The Effect of Bupi Tongluo Decoction Combined with Western Medicine in the Treatment of Microvascular Angina Pectoris with Qi Deficiency and Blood Stasis Syndrome and Its Imact on TCM Syndromes and Vascular Endothelial Function

ZHANG Botao; WANG Yahui; REN Jinping

doi:10.3969/j.issn.1002-3429.2025.14.020

Abstract：Objective To explore the effect of Bupi Tongluo decoction combined with Western medicine in the treatment of microvascular angina pectoris(MVA)with qi deficiency and blood stasis syndrome and its impact on TCM syndromes and vascular endothelial function.Methods A total of 106 patients with MVA admitted from June to December 2023 were selected and divided into the observation group and the control group according to the random number table method.The observation group was treated with Bupi Tongluo decoction combined with conventional Western medicine,while the control group was treated with conventional Western medicine.The clinical efficacy,adverse reactions during treatment,occurrence of cardiovascular adverse events during follow-up,TCM syndrome scores before and after treatment,coronary artery hemodynamic indicators[end-diastolic velocity(EDV),resistance index(RI),peak systolic velocity(PSV),pulsatile index(PI)],and vascular endothelial function indicators[nitric oxide(NO),endothelin-1(ET-1),vascular endothelial growth factor(VEGF)],and the levels of disease-related indicators[complement C1q,tumor necrosis factor-related protein 1(CTRP1),visceral fatsin,oxidized low-density lipoprotein(ox-LDL),fibrinopeptide A(FPA)])of the two groups were compared.Results The total effective rate of the observation group was 88.68%(47/53),which was higher than that of the control group(67.92%,36/53),and the difference was statistically significant(P<0.05).After treatment,the TCM syndrome scores of both groups decreased,which were lower in the observation group than in the control group(P<0.05,P<0.01).After treatment,EDV,PSV and PI in both groups increased,while RI decreased.Moreover,EDV,PSV and PI in the observation group were higher than those in the control group,and RI was lower than that in the control group(P<0.05,P<0.01).After treatment,the levels of serum NO and VEGF in both groups increased,while ET-1 decreased.Moreover,the levels of serum NO and VEGF in the observation group were higher than those in the control group,and ET-1 was lower than that in the control group(P<0.05,P<0.01).After treatment,CTRP1,visceral fatsin,ox-LDL and FPA in both groups decreased,which were lower in the observation group than in the control group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P>0.05).The incidence of adverse cardiovascular events in the observation group during the follow-up period was lower than that in the control group(P<0.05).Conclusion The combination of Bupi Tongluo decoction and Western medicine in the treatment of MVA with qi deficiency and blood stasis syndrome has a definite effect.It can improve the symptoms of patients,coronary artery hemodynamics,protect vascular endothelial function,inhibit the inflammation-oxidative stress response,reduce the incidence of adverse cardiovascular events,and has certain safety.