Western medicine for the prevention and treatment of coronary heart disease

  There are three main treatment options for coronary artery disease: conservative drug therapy, coronary intervention and coronary artery bypass grafting.  For a small number of patients with mild coronary artery lesions, minor stenosis and few branches of the coronary arteries involved, simple drug therapy is sufficient. The main drugs are: ①, coronary artery dilation drugs, which can dilate coronary arteries, prevent coronary artery spasm, prevent or relieve angina pectoris and myocardial infarction. The representative drugs are nitroglycerin; ②, anti-platelet coagulation drugs. The most commonly used is aspirin, which is cheap and easy to obtain, with low side effects and easy for long-term application. In addition, there are other anti-platelet coagulation drugs, such as Bolivar, etc.; ③, β-adrenergic blockers, which can reduce the heart rate and reduce myocardial oxygen consumption, prevent myocardial ischemia and prevent sudden death. The representative drugs are betalac; ④, calcium antagonists, the representative drugs are diltiazem; ⑤, anti-arrhythmic drugs, if combined with arrhythmias applied.  (6) Other anti-hypertensive drugs and drugs to regulate blood pressure, blood glucose and blood lipids are used to control blood pressure, blood glucose and blood lipids, thus slowing down the progress of atherosclerotic lesions and slowing down the process of coronary artery lesions.  For most patients with coronary artery disease, medication alone is not sufficient and coronary intervention or coronary artery bypass grafting by a cardiac surgeon is required. If the coronary artery lesion is localized to a branch vessel, is not extensive, and does not involve openings in other branches, the patient may be treated with coronary intervention by an internist. A special catheter is used to puncture through the femoral artery, as in coronary angiography, to retrograde into the coronary artery stenosis. A balloon is then used to dilate the stenosis before a coronary stent is placed to expand the narrowed coronary artery lumen and allow blood flow to pass through, thereby restoring myocardial perfusion.  Coronary intervention is less invasive, quicker to recover, and easier to be accepted by patients, which is its advantage. However, its indications are narrow, and it is difficult to deal with complex coronary lesions such as left main stem lesions, multi-branch lesions, long segment lesions, complete blockage of vessels, small vessels, and distal stenosis, etc. Also, the problem of interventional failure due to restenosis after stent placement due to retention of allogeneic materials should not be ignored. The restenosis rate after early medical intervention is significantly higher than that of bypass surgery, and the improvement in survival and quality of life is not significant.  The short- and intermediate-term results are even comparable to those of coronary artery bypass grafting, but the late thrombosis and restenosis caused by it cannot be ignored, and its long-term results are still inconclusive.  Coronary artery bypass grafting is commonly known as coronary artery bypass grafting. The most common vascular materials used for “bridging” are the autologous internal mammary artery, saphenous vein, radial artery, as well as the right gastric omental artery and the cephalic brachial vein.  It is suitable for patients with complex coronary artery lesions such as left main lesions, multi-branch lesions, long segmental lesions, complete blockage, small branches, distal coronary stenosis, wall calcification, restenosis after stenting, complications of interventional treatment, and other metabolic diseases such as combined diabetes.  In general, coronary artery bypass grafting is feasible for patients who cannot undergo medical intervention for various reasons or whose interventional treatment has failed. With the continuous maturation of CABG technology, the rapid development of non-stop bypass technology, the development of minimally invasive surgery, the application of endoscopic technology, the improvement of preoperative evaluation and preparation, the improvement of intraoperative myocardial perfusion protection technology, the importance of intraoperative and postoperative protection and maintenance of the bridge vessels, and the improvement of postoperative monitoring, the mortality rate of CABG surgery has been greatly reduced. Several studies have shown that coronary artery bypass grafting has significant advantages in terms of symptom relief. In patients with coronary artery disease, it is important to restore myocardial perfusion, which we call “recanalization”. CABG bridgework has been recognized worldwide for its 95.7% 1-year patency rate and over 90% 10-year patency rate for left anterior descending branch anastomosis of the left internal mammary artery. The radial artery as bridge material has a high long-term patency rate, with a 1-year patency rate of 90% and a 5-year patency rate of 84%. The saphenous vein is the most commonly used vessel, which is easy to take, has a large caliber and suitable length, and has a 10-year patency rate of about 50-60%.  Prevention can prevent the occurrence of coronary heart disease.  First of all, good living habits are very important. Coronary heart disease is caused by many bad habits, such as smoking, high-fat and high-calorie diet, and lack of exercise. Smoking may induce coronary artery spasm, platelet aggregation, reduce the reserve capacity of coronary artery and collateral circulation, and can also cause hypertension. Poor dietary habits can cause hyperlipidemia, obesity and diabetes, which are all risk factors for coronary heart disease. Therefore, smokers are strongly advised to quit smoking, obese people strictly control their weight, and it is more important to move more than to eat less.  Diet to reduce the total fat, saturated fat and cholesterol intake, overweight people should limit the total calories, if the blood lipid level is obviously abnormal, lipid regulators can be used. Participate in moderate physical activity and exercise. Second, avoid overload. People in middle age, various organs obviously degenerate, should learn to adjust the rhythm of life, relaxation, never long-term body “engine” is always running at full speed.  Thirdly, for patients with “three highs” (high blood pressure, high blood lipids, high blood sugar), blood pressure, blood sugar and blood lipids should be controlled to normal levels. For middle-aged and elderly people, they should have regular health checkups and try to “move but not, eat but not fat, strong but not fat”.  Fourth, if you suffer from coronary heart disease, you should actively seek medical advice, and do not “avoid the disease”. Early detection, early diagnosis, early treatment, can avoid the transformation of minor diseases into major diseases, not only lower costs, and the treatment effect is more obvious.