CHEN Yan;MIAO Xiaofan;LU Xin;ZHU Boqian;LIU Fuming;CHEN Kai;Department of Cardiology,Jiangsu Province Hospital of Chinese Medicine;Objective:To analyze the effect of Guanxinping Tablet(冠 心 平 片) combined with western medicine on left ventricular myocardial torsion and myocardial work in patients with stable coronary heart disease of qi and yin deficiency type by applying two-dimensional speckle tracking imaging technology and left ventricular pressure-strain loop(LVPSL) quantitative analysis,and to evaluate its clinical efficacy. Methods:Sixty-six patients with stable coronary heart disease of qi and yin deficiency type were selected and divided into the Guanxinping Tablet group(33 cases) and the conventional group(33 cases) by using the random number table method. Meanwhile,33 physical examination volunteers were selected as the blank control group. Patients in the conventional group received conventional western medicine treatment,while those in the Guanxinping Tablet group received comprehensive intervention with Guanxinping Tablets in addition to western medicine treatment. The traditional Chinese medicine(TCM) syndrome scores of the two groups of patients before and after treatment were compared,and the clinical efficacy was evaluated. Changes in conventional echocardiographic parameters were compared before and after treatment among the three groups. Meanwhile,two-dimensional speckle tracking imaging technology was applied to obtain the parameters of left ventricular torsional motion(left ventricle overall torsional degree and torsional rate,apical rotation degree and rotation rate,pericardial rotation degree and rotation rate). The left ventricular myocardial work parameters[global work index(GWI),global constructive work(GCW),global wasted work(GWW),and global work efficiency(GWE)] were measured by LVPSL technology. The left ventricular torsional motion parameters and left ventricular myocardial work parameters of each group of patients before and after treatment were compared. Results:After treatment,the symptom score of chest tightness in the conventional group was lower than that before treatment(P<0.01),while there was no statistically significant difference in the symptom scores of chest pain,palpitations,shortness of breath,dizziness,and insomnia with frequent dreams compared with those before treatment(P>0.05). After the treatment,the symptom scores of chest tightness,chest pain,palpitations,shortness of breath,dizziness,and insomnia with frequent dreams in the Guanxinping Tablet group were all lower than those before the treatment(P<0.01). Moreover,the scores of chest tightness,chest pain,palpitations,shortness of breath,dizziness,and insomnia with frequent dreams in the Guanxinping Tablet group were all lower than those in the conventional group(P<0.05 or P<0.01). The total effective rate of the clinical efficacy in the conventional group was 73.33%,which was lower than 93.33% in the Guanxinping Tablet group. There was a statistically significant difference in the clinical efficacy between the two groups(P<0.05). There was no statistically significant difference in the conventional echocardiographic detection indicators before and after treatment in each group(P>0.05). Before treatment,the overall torsion degree of the left ventricle,the overall torsion rate of the left ventricle,the pericardial rotation rate,and the apical rotation rate of patients in the conventional group and the Guanxinping Tablet group were all lower than those in the blank control group(P<0.05 or P<0.01). There was no statistically significant difference in the rotation degree of the pericardial and apical compared with the blank control group(P>0.05). After treatment,no statistically significant differences were observed in the overall torsion degree of the left ventricle,the overall torsion rate of the left ventricle,the pericardial rotation degree and rotation rate,and the apical rotation degree and rotation rate in the conventional group(P>0.05). After treatment,the overall torsion degree of the left ventricle,the overall torsion rate of the left ventricle,and the pericardical rotation rate in the Guanxinping Tablet group were all higher than those before treatment(P<0.05 or P<0.01). After treatment,the overall torsion degree of the left ventricle,the overall torsion rate of the left ventricle,and the pericardical rotation rate in the Guanxinping Tablet group were all higher than those in the conventional group(P<0.05). Before treatment,the abosolute value of GLS,GWI,GCW,and GWE of patients in the conventional group and the Guanxinping Tablet group were all lower than those in the blank control group,and the GWW was higher than that in the blank control group(P<0.05). After treatment,the abosolute value of GLS,GWI,and GWE in the conventional group were all increased compared with those before treatment,and GWW was decreased compared with that before treatment(P<0.05). After treatment,abosolute value of GLS,GWI,GCW,and GWE in the Guanxinping Tablet group were all increased compared with those before treatment,while GWW was decreased compared with that before treatment(P<0.01). After treatment,the abosolute value of GLS,GWI,GCW,and GWE in the Guanxinping Tablet group were higher than those in the conventional group,while the GWW was lower than that in the conventional group(P<0.05 or P<0.01). The repeatability test showed that the within-observer and within-group correlation values of the left ventricular torsional motion parameters and myocardial work parameters all demonstrated excellent consistency. Conclusion: The combination of Guanxinping Tablet on the basis of conventional western medicine treatment can improve the clinical efficacy of patients with stable coronary heart disease of qi and yin deficiency type,and at the same time it can optimize the mechanical parameters of left ventricular torsion and the work efficiency of the myocardium.
2025 11 v.44;No.457 [Abstract][OnlineView][Download 1676K]