[Research progress in modern clinical application and mechanism of Guizhi decoction].

Guizhi decoction come from Typhoid Theory written by Zhang Zhongjing, a famous physician in the Han dynasty. It is called "the leading group of the group" by later doctors. At present, Guizhi decoction is widely used in treatment of many diseases of internal, external, gynecologic and other diseases. This article discusses the clinical application and mechanism of Guizhi decoction in two aspects. This article expounds that Guizhi decoction is widely used in colds, febrile diseases, various perspiration, digestive system diseases and respiratory diseases, Some diseases, such as ear, nose and throat disease, nervous system disease, cardiac autonomic neuropathy, and bone and joint disease. The mechanism of Guizhi decoction in the treatment of diseases may be related to the mechanism of biaxial regulation of body temperature and gastrointestinal motility, mucosal immune intervention, secretion of sweat glands, inflammation immune function and myocardial protective effect and so on.

[Correlation between syndrome factor combination and cardiac function as well as blood-lipid in coronary heart disease].

OBJECTIVE: To discuss the distribution laws of traditional Chinese medicine (TCM) syndrome factor and their combination in coronary heart disease (CHD), and to study the correlation between the TCM syndrome factor combination and cardiac function as well as blood-lipid. METHODS: The parameters of the cardiac function of 300 patients with a final diagnosis of CHD by coronary angiography were measured by echocardiography, and the levels of blood lipids in the CHD patients were detected. An analysis of the correlation was done between the TCM syndrome factor combination and cardiac function as well as blood-lipid in CHD. RESULTS: The TCM syndrome factor combinations of CHD were blood stasis due to qi deficiency, qi and yin deficiency, intermingled phlegm and blood stasis, and yang deficiency and blood stasis. The ejection fraction of CHD patients with yang deficiency and blood stasis was markedly decreased. The levels of triglyceride and low-density lipoprotein cholesterol in CHD patients with intermingled phlegm and blood stasis were markedly increased, and the level of triglyceride in CHD patients with qi and yin deficiency was markedly increased too. CONCLUSION: The treatment of CHD should aim directly at the symptoms and causes. It is also proved that some compound traditional Chinese herbal medicines for supplementing qi and activating blood circulation, nourishing yin and resolving phlegm, and activating yang should be used in treatment of CHD. In cases of CHD with low cardiac function, particular emphasis should be laid on activating yang and blood circulation, while in cases of CHD with blood-lipid disturbance, particular emphasis should be laid on resolving phlegm and activating blood circulation, replenishing qi and nourishing yin.

[Factor analysis of traditional Chinese medicine syndromes in 815 patients with unstable angina].

OBJECTIVE: To explore the laws of traditional Chinese medicine (TCM) syndromes in unstable angina, and to establish the preliminary diagnostic criteria for TCM syndromes. METHODS: Multi-center prospective research on TCM syndromes in 815 cases of unstable angina was done with the nonlinear dimension reduction by factor analysis. RESULTS: There were five extracted factors in factor analysis: F1, F2, F3, F4 and F5. F1 was yin deficiency of heart and kidney, F2 was deficiency of both heart and spleen, F3 was intermingled phlegm and blood stasis, F4 was qi deficiency and blood stasis, and F5 was yang deficiency and coagulated cold. Qi deficiency and blood stasis (F4) syndrome accounted for the maximum proportion. The diagnostic criteria for TCM syndromes were preliminarily and respectively established. CONCLUSION: Qi deficiency and blood stasis is the key factor of pathogenesis. The factor analysis can help us classify traditional Chinese medicine syndromes and establish the preliminary diagnostic criteria.

[Study on the therapeutic status of 1242 hospitalized acute myocardial infarction patients in Beijing].

OBJECTIVE: To investigate and analyze the therapeutic level and the existing problems on acute myocardial infarction (AMI) management in Beijing. METHODS: We collected clinic data of 1242 AMI patients from 12 hospitals in Beijing, from January 2000 to March 2001, using a uniformed questionnaire, and evaluated the status of the diagnosis and treatment of AMI according to the Chinese guidelines issued on Decmeber 2001. Corresponding factors which influencing the mortality were also analyzed by one-way factor and multiple factors analysis methodologies. RESULTS: The mean age of the 1242 AMI patients was 63.0 years old and about one third of them were under 55 years old. In hospitals, the total mortality was 9.10%. 37.9% of the patients had received therapy of the intravenous thrombolysis and emergency PCI with a total rate of reperfusion therapy as 56.0%. The in-hospital rates of drug use were as follows: Nitrates 90.0%, Aspirin 87.8%, heparin 88.7%, beta-blockers 73.4%, angiotensin converting enzyme inhibitors(ACEI) 77.6%, lipid regulating agents 43.6%. The rate of intravenous therapy of TCM by promoting the blood circulation and supplementing the vital energy was 30.5%. Results from multiple factors analysis showed that the compositive factors which could lower the mortality were reperfusion therapy,lipid regulating agents, intravenous therapy of TCM, beta-blockers, ACEI, lower molecule heparin and digitalis. CONCLUSION: Data from this study showed that there still existed a gap between clinical management on AMI and the guideline in Beijing. To set up a straightway passage of reperfusion therapy, to become more standardized to follow the guideline in undertaking the medical treatment practice, and to go deep into discuss the status of TCM on AMI management seemed the important tasks we are facing.

[An investigation on clinical studies of TCM in preventing and treating angina pectoris of coronary heart disease].

OBJECTIVE: To analyze the current status of clinical studies of TCM in preventing and treating angina pectoris of coronary heart disease. METHODS: A statistical analysis of articles regarding the use of TCM in preventing and treating angina pectoris, published in TCM core journals or journals of TCM university (college) from January 2001 to June 2002 was conducted, the items analyzed included the differentiation of stable angina (SA) and unstable angina (UA), the grading or stratifying, standard for therapeutic efficacy evaluation, standardized drug therapy of UA (according to the "Suggestion on the diagnosis and treatment of UA" formulated by Society of Cardiovascular Disease, Chinese Medical Association, etc. RESULTS: From the 44 articles that retrieved, UA and SA was not differed in 29 articles (65.9%), among which 11 articles came from provincial, national TCM institute or hospital affiliated to TCM university (college). In the 34 articles dealing with UA, only 3 articles mentioned the standardized drug therapy. Standard of therapeutic efficacy evaluation announced in 1979 was used in 35 articles (79.5%). CONCLUSION: Most articles dealing with clinical study on TCM prevention and treatment of angina pectoris, UA and SA, have the flaws of un-standardized, lacking in compact and insufficient science. Improvement of related standard for clinical therapeutic efficacy evaluation needs to be further perfected.