Efficacy of “Pinggan Formula” in Controlling Acute Type B Aortic Dissection Perioperative Blood Pressure: A Randomized Controlled Clinical Trial

Abstract

Objective To explore a new treatment that can proceed from the whole, control blood pressure smoothly and coordinate the treatment of multiple factors causing blood pressure fluctuations. Method We conducted a single-center, double-blinded, and randomized controlled clinical trial. 48 patients with acute Type B aortic dissection were randomly assigned into two groups: the experimental group, who received pinggan formula treatment, and the control group, who received placebo treatment. The drug was taken orally after meals three times a day. Only when the patients' blood pressure fluctuated, conventional antihypertensive drugs were given to maintain the blood pressure within the target range and the dosage was recorded to convert the DDD value. Meanwhile, the international standardized score was used to evaluate the defecation, sleep, pain, anxiety, and depression of patients in the two groups during the hospitalization. Result Univariate analysis was conducted on variables that might affect the assessment results, and it was found that grouping factors had a significant impact on the outcome variables, that is, after the intervention, the mean value of DDDs used in the perioperative period in the control group was 2.19 (0.38, 4.00). (P=0.0219), defecation score (2.13 (1.59, 2.67); P < 0.0001), sleep score (0.95 (0.40, 1.50); P=0.0014), pain score (1.77 (0.61, 2.93); P=0.0045), depression score (4.04 (2.95, 5.12); and P < 0.0001) were significantly higher than that of the experimental group, and the difference was statistically significant. Conclusion Pinggan formula has a clear therapeutic regulation effect on the overall hemodynamics of acute Stanford type B aortic dissection during the perioperative period and can be recommended as an auxiliary drug for conventional antihypertensive drugs at the current stage.

SERPINE1 Gene Is a Reliable Molecular Marker for the Early Diagnosis of Aortic Dissection

“…In traditional Chinese medicine, the etiology of aortic dissection is a kind of disease caused by congenital insufficiency, acquired dystrophy, and internal invasion of exogenous pathogens, resulting in deficiency of yin and blood, which cannot nourish the heart and weakens the heart [ 59 ]. Generally, the methods of nourishing blood and nourishing qi, nourishing the heart and veins, and treating according to syndrome are used to deal with it.…”

“…Chinese medicine treatment also includes acupuncture rehabilitation, traditional Chinese medicine ingredients, etc., and also symptomatic treatment according to individual physique. Conservative drug therapy reduces the patient's blood pressure to the lowest value that can be tolerated by antihypertensive drugs [ 59 ]. In addition, the patient's heart rate can be controlled as much as possible by oral medication to reduce the stress on the heart [ 60 ].…”

An Evidenced-Based Review of Emergency Target Blood Pressure Management for Acute Aortic Dissection

“…Te evidence in this study (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) elucidated the selection and considerations of drugs. In drug selection, β receptor blockers are the frst choice for the treatment of AAD [32], except for contraindication such as asthma and atrioventricular block.…”

“…A preliminary search of 6397 relevant documents, including 2002 duplicate documents, 1233 documents that could not be obtained in full text, 2675 documents with research objects and contents inconsistent with the subject, 465 documents with literature quality below grade B and updated old guidelines or expert consensus, was carried out, and 17 documents were fnally included, which are 6 clinical decisions [2,[11][12][13][14][15], 5 guidelines [16][17][18][19][20], 2 expert consensus [21,22], 1 systematic review [23], 1 randomized controlled trial [24], one cohort study [25], and one case series [26] (Figure 3 and Table 1).…”