved on their own.

[0093] 4 points: Chest tightness occurs frequently, but does not affect life and work.

[0094] 6 points: Chest tightness and shortness of breath, seriously affecting life and work.

[0095] 2. Chest pain:

[0096] 0 points: None.

[0097] 2 points: There are typical angina attacks, each lasting several minutes, with pain occurring at least 2-3 times a week, or 1-3 times a day, occasionally requiring nitroglycerin for relief.

[0098] 4 points: There are several attacks of angina pectoris every day, which can last from a few minutes to about 10 minutes and usually require nitroglycerin to relieve.

[0099] 6 points: There are multiple typical angina attacks every day, which affect daily life activities. Each attack lasts for a long time and requires multiple oral nitroglycerin to relieve symptoms.

[0100] 3. Dizziness

[0101] 0 points: None.

[0102] 2 points: Occasional dizziness, mild symptoms that can be relieved on their own.

[0103] 4 points: Dizziness occurs frequently, but does not affect life and work.

[0104] 6 points: Obvious dizziness, seriously affecting life and work.

[0105] 4. Palpitations:

[0106] 0 points: None.

[0107] 1 point: Palpitations easily occur after exertion.

[0108] 2 points: Palpitations after normal activities.

[0109] 3 points: Palpitations occur even when one is not active.

[0110] 5. Shortness of breath:

[0111] 0 points: None.

[0112] 1 point: Shortness of breath after exertion.

[0113] 2 points: Shortness of breath after normal activities.

[0114] 3 points: Feeling short of breath even when not physically active.

[0115] 6. Fatigue:

[0116] 0 points: None.

[0117] 1 point: Easy to feel tired after exertion.

[0118] 2 points: Feeling tired after usual activities.

[0119] 3 points: Feeling weak even without regular physical activity.

[0120] 7. Feeling heavy:

[0121] 0 points: None.

[0122] 1 point: The body tends to feel heavy after exertion.

[0123] 2 points: Feeling of heaviness after normal activities.

[0124] 3 points: Usually feel heavy and don't like to move.

[0125] 8. Coughing up phlegm

[0126] 0 points: None.

[0127] 1 point: A small amount of sputum

[0128] 2 points: Occasional cough with sticky phlegm

[0129] 3 points: Coughing up a lot of sticky phlegm

[0130] 9. Tongue:

[0131] 0 points: red tongue with thin white coating.

[0132] 1 point: dark red tongue with white coating.

[0133] 2 points: dark red tongue with greasy white fur, petechiae, greasy white fur, and tortuous sublingual veins. 3 points: dark purple tongue with petechiae, greasy white fur, and obvious tortuous sublingual veins.

[0134] 10. Pulse:

[0135] 0 points: The pulse is harmonious.

[0136] 1 point: deep or weak pulse.

[0137] 2 points: The pulse is deep and slightly astringent or slightly slippery.

[0138] 3 points: The pulse is deep, sluggish or slippery.

[0139] 3. Case Selection Criteria

[0140] 1. Case inclusion criteria

[0141] (1) Patients who meet the Western medicine diagnostic criteria of the "Guidelines for the Diagnosis and Treatment of Stable Coronary Heart Disease";

[0142] (2) Patients who meet the diagnostic criteria for qi deficiency syndrome, heat, toxicity, phlegm and blood stasis syndrome;

[0143] (3) Female or male patients aged ≥18 years;

[0144] (4) After understanding the risks of the trial in detail, sign the risk informed consent form.

[0145] (II) Case Exclusion Criteria

[0146] (1) Those who do not meet the diagnosis of coronary artery atherosclerosis and carotid artery atherosclerosis;

[0147] (2) Patients whose TCM diagnosis does not identify them as qi deficiency syndrome or syndrome of heat, toxicity, phlegm and blood stasis;

[0148] (3) patients with severe liver and kidney dysfunction, or severe, life-threatening diseases of other organs, such as acute pulmonary embolism, aortic dissection, malignant arrhythmia, acute myocardial infarction, etc.;

[0149] (4) Those aged less than 18 years;

[0150] (5) The subjects are pregnant or lactating women, have allergic constitutions, or are allergic to multiple drugs.

[0151] 3. Case dropout, exclusion and termination of observation criteria

[0152] (1) Patients who experience severe adverse reactions or serious complications during the trial;

[0153] (2) Patients who voluntarily request to withdraw from the trial or fail to take medication as required;

[0154] (3) Patients who are unable to follow the study protocol and have poor compliance.

[0155] 4. Research content and methods

[0156] (I) Enrollment method

[0157] Patients with coronary atherosclerotic heart disease and carotid atherosclerosis who visited the Department of Cardiovascular Diseases IV, Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1, 2023 to September 30, 2024, and whose symptoms were qi deficiency, heat, toxicity, phlegm and blood stasis, were included.

[0158] (II) Treatment methods

[0159] Refer to the "Guidelines for the Diagnosis and Treatment of Stable Coronary Heart Disease" and "Guidelines for the Diagnosis and Treatment of Carotid Artery Stenosis" for reasonable use of standardized treatment:

[0160] 1. Drugs for relieving symptoms and improving ischemia: They were used differently according to the basic conditions of the subjects. Beta-blockers: Metoprolol succinate sustained-release tablets (AstraZeneca Pharmaceuticals Co., Ltd., national medicine standard number J20150044,) 47.5 mg / time, once a day; calcium channel blockers: Amlodipine besylate tablets (Pfizer Pharmaceuticals Co., Ltd., national medicine standard number H10950224) 5 mg / time, once a day; nitrate drugs: Isosorbide mononitrate tablets (Lunan Beite Pharmaceuticals Co., Ltd., national medicine standard number H10940039) 20 mg / time, twice a day; Nitroglycerin tablets (Beijing Yimin Pharmaceuticals Co., Ltd., national medicine standard number H11021022) 0.5 mg, oral, used when necessary.

[0161] 2. Antiplatelet therapeutic drugs: Enteric-coated aspirin tablets (Bayer Healthcare Co., Ltd., National Medicine Approval No. J20130078) 0.1g / time, once a day; those who are intolerant can switch to clopidogrel (Sanofi Pharmaceuticals Co., Ltd., National Medicine Approval No. J20180029) 75mg / time, once a day.

[0162] 3. Statins: Rosuvastatin calcium tablets (AstraZeneca Pharmaceuticals Co., Ltd., National Medicine Approval No. J20120006) 10 mg / time, once / d.

[0163] On the basis of the above-mentioned conventional western medicine treatment, Tongyang Sanjie Decoction was taken, which consisted of the following ingredients: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Tangerine Peel, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of Radix Phellodendri, 24g of Herba Cat's Eyes, 9g of Curcuma, 9g of Drynaria, 9g of Drynaria, 12g of Salvia miltiorrhiza, 9g of Cinnamon Twig, and 9g of Radix Glycyrrhizae Preparata. The ingredients were added or subtracted according to the changes in the patient's symptoms.

[0164] The above Chinese medicines are all from the Chinese medicine pharmacy of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.

[0165] Decoction method: Weigh the raw materials for each dose of medicine by weight, soak in warm water for 360 minutes, add water to cover the medicine by about 1-2 cm, boil the cat's eye grass first and then decoct for 60 minutes, add the remaining medicine and decoct twice, boil each time and decoct for about 60 minutes, combine the two medicinal liquids to a total of 400 ml, take warm 2 hours after breakfast and dinner, 200 ml each time, one dose per day.

[0166] Take the medicine continuously for 6 months.

[0167] (III) Observation indicators

[0168] Compare the blood lipid levels of patients before and after treatment: cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) levels were measured before and after treatment.

[0169] The degree of coronary artery stenosis adopts a universal method, that is, the relative normal lumen diameter at the proximal end of the stenosis is used as a reference value to quantitatively evaluate the degree of stenosis. The specific calculation formula is: degree of vascular stenosis = (normal vessel diameter at the proximal end of the stenosis - diameter at the stenosis) / normal vessel diameter at the proximal end of the stenosis × 100%.

[0170] Compared with the coronary artery, the carotid artery is superficial and can indirectly evaluate the coronary artery. Carotid plaques have a good predictive value for the degree of coronary artery lesions. Color Doppler ultrasound diagnostic instrument was used to examine carotid plaques. The three diameters of each plaque were measured, and the two diameters with the largest values ​​were selected as the length and width. The two were multiplied and compared to calculate the area of ​​the largest plaque. Carotid Crouse score: The maximum thickness of each plaque (bilateral common carotid artery, carotid artery, carotid bifurcation, internal carotid artery, external carotid artery) was added. The length of each plaque was not analyzed. The sum of the bilateral plaque scores was the total plaque score.

[0171] 4. Clinical efficacy evaluation

[0172] Standards for judging the efficacy of TCM symptoms

[0173] Refer to the coronary heart disease scoring method in the "Guidelines for Clinical Research of New Chinese Medicines" to determine the efficacy of TCM symptoms: efficacy index (N) = (pre-treatment score - post-treatment score) / pre-treatment score * 100%

[0174] Markedly effective: clinical symptoms and signs disappeared or improved significantly, N ≥ 70%;

[0175] Effective: clinical symptoms and signs have improved, 30%≤N<70%;

[0176] Ineffective: clinical symptoms and signs have no significant improvement, or even worsen, N < 30%;

[0177] Aggravation: The original symptoms worsen after treatment, and the total score increases by more than 10% compared with before treatment.

[0178] 5. Statistical methods

[0179] SPSS 26.0 statistical software was used. If the results before and after treatment were in accordance with normal distribution, t test was used. If they were not in accordance with normal distribution, rank sum test was used. P < 0.05 was considered to be significantly different, P < 0.01 was considered to be very significantly different, and P < 0.001 was considered to be extremely significantly different.

[0180] V. General Information

[0181] Among the enrolled patients, there were 29 males and 11 females, with an age range of 36 to 76 years old, and an average age of 55.70±8.33 years old.

[0182] See Table 1.

[0183] Table 1 Gender of patients

[0184]

[0185] VI. Efficacy Analysis

[0186] 1. Comparison of blood lipid levels

[0187] Table 2 Comparison of blood lipid levels before and after treatment ( mmol / L)

[0188]

[0189] Note: Compared with before treatment, ** P<0.01.

[0190] After treatment, TC, TG, and LDL-C levels decreased compared with those before treatment (P < 0.01), see Table 2.

[0191] 2. Comparison of the degree of coronary artery stenosis

[0192] After the trial, 10 patients had complete coronary CTA reports, and the degree of stenosis at each site in the coronary CTA was statistically analyzed.

[0193] Table 3 Coronary artery stenosis degree before and after treatment: M (p25, p75, %)

[0194]

[0195] After treatment, the degree of coronary artery stenosis decreased, with statistical significance (P < 0.01), as shown in Table 3.

[0196] (III) Carotid artery plaque comparison

[0197] After the trial, 35 patients had complete carotid artery color Doppler ultrasound reports, and their carotid artery plaque area and Crouse score were statistically analyzed.

[0198] Table 4 Carotid artery plaque area before and after treatment ( mm 2 )

[0199]

[0200] After treatment, the area of ​​carotid artery plaque was reduced, with statistical significance (P < 0.01), as shown in Table 4.

[0201] Table 5 Carotid artery Crouse score before and after treatment:

[0202]

[0203] After treatment, the carotid artery Crouse score decreased, with statistical significance (P < 0.01), as shown in Table 5.

[0204] (IV) Comparison of TCM symptoms

[0205] Table 6 Comparison of the main TCM symptom scores of patients before and after treatment

[0206]

[0207] Note: Compared with before treatment, & P<0.01.

[0208] After treatment, the symptom scores of chest tightness, chest pain, and dizziness all decreased, with statistically significant differences (P < 0.01), as shown in Table 6.

[0209] Table 7 Comparison of the scores of minor TCM symptoms of patients before and after treatment

[0210]

[0211] Note: Compared with before treatment, & P<0.01, △△ P>0.05.

[0212] After treatment, the scores of shortness of breath, fatigue, heaviness, sputum, tongue and pulse were significantly reduced, with statistical significance (P < 0.01). Although the score of palpitations decreased, it was not statistically significant (P > 0.05), as shown in Table 7.

[0213] Table 8 Evaluation of TCM syndrome efficacy

[0214]

[0215] After patients took Tongyang Sanjie Decoction, the TCM syndrome scores decreased, and the difference was statistically significant (P < 0.01), as shown in Table 8.

[0216] No adverse events occurred during the study, and all subjects completed the trial. Tongyang Sanjie Decoction has high clinical safety.

[0217] It can be seen from the above statistical data that this program has a reliable effect on improving patients' clinical symptoms, eliminating coronary atherosclerotic plaques and carotid artery plaques, and improving patients' quality of life. It is especially suitable for patients with chest pain with symptoms of qi deficiency, heat, toxicity, phlegm and blood stasis.

[0218] Example 1

[0219] Case of coronary atherosclerosis, carotid atherosclerosis and middle cerebral artery balloon angioplasty: Mr. Zhao, male, 51 years old.

[0220] The patient was first diagnosed on April 12, 2023, and was diagnosed with paroxysmal chest tightness and palpitations for 1 year. The patient had chest tightness and palpitations 1 year ago. Coronary angiography showed: LAD: 60-70% stenosis in the middle segment, 90% stenosis of the D1 opening, 90% stenosis of the OM opening, and 50% stenosis in the near middle segment of the RCA. The patient wanted to seek traditional Chinese medicine treatment, so no interventional treatment was performed. Color Doppler ultrasound of the neck showed: atherosclerosis and plaque formation in the bilateral carotid arteries, and atherosclerotic plaque formation in the right subclavian artery. The first diagnosis showed: paroxysmal chest tightness and palpitations, which worsened after activity, chest tightness and palpitations during sleep at night, chest pain sometimes extending to the back, dull pain, lasting for several hours, fatigue, easy fatigue, shortness of breath, dizziness, heartburn, acid reflux, fear of cold, sweating, spontaneous sweating, night sweats, dry mouth, bitter mouth. Appetite and sleep are good, and bowel movements are regular. The tongue is dark red, the tongue coating is yellow and greasy, and the pulse is deep, thin, rapid and astringent. The prescription is formulated according to the conventional method of invigorating qi and activating blood circulation, and invigorating qi and returning to the kidney: 24g of Astragalus, 12g of Ginseng, 15g of Atractylodes, 9g of Angelica, 9g of Tangerine Peel, 9g of Cimicifuga, 9g of Bupleurum, 15g of Amomum, 12g of Aconite, 6g of Vinegar-Based Tortoise Shell, 21g of Phellodendron, 15g of Roasted Licorice, 9g of Prunella Vinegar, 12g of Salvia miltiorrhiza, 18g of Pueraria, 18g of Honeysuckle, 18g of Artemisia Capillaris, 9g of Cinnamon Twig, 14 doses.

[0221] Second visit on April 29, 2023, effective, symptoms: still chest pain with chest tightness, lasting for several hours, easy to dizzy when changing body position, no headache, heartburn, acid reflux. Excessive sweating, spontaneous sweating, cold neck, no dry mouth, bitter mouth, easy fatigue. Appetite and sleep are good, bowel movements are normal. The tongue is dark red, the coating is thin and white, and the pulse is deep, fine and astringent. The treatment should be to invigorate qi and detoxify, to promote yang and disperse the knot. The prescription is Tongyang Sanjie Decoction with modifications, and 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Tangerine Peel, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of White Head, 24g of Cat's Eye Grass, 9g of Curcuma, 9g of Dry Ginger, 9g of Rhizoma Licorice, and 12g of Salvia Miltiorrhiza, 21 doses.

[0222] On the third visit on May 21, 2023, the patient's symptoms were relieved, with symptoms of occasional chest tightness, palpitations relieved, dizziness when changing body position, no headache, sweating, night sweats, cold neck, no dry mouth, bitter mouth, cold food, easy fatigue. Appetite and sleep are good, bowel movements are normal. The tongue is dark red, the coating is thin and white, and the pulse is deep and fine. 12g of cinnamon twig is added to the above prescription to increase the power of warming and promoting heart yang, and 21 doses are given.

[0223] On July 10, 2023, the fourth visit showed symptoms: chest tightness when emotional fluctuations occur, panic rarely, dizziness when body position changes, occasional dull pain on the left side of the head, more secretions in the inner and outer canthi of the eyes, sweating after dryness and heat, night sweats, no dry mouth and bitter mouth, occasional dull pain in the abdomen disappears, and fatigue is easy. Appetite and sleep are good, and bowel movements are normal. Pulse is deep and fine, tongue is dark red, and the fur is white. Prescription Tongyang Sanjie Decoction, Astragalus 16g, Pueraria lobata 10g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 10g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Roasted Licorice 9g, Cinnamon Twig 12g, Salvia miltiorrhiza 18g, Peucedanum 12g, 15 doses.

[0224] On August 2, 2023, the fifth visit showed that the symptoms of palpitation were alleviated, and there was occasional palpitation during mood swings. Chest tightness and dizziness were alleviated, and there was no headache, night sweats, dry mouth and bitter mouth, fear of cold was improved, fatigue, impatience, and anxiety. Appetite and sleep were good, and bowel movements were normal. The tongue was pale red, the coating was thin and yellow, and the pulse was deep and fine. The prescription was continued, and the prescription Tongyang Sanjie Decoction was modified, with 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Tangerine Peel, 9g of Scutellaria, 12g of Lithospermum officinale, 12g of Cat's Eye Grass, 9g of Curcuma, 9g of Dry Ginger, 9g of Rhizoma Lithospermi, 9g of Cinnamon Twig, 12g of Salvia miltiorrhiza, 9g of Peach Kernel, and 3g of Asarum. 21 doses were given, and the patient was advised to check the neck color Doppler ultrasound and coronary CTA before the follow-up visit.

[0225] On September 10, 2023, the sixth visit showed no obvious chest discomfort, no dizziness, no headache, normal sweating, suitable cold and heat, no dry mouth or bitter taste, muscle soreness after activity, and obvious fatigue. Appetite and sleep were normal, and bowel movements were normal. The tongue was pale red, the coating was thin and white, and the pulse was deep. The color Doppler ultrasound of the neck showed: no abnormal sound and image of the bilateral neck vessels. Coronary CTA showed: RCA: CAD-RADS: 3; LMA: CAD-RADS: 0; LAD: CAD-RADS: 0; LCX: CAD-RADS: 0, the coronary artery plaques were largely disappeared, and the carotid artery plaques were largely disappeared. The prescription is Tongyang Sanjie Decoction with modifications, including 30g of Astragalus, 10g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 10g of Atractylodes, 9g of Pinellia, 6g of Citrus Reticulata, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of White Head, 24g of Cat's Eye Grass, 9g of Curcuma, 9g of Drynaria, 9g of Drynaria, 9g of Rhizoma Ligustici, 9g of Cinnamon Twig, 12g of Salvia miltiorrhiza, 6g of Fritillaria Thunbergii, and 6g of Cyathula capitata. Take 14 doses for follow-up.

[0226] Before treatment, coronary angiography showed: LAD: middle segment stenosis 60-70%, D1 opening stenosis 90%, OM large opening stenosis 90%, RCA near middle segment stenosis 50%. Before treatment, neck color Doppler ultrasound showed: bilateral carotid artery atherosclerosis and plaque formation, right subclavian artery atherosclerosis plaque formation. After treatment, coronary CTA showed: RCA: CAD-RADS: 3; LMA: CAD-RADS: 0; LAD: CAD-RADS: 0; LCX: CAD-RADS: 0, coronary artery plaques have basically disappeared.

[0227] Example 2

[0228] Case of coronary artery atherosclerosis and carotid artery atherosclerosis, Mr. Han, male, 45 years old.

[0229] On April 29, 2023, the patient was diagnosed with precordial stabbing pain for more than 6 months, which worsened half a month ago. The current symptoms are: precordial stabbing pain without obvious cause, paroxysmal palpitation, chest tightness, shortness of breath, irritability, and relief after rest. Dizziness, no headache, sweating, fear of heat, dry mouth and bitter mouth. Occasionally coughing up a small amount of yellow sticky sputum, good appetite and sleep, and regular bowel movements. The tongue is dark red, the fur is thin and yellow, and the pulse is deep and fine. It is diagnosed as phlegm and blood stasis, and both qi and yin are deficient. The treatment should be to invigorate qi and detoxify, and to promote yang and disperse the knot. Tongyang Sanjie Decoction is prescribed with modifications: Astragalus 24g, Ginseng 9g, Qing Banxia 9g, Ophiopogon 15g, Baiqian 15g, Angelica 12g, Chuanxiong 15g, Scutellaria 9g, Lithospermum 15g, Cat's Eye Grass 30g, Salvia 15g, Curcuma 12g, Schisandra 9g, and Licorice 9g, 12 doses.

[0230] Second visit on May 18, 2023, the effect is good, the current symptoms are: chest pain after fatigue, chest tightness and shortness of breath, occasional back pain, no panic, easy to be upset, sweating, dry mouth, bitter mouth, intolerance to cold and heat. Appetite and sleep are good, bowel movements are normal. The tongue is dark red, the coating is thin and white, and the pulse is deep, fine and astringent. Prescription: Add 18g of Pueraria root and 9g of Magnolia officinalis to the above prescription, 21 doses.

[0231] On June 12, 2023, the third visit was effective. After taking the above prescription, the chest pain symptoms improved, no headache, no dizziness. Fear of cold, dry mouth, bitter mouth, numbness and weakness in the left upper limb. Appetite and sleep are good, and bowel movements are normal. The tongue is pale red, the coating is thin and white, and the pulse is deep and fine. Prescription: Remove 18g of Pueraria root and 9g of Magnolia officinalis from the above prescription, add 12g of Sinomenium sinomenium and 12g of Notopterygium wilfordii, 7 doses.

[0232] On June 21, 2023, the fourth visit showed good results. The current symptoms are: occasional pain in the anterior axilla, sternum and sternum area, chest tightness is relieved, no dizziness and headache, dry mouth, bitter mouth, fatigue improvement, left upper limb fatigue accompanied by numbness is relieved, dry eyes are occasionally seen, no tinnitus. Appetite and sleep are good, and bowel movements are normal. The tongue is dark red, the fur is thin and yellow, and the pulse is deep and fine. Prescription: Astragalus 15g, Pueraria lobata 9g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 9g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Roasted Licorice 9g, Salvia miltiorrhiza 12g, 14 doses.

[0233] The fifth visit on July 10, 2023, was effective. The current symptoms are: less chest pain, no back pain, no chest tightness, no panic, fear of cold, dry mouth and bitter mouth in the morning, and improved physical strength. The tongue is pale red, the coating is thin and white, and the pulse is deep and sluggish. Prescription: 9g of Morinda officinalis above, 14 doses.

[0234] Afterwards, the prescription was adjusted based on Tongyang Sanjie Decoction. Before treatment, coronary angiography showed that the distal segment of LM was narrowed by about 20%, and the opening of LAD was narrowed by 70%. Before treatment, color Doppler ultrasound of the neck showed mild thickening of the intima-media of bilateral carotid arteries. After treatment, coronary CTA showed that the left coronary artery originated from the left sinus, the wall of the left coronary artery trunk and the left anterior descending branch was smooth, and there was no obvious stenosis of the lumen. The middle wall of the left anterior descending branch was coronary artery. After treatment, color Doppler ultrasound of the neck showed thickening of the intima-media of the bilateral common carotid arteries, and atherosclerotic plaque formation in the initial segment of the right subclavian artery.

[0235] Example 3

[0236] Case of coronary atherosclerosis combined with carotid atherosclerosis, Mr. Li, male, 45 years old.

[0237] First visit on April 5, 2023. The patient came to the hospital for more than a month because of burning pain in the left chest. Coronary CTA was performed at Shandong Provincial Second People's Hospital, showing: LMA: mild stenosis of about 10%, LAD: moderate stenosis of about 60%. Carotid ultrasound showed: atherosclerotic plaque formation on both sides of the carotid arteries. Current symptoms: left chest tightness, occasional dull pain, shortness of breath, occasional panic, no dizziness, no headache, occasional feeling of heaviness, suitable for cold and heat, sweating, general physical strength, no dry mouth and bitter mouth, good appetite and sleep, good urination, and occasional unformed stool. The tongue is dark red, the fur is thin and yellow, and the pulse is deep and fine. It is diagnosed as qi deficiency syndrome, heat toxin, phlegm and blood stasis syndrome, and the treatment should be to invigorate qi and detoxify, and promote yang and disperse the knot. The prescription is Tongyang Sanjie Decoction with modifications: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Citrus Reticulata, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of White Head, 24g of Cat's Eye Grass, 9g of Curcuma, 9g of Drynaria, 9g of Drynaria, 9g of Rhizoma Ligustici, 9g of Cinnamon Twig, 12g of Salvia miltiorrhiza, 7 doses.

[0238] Second visit on April 20, 2023, good effect, current symptoms: left chest tightness and dull pain basically disappeared, occasionally go upstairs, feel chest burning with tightness after fatigue, no dizziness, no headache, occasional head swelling, appropriate cold and heat, no dry mouth, no bitter mouth, sweating, physical strength improved. Appetite is good, occasional sleep is poor, urine is yellow, bowel movements are good. The tongue is dark red, the fur is thin and yellow, and the pulse is deep and fine. Keep the prescription and continue to take it, give Tongyang Sanjie Decoction with modifications: Astragalus 15g, Pueraria lobata 9g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 9g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Zhi Gancao 9g, Cinnamon Twig 9g, Salvia miltiorrhiza 12g, Calcined Corrugated Seed 9g, 21 doses.

[0239] On May 15, 2023, the third visit showed good results. The current symptoms are: when going uphill, the left chest is easily felt heavy, there is no chest tightness, no panic, no chest pain, occasional chest tightness, occasional dull pain in the left sternum, no head swelling, normal sweating, appropriate cold and heat, no dry mouth and bitter mouth, and good physical strength. Appetite and sleep are good, and bowel movements are normal. The tongue is dark red, the coating is thin and yellow, and the pulse is deep and fine. Prescription: Remove the calcined corrugated seeds from the above and add 12g of Zhishi and 3g of Xixin, 21 doses.

[0240] On June 8, 2023, the fourth visit showed the following symptoms: the patient felt that his physical strength had recovered, the amount of activity had increased, he occasionally felt chest tightness when angry or active, but he did not feel panic or chest pain, and his sweating was normal. He had a suitable temperature and temperature, and did not have dry mouth or bitter taste. His physical strength was good. His appetite and sleep were good, his urine was yellow, and his bowel movements were normal. His tongue was dark red, his fur was thin and yellow, and his pulse was deep and fine. Prescription: Remove Zhishi and Xixin from the above prescription, and continue to take 21 doses.

[0241] The fifth visit on June 30, 2023, showed symptoms: chest heaviness after fatigue, no chest tightness, no chest pain, little panic, diarrhea after eating cold food, normal sweating, suitable cold and heat, no dry mouth, no bitter mouth, and good physical strength. Appetite and sleep are good, and bowel movements are normal. The tongue is light red, the coating is thin and white, and the pulse is deep and fine. Prescription: Add 6g of cinnamon, 12g of Notopterygium, and 12g of dried ginger to the above prescription, 21 doses. Consolidate the therapeutic effect.

[0242] Before treatment, the color Doppler ultrasound of the carotid arteries showed: atherosclerotic plaques formed on both sides of the carotid arteries, and several plaque echoes were detected in the left and right lumens. The larger one on the left was located on the posterior wall of the bifurcation, with a size of about 2.10*0.18cm; the larger one on the right was located on the posterior wall of the bifurcation, with a size of about 0.53*0.15cm. After treatment, the color Doppler ultrasound of the carotid arteries showed: atherosclerotic plaques formed on both sides of the carotid arteries, and several plaque echoes were detected in the left and right lumens. The larger one on the left was located on the posterior wall of the bifurcation, with a size of about 1.21*0.16cm; the larger one on the right was located on the posterior wall of the bifurcation, with a size of about 0.34*0.13cm. The carotid plaques were significantly reduced.

[0243] Example 4

[0244] Case of coronary artery atherosclerosis and carotid artery atherosclerosis, Zhang, female, 59 years old.

[0245] First visit on February 5, 2023. The patient came to the hospital for chest tightness for more than 5 years. The current symptoms are: persistent chest tightness, occasional palpitations, fatigue, especially in the lower limbs, cold back, pain in the occipital area, heavy body, no dizziness, no headache, fear of cold, no dry mouth, bitter mouth, and irritability. Appetite and sleep are good, and bowel movements are normal. The tongue is dark red, the coating is white, and the pulse is deep, fine and astringent. It is diagnosed as deficiency of heart and kidney qi and internal excess of virtual fire. Prescription: Astragalus 24g, Atractylodes 15g, Tangerine peel 9g, Cimicifuga 9g, Bupleurum 9g, Angelica 9g, Ginseng 12g, Phellodendron 15g, Amomum 12g, Tortoise shell 9g, Roasted Licorice 15g, Cinnamon twig 12g, Pueraria lobata 18g, Asarum 3g, 7 doses.

[0246] On February 13, 2023, the symptoms were slightly relieved. The patient still felt chest tightness, palpitations, fatigue, especially in the lower limbs, phlegm in the throat that was difficult to cough up, back coldness relieved, pain in the back of the head, body heaviness relieved, no dizziness, no headache, fear of cold, no dry mouth, bitter mouth, excessive thinking, and good physical strength. The patient had a good appetite, difficulty falling asleep, yellow urine, and normal bowel movements. The tongue was dark red, the coating was white, and the pulse was deep and fine. Observing the patient's pulse and symptoms, it was diagnosed as a syndrome of qi deficiency, heat, toxicity, phlegm and blood stasis, and the prescription was formulated to invigorate qi, resolve toxicity, and promote yang and disperse the accumulation of qi. The prescription was Tongyang Sanjie Decoction: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Citrus Reticulata, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of Radix Phellodendri, 24g of Cat's Eye Grass, 9g of Curcuma, 9g of Drynaria, 9g of Ginger, 9g of Rhizoma Licorice, 9g of Cinnamon Twig, and 12g of Salvia miltiorrhiza. 7 doses.

[0247] On February 21, 2023, the third visit showed slight relief. Symptoms: chest tightness, panic in the morning, occasional dizziness, no headache, reduced back coldness, occasional feeling of upper abdominal blockage, phlegm in the throat, sticky and yellow, occasional feeling of heaviness, normal sweating, intolerance to cold and heat, no dry mouth or bitter taste, fatigue, and excessive thinking. Appetite is good, difficulty falling asleep, bowel movements are normal. The tongue is dark red, the coating is white, and the pulse is deep and fine. It is still diagnosed as qi deficiency syndrome, heat toxicity, phlegm and blood stasis syndrome, and the prescription is continued for 21 doses.

[0248] On March 24, 2023, the symptoms were relieved compared with the previous ones. Symptoms: chest tightness improved, phlegm in the throat was easy to cough, white and gray in color, feeling of blockage in the upper abdomen when angry, body heaviness relieved, no headache, occasional dizziness, no headache, intolerance to cold and heat, no dry mouth and bitter taste, good physical strength, easy to be impatient. Appetite is good, it is difficult to fall asleep, and the bowel movements are normal. The tongue is dark red, the fur is yellow, and the pulse is deep and thin. Prescription: Astragalus 15g, Pueraria lobata 9g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 9g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Roasted Licorice 9g, Cinnamon Twig 9g, Salvia miltiorrhiza 12g, Cuscuta chinensis 15g, Pueraria lobata 18g, 21 doses.

[0249] On April 21, 2023, the fifth visit showed that the symptoms were reduced. Symptoms included: chest tightness and shortness of breath after emotional fluctuations, occasional panic with sweating, phlegm in the throat that was difficult to cough, reduced coldness in the back, reduced feeling of blockage in the upper abdomen, no headache, occasional dizziness, no headache, intolerance to cold and heat, no dry mouth and bitter mouth, and good physical strength. Worrying a lot. Appetite was good, it was difficult to fall asleep, the urine was yellow, and the stool was regular. The tongue was dark red, the coating was white, and the pulse was deep and thin. The prescription of Tongyang Sanjie Decoction was still modified: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Tangerine Peel, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of Whitehead, 24g of Cat's Eye Grass, 9g of Curcuma, 9g of Dry Ginger, 9g of Rhizoma Licorice, 9g of Cinnamon Twig, 12g of Salvia Miltiorrhiza, and 6g of Amomum. 21 doses.

[0250] On May 24, 2023, the sixth visit was effective. Symptoms: chest tightness and shortness of breath were relieved, occasional palpitations were relieved, phlegm in the throat was difficult to cough, back coldness was relieved, upper abdominal blockage was relieved, occasional dizziness, no headache, intolerance to cold and heat, dry mouth without bitter taste, and physical strength was good. Appetite was good, it was difficult to fall asleep, urine was yellow, and bowel movements were regular. The tongue was dark red, the coating was white, and the pulse was deep and thin. Remove the Amomum villosum from the above prescription and add 9g of peach kernel and 15g of Alisma orientalis for 21 doses. All follow-up visits were treated with Tongyang Sanjie Decoction with modifications.

[0251] On August 4, 2023, the tenth visit showed that the symptoms were significantly alleviated. Symptoms included: occasional shortness of breath after activity, occasional palpitations, sweating, fear of heat, improved physical strength, and occasional feeling of heaviness. Appetite was OK, with occasional insomnia, yellow urine, and normal bowel movements. The tongue was red, the coating was thin and yellow, and the pulse was slightly thin. Prescription: Astragalus 15g, Pueraria lobata 9g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 9g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Roasted Licorice 9g, Cinnamon Twig 9g, Salvia miltiorrhiza 12g, Cornus officinalis 12g, 14 doses to consolidate the therapeutic effect.

[0252] Before treatment, the carotid artery color Doppler ultrasound showed: uneven thickening of the intima-media of bilateral carotid arteries with plaque formation; uneven thickening of the intima-media of the right subclavian artery with plaque formation. After treatment, the carotid artery color Doppler ultrasound showed: uneven thickening of the intima-media of the left carotid artery; uneven thickening of the intima-media of the right carotid artery with plaque formation; uneven thickening of the intima-media of the right subclavian artery. Some carotid artery plaques have significantly subsided.

[0253] Example 5

[0254] Case of coronary artery atherosclerosis and carotid artery atherosclerosis, Ma, female, 62 years old.

[0255] First visit on June 6, 2023. The patient came to see a doctor because of left anterior descending branch stenosis of coronary heart disease more than 6 months ago. The current symptoms are: pharyngeal obstruction, chest tightness, no chest pain, no panic, no discomfort in the left shoulder and back, discomfort in the epigastric area after meals, sweating, cold and heat, dry mouth, and physical strength. Appetite and sleep are OK, and bowel movements are normal. The pulse is deep, fine and astringent, the tongue is dark red, and the tongue coating is white. Coronary CT shows: severe stenosis of the proximal LAD segment: 80%-90%, mild stenosis of the proximal D1 segment: 30%-40%. 2 Neck color Doppler ultrasound shows: thickening of the intima of the bilateral carotid arteries with plaque formation; tortuous course of the cervical segments of the bilateral vertebral arteries; plaque formation in the left subclavian artery. It is diagnosed as qi deficiency syndrome, heat toxin, phlegm and blood stasis syndrome, and the treatment should be to invigorate qi and detoxify, and promote yang and disperse the knot. The prescription is Tongyang Sanjie Decoction with modifications: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Citrus Reticulata, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of Radix Phellodendri, 9g of Curcuma, 9g of Drynaria, 9g of Rhizoma Glycyrrhizae, 9g of Rhizoma Cinnamomi, 12g of Salvia miltiorrhiza, 12 doses.

[0256] Second visit on June 17, 2023, the effect is good, symptoms: numbness of fingers, feeling of pharyngeal obstruction, no chest tightness, no chest pain, no panic, no discomfort in left shoulder and back, sweating, appropriate cold and heat, dry mouth, physical strength. Appetite is good, sleep is good, bowel movements are normal. The tongue is dark red, the coating is white, and the pulse is deep, stringy and astringent. Add 24g of cat's eye grass, 12g of cinnamon twig, and 15g of salvia miltiorrhiza to the above, 21 doses.

[0257] On September 16, 2023, the third visit showed good results. Symptoms: occasional shortness of breath, no numbness of fingers, reduced pharyngeal obstruction, no chest tightness, no chest pain, no panic, no discomfort in the left shoulder and back, good sweating, suitable for cold and heat, dry mouth, and good physical strength. Appetite, sleep, and bowel movements were normal. The tongue was dark red, the tongue coating was white, and the pulse was deep. The above-mentioned Danshen was changed to 12g, the cinnamon twig was changed to 9g, and the cornus fruit was added 6g, 21 doses. The subsequent treatment was based on the Tongyang Sanjie Decoction. The coronary CT showed: LAD: 30-50% stenosis in the proximal and middle segments. The neck color Doppler ultrasound showed: tortuous cervical segments of bilateral vertebral arteries.

[0258] Example 6

[0259] Case of carotid atherosclerosis after PCI for coronary atherosclerosis: Kong, male, 62 years old.

[0260] On April 10, 2023, the patient visited our outpatient department for chest pain and chest tightness after fatigue. More than 40 days after LAD and LCX stent implantation, the patient was not suitable for Jinan Municipal Fifth Hospital in January 2023 due to self-perceived paroxysmal chest tightness. After heart stent surgery, he was discharged after the condition was relieved. Coronary CT showed: LAD: 85% stenosis of the opening, 40% of the proximal segment, 70-85% of the middle segment; LCX: 50% stenosis of the proximal segment, 90% stenosis of the middle segment, 50-60% of the distal segment; RCA: 75% stenosis of the middle segment. Current symptoms: general fatigue, left chest pain when tired, no chest tightness, obvious abdominal distension after eating and drinking, fear of cold, cold feet, no dizziness, no dry mouth or bitter mouth, easy fatigue, irritability. Appetite and sleep are good, and bowel movements are regular. The pulse is thin, rapid and deep, the tongue is dark red, with ecchymosis, and the tongue coating is thin and white. At the first visit, it was considered that the patient had deficiency of heart and kidney qi and excessive internal virtual fire. The treatment should be to suppress yang and tonify the middle, and to absorb qi and return it to the kidney. The prescription was Buzhong Yiqi Decoction combined with Qianyang Fengsui Dan with modifications: Astragalus 24g, ginseng 12g, Atractylodes 15g, Angelica 9g, Tangerine peel 9g, Cimicifuga 9g, Bupleurum 9g, Amomum 15g, Aconite 12g, Vinegar Turtle Shell 6g, Phellodendron 21g, Roasted Licorice 15g, 7 doses.

[0261] On April 20, 2023, the second visit showed no significant relief. Symptoms: pain behind the sternum after fatigue, slight chest tightness, no panic, easy stomach distension after eating, normal sweating, reduced fear of cold, no dry mouth, bitter mouth, fatigue, and irritability. Appetite and sleep are good, urination is good, stool is unformed and sticky, once every 2 days. Pulse is deep and fine, tongue is dark red with ecchymosis, and the tongue coating is thin and yellow. It is diagnosed as Qi deficiency syndrome, heat toxicity, phlegm and blood stasis syndrome, and the treatment should be to invigorate Qi and detoxify, promote Yang and disperse the knot. The patient was treated with Tongyang Sanjie Decoction with modifications: 16g of Astragalus, 10g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 10g of Atractylodes, 9g of Pinellia, 6g of Citrus Reticulata, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of Radix Phellodendri, 24g of Herba Cat's Eye, 9g of Curcuma, 9g of Drynaria, 9g of Rhizoma Glycyrrhizae, 9g of Radix Glycyrrhizae, 12g of Cinnamon Twig, and 18g of Salvia miltiorrhiza, 14 doses, and then the patient was treated with Tongyang Sanjie Decoction with modifications.

[0262] On June 21, 2023, the fifth visit showed good results. The chest tightness and chest pain symptoms disappeared, the bloating was relieved, there was no dizziness, no headache, sweating was OK, cold and heat were appropriate, there was no dry mouth and no bitter taste in the mouth, and physical strength was improved. The appetite and sleep were OK, the urination was OK, the stool was occasionally loose, once every 2 days, and there was a lot of flatulence. The pulse was deep and thin, the tongue was light red, and the fur was thin and yellow. The prescription was treated with Tongyang Sanjie Decoction with modifications: Astragalus 16g, Pueraria lobata 10g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 10g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Zhigancao 9g, Cinnamon Twig 12g, Salvia miltiorrhiza 18g. After the follow-up visit, the effect was not changed. All the prescriptions were treated with Tongyang Sanjie Decoction with modifications, and the symptoms gradually eased. Coronary CT showed: after LAD and LCX stent implantation, LCX: segment 11 stenosis 40-60% OM1: segment 12 mild stenosis 10% RCA: segment 1-3 mild stenosis, 10-20%.

[0263] Before treatment, coronary CT showed: LAD: 85% stenosis of the opening, 40% of the proximal segment, 70-85% of the middle segment; LCX: 50% stenosis of the proximal segment, 90% stenosis of the middle segment, 50-60% of the distal segment; RCA: 75% stenosis of the middle segment. After treatment, coronary CT showed: LAD, LCX stent implantation, LCX: 40-60% stenosis of 11 segments OM1: 10% mild stenosis of 12 segments RCA: 1-3 segments mild stenosis, 10-20%.

[0264] Example 7

[0265] Case of coronary artery atherosclerosis and carotid artery atherosclerosis, Mr. Shi, male, 55 years old.

[0266] First visit on November 24, 2023. The patient came for treatment because of chest tightness after activities for more than 6 years, which worsened 2 years ago. The current symptoms are:

[0267] Chest tightness when moving, with paroxysmal palpitations, no chest pain, dizziness, no headache, spontaneous sweating, cold and heat, bad taste in the mouth, no dry mouth, good physical strength, good appetite and sleep, normal bowel movements. Dark red tongue, white fur, deep and sluggish pulse. CAG shows: 1. The inner membrane of the anterior descending branch is not smooth, with 60-70% stenosis in the proximal and middle segments; 2. The inner membrane of the circumflex branch is not smooth, with 30% stenosis in the middle and distal segments; 3. The inner membrane of the right coronary artery is not smooth, with 80-85% stenosis in the distal segment. The patient has symptoms of qi deficiency, heat, toxicity, phlegm and blood stasis, and the treatment should be to invigorate qi, detoxify, and promote yang and disperse the stagnation. The prescription is Tongyang Sanjie Decoction with modifications: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Citrus Reticulata, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of White Head, 24g of Cat's Eye Grass, 9g of Curcuma, 9g of Drynaria, 9g of Drynaria, 9g of Rhizoma Ligustici, 9g of Cinnamon Twig, and 12g of Salvia miltiorrhiza. 21 doses.

[0268] On December 29, 2023, the second visit showed symptoms: chest tightness after strenuous activities, paroxysmal palpitations were relieved, no chest pain, dizziness, no headache, spontaneous sweating, appropriate cold and heat, reduced bad breath, no stomach discomfort, no dry mouth, good physical strength, good appetite and sleep, and normal bowel movements. The tongue was dark red, with white and greasy coating in the middle and lower third of the tongue, and the pulse was deep and sluggish. If the effect is not changed, remove the tangerine peel from the above prescription, add 9g of Zexie and 12g of Rhizoma Cynoglossi, and take 14 doses.

[0269] On January 19, 2024, the third visit showed symptoms: chest tightness after strenuous activities, paroxysmal palpitations were relieved, no chest pain, occasional dizziness, no headache, spontaneous sweating, appropriate cold and heat, bad taste in the mouth, no stomach discomfort, no dry mouth, good physical strength, good appetite and sleep, and normal bowel movements. The tongue was dark red, the coating was thin and white, and the pulse was deep and sluggish. The first visit prescription was added with 12g of Qianghuo, 3g of Xixin, and 12g of Cornus officinalis, 42 doses.

[0270] On March 15, 2024, the fourth visit showed good results. Symptoms: chest tightness is relieved after a full meal or strenuous activity, paroxysmal palpitations disappear, no chest pain, occasional dizziness, no headache, spontaneous sweating is relieved, cold and heat are appropriate, there is a bad taste in the mouth, no stomach discomfort, no dry mouth, good physical strength, good appetite and sleep, and normal bowel movements. The tongue is dark red, the coating is thin and white, and the pulse is deep. The first visit prescription was added with 12g of Magnolia officinalis, 9g of peach kernel, 12g of red peony root, and 30g of coix seed, and 42 doses were given.

[0271] CTA showed: 1. Non-calcified plaque and calcified plaque in the proximal segment of the left anterior descending artery (LAD), moderate stenosis of the lumen, and muscle bridge in the middle segment. 2. Non-calcified plaque in the right coronary artery (RCA), mild stenosis of the lumen.

[0272] Afterwards, the prescription was adjusted based on Tongyang Sanjie Decoction. On August 9, 2024, the seventh visit was effective. Symptoms: chest tightness was relieved, paroxysmal palpitations disappeared, no chest pain, no dizziness, no headache, spontaneous sweating was reduced, cold and heat were appropriate, there was a bad taste in the mouth, no stomach discomfort, no dry mouth, good physical strength, good appetite and sleep, and normal bowel movements. The tongue was dark red, the coating was thin and white, and the pulse was deep. The prescription was Tongyang Sanjie Decoction with modifications: Astragalus 15g, Pueraria lobata 9g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 9g, Pinellia 9g, Tangerine peel 6g, Scutellaria 9g, Lithospermum 12g, White Head 12g, Curcuma 9g, Dry Ginger 9g, Roasted Licorice 9g, Cinnamon Twig 9g, Salvia miltiorrhiza 12g, Ranunculaceae 15g, Sargentodoxae 15g, Peach Kernel 6g, Coix Seed 21g, Ephedra 6g, 42 doses were taken to consolidate the therapeutic effect.

[0273] Before treatment, CAG showed: 1. The intima of the left anterior descending artery was not smooth, with 60-70% stenosis in the proximal and middle segments; 2. The intima of the circumflex artery was not smooth, with 30% stenosis in the middle and distal segments; 3. The intima of the right coronary artery was not smooth, with 80-85% stenosis in the distal segment. After treatment, CTA showed: 1. Non-calcified plaques and calcified plaques in the proximal segment of the left anterior descending artery (LAD), moderate stenosis of the lumen; muscle bridges in the middle segment. 2. Non-calcified plaques in the right coronary artery (RCA), mild stenosis of the lumen.

[0274] Example 8

[0275] Case of coronary artery atherosclerosis and carotid artery atherosclerosis, Mr. Li, male, 62 years old.

[0276] First visit on November 30, 2023. The patient came for treatment for more than half a year because of shortness of breath after activities. The current symptoms are: shortness of breath after activities, less chest pain, dizziness, no headache, sweating, night sweats, cold and heat, dry mouth, no bitter mouth, fatigue, good appetite and sleep, and regular bowel movements. Outpatient blood pressure: 130 / 85mmHg. The tongue is dark red, the tongue coating is white, and the pulse is deep and astringent. It is diagnosed as Yin deficiency and fire, Qi deficiency and blood stasis syndrome, and the treatment should be to nourish Yin and reduce fire, and invigorate Qi and activate blood circulation. The prescription is Danggui Liuhuang Decoction with additions and subtractions: Danggui 6g, Astragalus 15g, Coptis chinensis 6g, Phellodendron chinense 6g, Shengdihuang 6g, Rehmannia glutinosa 6g, Chuanlianzi 6g, Adenophora 15g, Cimicifuga 6g, Peach Kernel 6g, 7 doses.

[0277] On December 7, 2023, the second visit was effective. Symptoms: shortness of breath was slightly relieved after activity, less chest pain, dizziness, no headache, hyperhidrosis was relieved, night sweats were relieved, cold and heat were appropriate, dry mouth in the morning and at night, no bitter taste in the mouth, good physical strength, good appetite and sleep, and normal bowel movements. The tongue was dark red, the fur was white, and the pulse was deep and astringent. The prescription was Tongyang Sanjie Decoction with modifications: Astragalus 15g, Pueraria lobata 9g, Ginseng 9g, Angelica 6g, Cimicifuga 6g, Bupleurum 6g, Atractylodes 9g, Pinellia 9g, Tangerine Peel 6g, Scutellaria 9g, Lithospermum officinale 12g, Whitehead 12g, Cat's Eye Grass 24g, Curcuma 9g, Dry Ginger 9g, Roasted Licorice 9g, Cinnamon Twig 9g, Salvia miltiorrhiza 12g, Peach Kernel 12g, Red Peony 12g, 21 doses.

[0278] On January 15, 2024, the third visit showed good results. Symptoms: shortness of breath was relieved after activity, no chest pain, no dizziness, no headache, night sweats were relieved, cold and heat were appropriate, there was little dry mouth, no bitter taste in the mouth, physical strength was good, appetite and sleep were good, bowel movements were normal. The tongue was dark red, the coating was thin and yellow, and the pulse was deep and sluggish. Add 15g of Phellodendron chinense and 12g of Amomum villosum to the above prescription, 14 doses.

[0279] On February 1, 2024, the fourth visit showed good results. Symptoms: shortness of breath was relieved after activity, no chest pain, no dizziness, no headache, night sweats were relieved, cold and heat were appropriate, there was little dry mouth, no bitter taste in the mouth, good physical strength, good appetite and sleep, and normal bowel movements. The tongue was dark red, the coating was thin and yellow, and the pulse was deep and sluggish. Phellodendron chinense 15g and Amomum villosum 12g were added to the above prescription, and 14 doses were taken. After that, the Tongyang Sanjie Decoction was used as the basic prescription for addition and subtraction.

[0280] On August 15, 2024, the 13th visit was effective. Symptoms: night sweats disappeared, occasional thirst, no other obvious discomfort, good physical strength, good appetite and sleep, and normal bowel movements. The tongue was slightly dark red, with yellow fur and deep pulse. Tongyang Sanjie Decoction was given with modifications: 15g of Astragalus, 9g of Pueraria, 9g of Ginseng, 6g of Angelica, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes, 9g of Pinellia, 6g of Tangerine Peel, 9g of Scutellaria, 12g of Lithospermum Officinale, 12g of Whitehead, 9g of Curcuma, 9g of Dry Ginger, 9g of Rhizoma Lithospermi, 9g of Rhizoma Cinnamomi, 9g of Radix Salviae Miltiorrhizae, 15g of Cat's Claw, and 15g of Artemisia Capillaris. 21 doses.

[0281] On September 19, 2024, the 14th visit showed good results. Symptoms included: no obvious discomfort, pale red tongue, thin white fur, and deep pulse. The above prescription was given without Artemisia capillaris, 14 doses, to consolidate the therapeutic effect.

[0282] Comparison of carotid ultrasound before and after treatment: Before treatment: a 9.8x2.2mm strong echo flat mass was seen on the posterior and lateral wall of the right common carotid artery bifurcation, a 7.0x3.2mm semi-circular strong echo mainly heterogeneous flat plaque was seen in the right internal carotid artery bulb (involving the anterior, posterior and lateral walls), a 5.0x1.5mm strong echo flat plaque was seen at the opening of the right vertebral artery, and a 10.3x1.8mm strong echo flat plaque was seen at the beginning of the right subclavian artery. A 23.8x3.2mm semi-circular strong echo mainly heterogeneous flat plaque was seen from the bifurcation of the left common carotid artery to the bulb of the internal carotid artery, with some posterior acoustic shadows, and an 18.8x2.7mm equal echo flat plaque was seen at the beginning of the left subclavian artery and continued to the opening of the left vertebral artery. After treatment: A 5.8x2.1mm strong echo flat plaque was seen on the posterior and lateral wall of the right common carotid artery bifurcation, a 7.6x3.1mm semi-circular strong echo mainly heterogeneous flat plaque was seen in the right internal carotid artery bulb (involving the anterior, posterior and lateral walls), and a 5.2x1.5mm strong echo flat plaque was seen at the opening of the right vertebral artery. A 9.6x1.8mm strong echo flat plaque was seen on the lateral wall of the starting segment of the right subclavian artery. A 24.7x3.3mm semi-circular strong echo mainly heterogeneous flat plaque was seen from the bifurcation of the left common carotid artery to the bulb of the internal carotid artery, involving the anterior and lateral walls, with some posterior acoustic shadows. A 17.0x2.8mm equal echo flat plaque was seen from the beginning of the left subclavian artery to the opening of the left vertebral artery, causing the inner diameter to become thinner.

Claims

1. A Chinese medicine composition for treating chronic coronary syndrome and eliminating coronary artery and carotid artery plaques, characterized in that: The raw materials include the following components by weight: 10-30g of Astragalus, 10-18g of Lithospermum officinale, 20-40g of Cat's Eye Grass, 6-15g of Pinellia ternata, 6-15g of Ginseng, 6-15g of Cinnamon Twig, 6-15g of Pueraria lobata, 6-15g of Dry Ginger, 5-15g of Cimicifuga heracleifolia, 5-15g of Bupleurum chinense, 6-20g of Atractylodes macrocephala, 5-15g of Citrus reticulata, 6-15g of Scutellaria baicalensis, 12-30g of Radix Phellodendri, 5-15g of Angelica sinensis, 5-15g of Curcuma aromatica, 10-30g of Salvia miltiorrhiza, and 6-15g of Radix Glycyrrhizae Preparata.

2. The Chinese medicine composition according to claim 1, characterized in that: The raw materials include the following components by weight: 15g of Astragalus, 12g of Lithospermum officinale, 24g of Cat's Eye Grass, 9g of Pinellia ternata, 9g of Ginseng, 9g of Cinnamon Twig, 9g of Pueraria lobata, 9g of Dry Ginger, 6g of Cimicifuga, 6g of Bupleurum, 9g of Atractylodes macrocephala, 6g of Tangerine Peel, 9g of Scutellaria baicalensis, 12g of White Head, 6g of Angelica sinensis, 9g of Curcuma aromatica, 12g of Salvia miltiorrhiza, and 9g of Radix Glycyrrhizae Preparata.

3. The Chinese medicine composition according to claim 1 or 2, characterized in that: The raw material medicine also includes: 10-20g of cat's claw.

4. A method for preparing the Chinese medicine composition according to any one of claims 1 to 3, characterized in that: The following steps are involved: For each dose of medicine, weigh the raw materials by weight, soak them in warm water for 180-360 minutes, add water to cover the raw materials by about 1-2 cm, boil the cat's eye grass for 60 minutes, and then boil it twice with other raw materials, 60-90 minutes after the first decoction and 60 minutes after the second decoction, and combine the two medicinal liquids.

5. Use of the Chinese medicine composition according to any one of claims 1 to 3 in the preparation of medicines for treating chronic coronary syndrome and eliminating coronary artery and carotid artery plaques.

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