Keywords: angina etiology and pathology
1, angina Overview
Angina, coronary insufficiency, myocardial rapidly, the clinical syndrome caused by temporary ischemia and hypoxia. Characterized by paroxysmal crushing chest pain feeling, may be accompanied by other symptoms, pain in the sternum rear may radiate the Zhixin before the area with the left upper extremity, often occur in labor or emotional, continued for several minutes, break or disappear after nitrate preparations.
The disease is more common in men, the majority of patients in more than 40 years of age, fatigue, agitation, satiation, chills, weather hindered rain, acute circulatory failure common incentives.
Be mechanical stimulation of the heart does not cause pain, myocardial ischemia and hypoxia cause pain. When the contradictions between the needs of the coronary blood supply to the heart dirty blood coronary blood flow can not meet the needs of the myocardial metabolism, causing myocardial sharp, temporary ischemia and hypoxia, which produce angina.
3, pathological anatomy and pathophysiology
Anatomic pathology examination revealed angina patients, the main branch at least one coronary artery lumen stenosis of more than 75% of the surface of the crosscutting. Collateral circulation, the main branch of the coronary artery is more serious obstruction to occur angina. Small arteries coronary angiography, on the other hand, found that 5% to 10% of patients with angina pectoris, the main branch of the coronary lesions, suggesting that these patients myocardial blood supply and oxygen supply shortage may be coronary artery spasm, coronary circulation abnormal lesions, hemoglobin and oxygen dissociation due to sympathetic overactivity, excessive catecholamine secretion or myocardial metabolic abnormalities.
Patients before angina attack, often increased blood pressure, increased heart rate, increased pulmonary artery pressure and pulmonary capillary pressure increased changes reflect the heart and lung compliance reduce. The attack reduced left ventricular contractility and contraction speed, spurting slowed left ventricular systolic pressure decreased stroke volume and cardiac output decreased left ventricular end-diastolic pressure and increased blood volume, left heart failure pathology physiological changes. Left ventricular wall was weakened contraction contraction uncoordinated or part of the ventricular wall.
[Clinical manifestations and genotyping typical angina pectoris in sudden sternal body on or after the middle of the press, the the Fullness or suffocation pain, may also spread to most of the precordial area, may radiate to the left shoulder, left upper limb ago the inside, up to the ring finger and little finger, even accompanied by the feeling of dying, often forcing the disease immediately stop the activity, severe sweating. The pain lasted for 1 to 5 minutes, rarely more than 15 minutes; to rest or containing nitroglycerin tablets, within 1 to 2 minutes (rarely more than 5 minutes) disappears. Often in physical exertion, emotional (angry, anxious, over-excited), chills, satiation occurs when smoking, anemia, tachycardia or shock can also be induced. Atypical angina, the pain can be located in the lower sternum the left precordium or upper abdomen, radiating to the neck, jaw, left the scapular or right chest, the pain can be very light or only left chest discomfort nausea feeling.
According to the the named diagnostic criteria of the World Health Organization “ischemic heart disease", the angina is divided into the tired and spontaneous two categories. Angina patients in recent years insight into some type angina will now be summarized to the following three categories:
① exertional angina
② spontaneous angina
(3) mixed angina
Clinical manifestations and typing
(1) Clinical manifestations
(2) sub-type: exertional angina, spontaneous angina mixed angina
5, at home and abroad for angina treatment technology overview:
(1) prevention of lipid-lowering, anticoagulant and for coronary atherosclerosis, the etiology of treatment to prevent the occurrence and development of atherosclerosis. After treatment, is the expansion of the progress of coronary atherosclerosis and reduce myocardial ischemia and hypoxia.
(2) treatment with nitrate lipids coronary vasodilator, expansion of coronary blood vessels, played an increase in coronary blood flow, improve myocardial blood supply to relieve angina pectoris.
(3) surgical treatment with coronary artery bypass graft surgery, vascular stenosis of coronary atherosclerosis caused by the bellows coronary angioplasty and interventional stent means to change.
6, for an assessment of the current treatment methods:
(1) is still a lack of effective drug treatment for coronary atheroma.
(2) lipids nitrate coronary vasodilator regarded as the most effective way to alleviate angina, the disadvantage is that it can not fundamentally improve coronary atherosclerosis hardening due to vascular stenosis.
(3) surgical treatment of coronary artery stenosis fundamentally solve, but there are two aspects, one is expensive, after surgery, some patients in the short-term content easy to form the coronary vascular restenosis.
7, the application of systematic synchronization method in the treatment of angina clinical research and observation.
The purpose and significance of the research:
Coronary heart disease caused by angina, the first since the cause is coronary atherosclerosis formation of coronary pipe stenosis, myocardial blood supply due to obstacles, and the current lack of clinically for coronary atherosclerosis, the formation of blood vessels to narrow these pathological changes effective treatment this Centre coronary heart disease research group for these pathological changes, screening blood circulation, Ditan tongluo, three types of traditional Chinese medicine, qi yang “composition of Guanxin fried I, and cardiac health of Chinese medicine, for different conditions of random selection of the treatment of coronary heart disease due to angina observed five years, and achieved good efficacy and clinical applications. Guanxin fried Chinese medicine preparations cardiac Kang, reuse leech, earthworm, earth element, gall Star, ginseng, Scorpion, etc. According to traditional Chinese medicine pharmacological studies show that the blood circulation Chinese herbs, traditional Chinese medicine leech, earthworm earth element, strong anti coronary intimal cell hyperplasia role of, and coronary atherosclerotic plaque with strong decomposition gall Star ginseng strong improvement of myocardial metabolism, enhance myocardial systolic and diastolic.
Although the party TCD according to coronary heart disease, coronary atherosclerosis, the pathological changes and set effective prescription for targeted treatment, its purpose in the development of effective prescription to control with conventional treatment clinical observation lift woes provide a scientific basis and explore new therapeutic approach, for the majority of patients with coronary heart disease.
The study of innovation and technology key.
Guanxin the fried I and cardiac health pure Chinese medicine is based on the coronary heart disease etiology and pathology of the major role in coronary artery stenosis, the duct cells intimal fibrosis proliferative pathological changes, the use of Chinese medicine for these pathological changes by antifibrotic decomposition of atherosclerotic plaques, inhibition of proliferation, repair the the heart tube endometrial reach state expansion of coronary restore myocardial blood supply, so as to achieve the coronal porridge from coronary heart disease atherosclerosis vascular stenosis, a fundamental treatment.
Institute of the process route.
Case selection, selected according to the diagnostic criteria of coronary heart disease induced angina, 200 cases were randomly divided into treatment group, 120 patients in the control group of 80 patients in the treatment group the oral Guanxinkang fried I and cardiac health, 2 times a day, and the control group in nitric acid lipid the crown expansion class of drugs, oral or intravenous.
Observed disease 3 course of treatment and follow-up of three courses.
Effective than the treatment methods play a good role in the elimination of angina and improve myocardial blood supply through a large number of clinical observation.