Clinical And Experimental Studies On The Formula Of JiangTang ShuXin(JTSX) On Diabetes With Coronary Heart Disease

Objective:Coronary heart disease(CHD) is one of main complications of diabetes mellitus(DM) and one of main cause to death with DM. Diabetes with CHD belongs to "emaciation thirst and obstruction of qi in the chest "category in TCM. The thesis research deeply about the prevention and treatment of diabetes with CHD with JTSX. which was demonstrated by the document and the clinic and the experiment.Methods: the main contents of the study including:(1) To study pathogenesis and principle of treatment of diabetes with CHD on the basis of epidemilogy of diabetes with CHD and the ancient documents and modem research achivement. (2) Jiang Tang Shu Xin Ke li(JTSXKL) was produced by the formula of JTSX with advanced industrial way and its toxicity analysis and side effect was determined.(3)To compare the clinical effect of JTSXKL on 35 paitents of diabetes with CHD and of nifepine on 32 paitents of diabetes with CHD. (4)The experimental type 2 diabetes with AS (atherosclerosis) rats were yielded by i.p streptozotocin(75mg/kg) and feeding hyperotrophic foods, then we observed the effect of insulin-sensitivity and glycometabolism and lipometabolism on the experimental rats by JTSXKL. (5)To research theeffect of LOX-1 and PDGF-A expression in aorta of experimental rats by JTSXKL. (6)To investigate the effect of JTSXKL on proliferation of VSMC induced by AGEs in vitro.Results:(1)it is considered that the defiency of both qi and yin and the disorder accumulation of blood circulation and stagnation ofphlegm-dampness in middle jiao were basic pathogenesis of diabetes with CHD. Nourishing yin and suppelementing qi and promoting blood circulation to remove blood stasis and resolving phlegm to invigorate pulse-beat(the formula of JiangTangShuXin) may be basic therapeutic principle of diabetes with CHD(2) JTSXKL was identical of the criterion of drugs and was safe in oral, its toxicity and side effect is no significant. (3)JTSXKL could improve paitents' symptoms and cardiac function and glycometabolism and lipometabolism. It could improved insulin resistance in the patient. (4)There were hyperglycemia and hyperlipidemia in the model rats, JTSXKL could improve insulin-sensitivity and alleviate or inhibit occurrence and development of atherosclerosis in the model rats. (5) It was found that upregulation of LOX-1 expression and downregluation of PDGF-A expression in aorta of experimental rats by JTSXKL.(6)JTSXKL could inhibit proliferation of VSMC induced by AGEs in vitro.Conclusion:(1)CHD is the most complication of DM. it was considered that the defiency of both qi and yin and the disorder accumulation of blood circulation and stagnation of phlegm-dampness in middle jiao was basic pathogenesis of diabetes with CHD. Stagnated blood and phlegm-dampness is the most important factor which emaciation thirst cause obstruction of qi in the chest(2)JTSXKL improved paitents' symptoms and cardiac function and insulin resistance by anti-hyperglycemia and anti-hyperlipidemia and anti-nonenzymatic glycosylation and protecting VEC. (3) JTSXKL alleviated or inhibited occurrence and development of atherosclerosis in diabetic rats by upregulation of LOX-1 expression and downregluation of PDGF-A expression and anti-proliferation of VSMC.(4)JTSXKL prevented and treated diabetes with CHD paitents by mechanism of mulitarget.