Objective  To investigate the effect of Xuefu Zhuyu Decoction combined with external counterpulsation therapy on angina pectoris attacks and brachial artery flow-mediated dilation (FMD) in patients with angina pectoris of heart blood stasis syndrome.

Methods  A total of 80 patients with stable coronary artery disease (SCAD) and angina pectoris who visited our hospital between March 2022 and December 2023 were selected as study subjects and randomly divided into control group (40 cases) and treatment group (40 cases). The control group received conventional treatment and Xuefu Zhuyu Decoction, while the treatment group received external counterpulsation therapy in addition to the control group′s treatment. The angina pectoris attacks before and after treatment in both groups was recorded. Color Doppler ultrasound was used to measure brachial artery FMD; electrocardiogram was used to measure heart rate variability indicators, including the standard deviation of the average of normal to normal intervals (SDANN) for 5 consecutive minutes, standard deviation of normal to normal intervals (SDNN), and square root of the mean of the sum of the squares of the differences between consecutive N-N intervals (rMSSD). A fully automatic biochemical analyzer was used to measure blood lipid indicators such as high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG). Nitrate reductase method was used to detect serum nitric oxide (NO) levels, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum endothelin-1 (ET-1) levels. Adverse events in both groups were recorded.

Results  After treatment, the attack frequency of angina pectoris decreased and duration shortened in both groups compared with before treatment, and the attack frequency of angina pectoris was lower and duration shorter in the treatment group than in the control group (P < 0.05). After treatment, FMD and NO levels increased, and ET-1 levels decreased in both groups compared with before treatment, and FMD and NO levels were higher, while ET-1 levels were lower in the treatment group than in the control group (P < 0.05). After treatment, SDANN, SDNN, and rMSSD increased in both groups compared with before treatment, and SDANN, SDNN, and rMSSD were higher in the treatment group than in the control group (P < 0.05). After treatment, HDL-C levels increased, while LDL-C, TC, and TG levels decreased in both groups compared with before treatment, and HDL-C levels were higher, while LDL-C, TC, and TG levels were lower in the treatment group than those in the control group (P < 0.05). No serious adverse reactions occurred during treatment in both groups, and vital signs were normal, with normal liver and kidney function.

Conclusion  Xuefu Zhuyu Decoction combined with external counterpulsation can effectively alleviate clinical symptoms, reduce the frequency of angina pectoris attacks, shorten the duration of angina pectoris, improve brachial artery FMD, endothelial function, heart rate variability, and blood lipid levels in patients with angina pectoris of heart blood stasis syndrome. Besides, it has higher safety.