| Menopausal syndrome (menopause syndrome.MS) is a kind of disease that affects the quality of life in premenopausal and postmenopausal women seriously.The main symptoms are hot flushes,sweating,palpitations,dizziness,insomnia,forgetfulness,irritability,vasomotor symptoms, autonomic nervous disorders and mental disorders.The main long term symptoms are increased risks of lipid metabolic abnormalities,arteriosclerosis,coronary heart disease. Endothelial function damage is the first link of the onset of atheroscierosis,dyslipidemia is the material basis of atherosclerosis, is a risk factor for cardiovascular disease.This paper closely discussed the vascular risk factors associated with cardiovascular disease.Through the literature retrieval in recent years,discusses the research progress of cardiovascular disease,menopause and traffic heart kidney and treating menopausal syndrome and menopause comprehensive status of cardiovascular disease,and two aspects of clinical and experimental research on menopause syndrome vascular risk factors were discussed.This study found that there were significant differences between the MS patients with different TCM Syndromes of blood lipid level,especially in the MS patients of disharmony between Heart and Kidney through analyzing the relationship of sex hormone and blood lipid levels in the clinical study of female MS of TCM syndromes in patients.In order to investigate the roles of coordinating heart-kidney method on vascular endothelial system of aging female rats and the probable mechanism invlolved.We also carried out animal experiment,by using aged female rats to simulate natural menopause syndrome,use the medicine restoring normal coordination between heart and kidney intervention in the aging female,and observed the estrogen receptor(ER) in hypothalamus,pituitary,ovary tissues of aged rats and the expression of vascular endothelial L-Arg/NOS/NO pathway.Together,we want to investagste the relationship between dyslipidemia and increased cardiovascular risk and TCM syndromes in MS patients,and the effects of coordinating heart-kidney method treatment,meanwhile provide certain experimental basis for the clinical application of coordinating heart-kidney method treatment of MS and menopause cardiovascular disease.Clinical researchObjectSearch for correlation between serum lipids and estrogen levels in different TCM syndromes in patients with menopause syndrome.MethodsDesign TCM syndrome score table according to the clinical manifestations of patients with MS and the relevant literature.All cases were enrolled according to the diagnostic criteria of MS carried on the questionnaire survey.Recorded the general condition,menstrual history and systemic symptoms,tongue and pulse of TCM differentiation of symptoms and signs,and the modified Kupperman Index(KI)and TCM syndrome score of the patients. We detected the levels of follicle stimulating hormone analysis method(FSH),estradiol(E2),the total cholesterol (TC),glycerin three greases(TG),high density lipoprotein cholesterol (HDL-C)low density-lipoprotein cholesterol(LDL-C),apolipoproteinAl(ApoAl),apolipoproteinB(ApoB),lipoprotein a(Lp(a)) by biochemical method.The database was established using Microsoft Excel,data entry using double entry method.Statistical analysis was conducted by SPSS 19.0.Measurement data using the mean±standard deviation in the form of description,count data using the number of cases(percentage)description.By comparison between the measurement data set independent sample t-test and single factor analysis of variance(one-way ANOVA),Does not meet the normal distribution measurement data was compared using non parametric test,count data were compared between groups using X 2test,Kruskal-Wams H.All test with bilateral P<0.05 was statistically significant.Results1.Correlation of TCM syndrome types and related risk factors of cardiovascular disease122patients met the inclusion criteria of patients with MS on the basis of TCM syndrome differentiation standard is divided into kidney and liver yin deficiency type 43 cases, insufficiency type of kidney Yin-Yang 27 cases,23 cases of kidney deficiency and liver stagnation,disharmony between Heart and Kidney 29 cases.The TCM syndrome types number of 122 MS patients in descending order:kidney and liver yin deficiency(35.25%)>disharmony between Heart and Kidney(23.77%)>two of kidney yin and yang deficiency(22.13%)>kidney deficiency and liver stagnation (18.85%).MS patients with different TCM syndrome type had no obvious correlation among the patient’s age,menopausal status,education level and blood pressure,blood glucose,smoking,drinking,exercises.2.Correlation of TCM syndrome types and blood lipids indexThere was statistical significance of MS patients with different TCM syndrome types of serum TG,TC/HDL-C(P<0.05).The comparison between two two groups explained MS stagnation of disharmony between Heart and Kidney syndrome TG,TC/HDL-C levels were significantly higher than other three syndrome types(P<0.05);LDL-C,ApoB,Lp(a), ApoB/ApoAl,LDL-C/HDL-C,TG/HDL-C, ApoB/HDL-C,non-HDL-C increase but do not have significant difference(P>0.05),HDL-C,ApoAl in Heart kidney incoordination decreased compared with other three syndrome types but do not have significant difference(P>0.05);3.Correlation between severity of MS and blood lipid indexesAccording to the KI score,the MS were divided into mild,moderate and severe,by the single factor analysis of variance, three groups of patients with TC,TG,HDL-C,LDL-C andApoA1,ApoB,Lp(a),LDL-C/HDL-C,TG,HDL-C,TC/HDL-C,ApoB/ApoA1,ApoB/HDL-C,non-HDL-C were no significant difference(P>0.05).Conclusion1.MS patients with different TCM syndrome type had no obvious correlation among the patient’s age,menopausal status,education level and blood pressure,blood glucose,,smoking, drinking,exercises.Disharmony between Heart and Kidney MS may be more prone to menopausal cardiovascular disease.2.There was no obvious correlation between the severity of MS and blood lipid indexes.Experimental studyObjectObserved use the medicine restoring normal coordination between heart and kidney intervention in the aging female,and the ER,ERmRNA in hypothalamus,pituitary,ovary tissues of aged rats and the expression of vascular endothelial L-Arg/NOS/NO pathway.Methods1.This study simulates the natural menopause,nitrate reductive enzymatic determination of nitric oxide(NO),Colorimetric determination of nitric oxide synthase(NOS),a-naphthol diacetyl method for quantitative determination of L-arginine(L-Arg) by using aged female rats model.Radioimmunoassay was used to measure the levels of follicular stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2).Elisa method to detect the animal model of ER content in the hypothalamus,pituitary,ovary,RT-PCR analysis of ERamRNA and ERPmRNA expression level.Observe the aged female rats FSH,E2,LH and the hypothalamus, pituitary and ovarian tissue ER expression level and vascular endothelial L-Arg/NOS/NO changes of the pathways and their correlation.2.Traditional Chinese medicine(TCM) uses the method of coordinating heart-kidney NinggengDan,pentanoic acid estradiol,Gengnian’an tablets intervention on animal model. Through the determination of model rats serumFSH,E2,LH,ER content in the hypothalamus, pituitary,ovary,and L-Arg/NOS/NO pathway,to explore the effect of method of coordinating heart-kidney of rat hypothalamic pituitary ovarian axis and the expression of L-Arg/NOS/NO pathway in vascular.Results1.Results of E2,FSH and LHCompared with before treatment,Chinese medicine treatment group and Western medicine control group E2 increased significantly,and there was significant difference (P<0.05),Chinese medicine control group were slightly increased,but there was no significant difference;FSH of Chinese medicine treatment group,western medicine control group,Chinese medicine control group were lower,and there are significant differences(P<0.05);LH results:there was no difference between the five groups.2.Results of ERCompared with the aged model group,the hypothalamus ER in Chinese medicine treatment group increased significantly,with significant difference(P< 0.05),the western medicine control group and Chinese medicine control group had a similar effect;Pituitary ER in Chinese medicine control group decreased,with significant difference(P<0.05),Chinese medicine treatment group increased significantly,and there are significant differences(P<0.05).Chinese medicine treatment group of ovarian ER increased significantly and there was significant difference (P<0.05).The results of ERamRNACompared with the aged model group,the hypothalamus ERamRNA groups have no significant difference (P>0.05);Pituitary ERamRNA had elevated of Chinese medicine treatment group,with significant difference (P<0.01),while Chinese medicine control group and western medicine control group slightly higher,there were no significant differences (P>0.05).Ovarian ERamRNA of Chinese medicine treatment group,Chinese medicine control group,western medicine control group decreased and there was significant difference(P<0.05). The results of ERβmRNACompared with the aged model group.Chinese medicine treatment group,western medicine control group and Chinese medicine control group the hypothalamus ERβmRNA were significantly increased,but there is no significant difference because of the standard error is too large;Pituitary ERβmRNA of Chinese medicine treatment group was increased and there was significant difference(P<0.01),Chinese medicine control group and western medicine control group ERβmRNA rise slightly,no significant difference(P>0.05);ovarian ERβmRNA of Chinese medicine treatment group,western medicine control group and Chinese medicine control group were increased,and there were significant difference(P<0.01).3.Results of L-Arg,NOS,NOCompared with the aged model group,L-Arg of Chinese medicine control group decreased,and there are significant differences(P<0.05).L-Arg of Chinese medicine treatment group and Western medicine control group slightly increased but no significant difference(P>0.05);NOS of Chinese medicine control group decreased significantly,and there was significant difference(P<0.05),Chinese medicine treatment group NOS decreased slightly but no significant difference(P>0.05);Chinese medicine treatment group and western medicine control group NO increases,and there are significant differences(P<0.05),Chinese medicine control group NO rise slightly,but there was no significant difference(P>0.05).ConclusionHeart-kidney method treatment Ning Gengdan can significantly increase serum E2 and ER in hypothalamus,pituitary and ovary,and promote the ERβmRNA expressions in hypothalamus,pituitary,ovary and ERamRNA expression level in pituitary,inhibition the ERamRNA expression in ovarian.At the same time,it can significantly promote vascular endothelial NO and L-Arg expressions in rats,which means it may be affected by the hypothalamic pituitary ovarian axis and reproductive regulation pathway of vascular endothelial L-Arg/NOS/NO and then exert protective effects on MS and menopausal cardiovascular diseases. |
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