Circulation Down The Muddy Mixture Of Intervention Efficacy Evaluation Of The Metabolic Syndrome And Its Impact Factor On The Part Caused By Artery Atherosclerosis

My thesis includes three parts: literature summarization, clinical observation and experimental research.The part of literature summarization reviews the progress of clinical and experimental research on treating metabolic syndrome (MS), including the aspects of Western Medicine and Traditional Chinese Medicine (TCM). This part reflects the status quo of researches on epidemiology, diagnosis, evaluation criteria, pathogenesis, clinical features and intervention. It also summarizes the knowledge of scholars of TCM on the etiology, pathogenesis, differentiation of TCM syndrome, and TCM intervention and mechanism. Unsolved problems, weak points and possible solution of researches on MS are also analyzed in this part.Clinical research was performed to observe the clinical efficiency of HuaYu JiangZhuo Mixture (HYJZM) on MS and its effect on pro-atherosclerosis risk factors. 70 MS patients conforming to 2005 definition given by International Diabetes Federation (IDF) were randomly divided into two groups: HYJZM-treated group (n=35) and western medicine- treated group (n=35). The patients were identified as the syndrome of blood stasis and phlegm-dampness and treated with HYJZM or Rosiglitazone for 8 weeks. Clinical symptom, body mass index (BMI), waist-hip ratio (WHR), fasting plasma glucose (FPG), two hour plasma glucose (2hPG), blood pressure (BP), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), insulin action index (IAI), high sensitive C reactive protein (hs-CRP), homocysteine (Hcy), fibrinogen, urinary albumin excretion rate (UAER), brachial artery dilation and adverse reaction were observed before and after treatment for the two groups. Results showed that clinical manifestation of HYJZM-treated group was improved significantly (P<0.05). The total efficiency of HYJZM on TCM syndrome was as high as 78.79%, which was higher than that of Rosiglitazone- treated group (P<0.05). Hyperglycemia and lipid metabolism disturbance were improved in both HYJZM- and Rosiglitazone-treated groups (P<0.05) and there was no statistical significance between these two groups. BP in both groups was slightly lowered, showing no difference when compared with that before treatment. Pulse pressure was decreased in HYJZM-treated group, which was lower than that before treatment (P<0.05). IAI was augmented in both groups, suggesting that HYJZM and Rosiglitazone have similar improving effects on insulin resistance. The plasma levels of hs-CRP, Hcy, fibrinogen, and UAER were decreased and brachial artery dilation was improved when treated with HYJZM. These data support the notion that HYJZM may protest against the process of atherosclerosis through controlling pro-atherosclerosis risk factors. No obvious adverse reaction and side effect were observed in HYJZM-treated group. Rat insulin resistance model was established through feeding a high-fat-salt diet. The effects of HYJZM on body weight, glucose and lipid metabolism, BP, IAI were observed. Serum levels and mRNA expressions in adipose tissue of TNF-αand adiponectin were also investigated. Results showed that HYJZM treatment suppressed the increase of body weight significantly, which was better than Rosiglitazone treatment. HYJZM and Rosiglitazone had similar improving effects on glucose and lipid metabolism disturbance and insulin sensitivity. BP was lowered slightly in HYJZM-treated group (P>0.05). HYJZM suppressed the mRNA expression of TNF-αin adipose tissue and lowered the serum level of TNF-α. Furthermore, the mRNA expression in adipose tissue and serum level of adiponectin were promoted in HYJZM-treated group. Taken together, HYJZM has improving effect on glucose and lipid metabolism and insulin sensitivity. HYJZM treatment augments adiponectin level and exerts anti-inflammatory effect. These results suggest that HYJZM may prevent the development and progress of atherosclerosis through protecting the function of vascular endothelia.