Changes Of Vascular Endothelial Function In Different Syndromes Of Coronary Heart Disease And The Effect Of Tanshinone On The Intervention

This article contains two parts:literature survey and clinical investigation.First, literature survey:To investigate the function of vascular endothelial, Chinese and western medicine’s understanding of coronary heart disease, and the relationship between vascular endothelial’s dysfunction and coronary heart disease.Normally,vascular endothelial take part in many physical reactions.Modern clinical research and Animal experiments have shown that:vascular endothelial’s dysfunction almost exists in all the cardiovascular disease,and is the originating factor.Because of hypertension,hypercholesterolemia,cigarette and many other risk factors,people with coronary heart disease have different degrees of endothelial injury.The latter can worsen the CHD,and plays vital role in the development of CHD.No-reflow after PCI,reperfusion injury and in-stent restenosis relate with the vascular endothelial’s dysfunction.Early detection of it,change of life style and proper drug may ameliorate the vascular endothelial function, reduce the incidence of CHD and improve the general level of the health.In addition,from the traditional Chinese medicine angle,the article analyses the etiology and pathogenesis, common type,prescription drugs of chest pain.This part systematically discourse pathogenesis of vascular endothelial function injury and its relationship with CHD,and the progress in traditional Chinese and western medicine treatment of vascular endothelial injury.Second, clinical investigation:Objection:By measuring vascular endothelial function of different syndrome types of in patients with coronary heart disease, and impact of tanshinone IIA sulfonate.Method:We recruited 140 patients with coronary heart disease and 33 healthy subjects. Analysis the determination of age, gender,BMI,smoking history, biochemical items,HS-CRP,FMD,typing of TCM and other data.Meanwhile,30 cases of hospitalized patients with coronary heart disease, on the basis of conventional therapy,was given Tanshinone IIA sulfonate intravenously once a day.And measure their FMD 14 days later,compare with pre-treatment.All data was analyzed by Excel and SPSS 17.0 statistical software.Result:1. Patients with coronary heart disease had a significantly lower FMD than healthy subjects(p< 0.01).Patients with CHD,their vascular endothelial injury was light,coronary heart disease and hypertension group followed by.Vascular endothelial injury of patients with hypertension and diabetes mellitus was most serious.Those groups are different than those in the control group(P<0.05).The difference between CHD group and patients with HT,DM group was statistically (P<0.05).2.Patients with/without family history of coronary heart disease,were significantly compared with the healthy subjects,and there were no significant difference between them (P=0.134).3.Coronary artery lesions were negatively correlated with FMD values.Patients with multivessel disease had the most severe endothelial dysfunction(P<0.01).4.Compared with the control group,male and female patients had significantly difference(P<0.01).Among different patient groups were compared no gender difference(P>0.05).5.Patients with smoking history had lower FMD than those never smoked (P<0.01).In those who smoked analogously,FMD had no gender difference with differnt smoking time (P>0.05).6.Patiens in phlegm and blood stasis were the most(35%),phlegm resistance syndrome was less(27.14%). The rank of TCM Syndromes of endothelial function in coronary heart disease:Qi deficiency and blood stasis group< Phlegm dampness<Phlegm and blood stasis<Phlegm dampness,there are significant differences between these group and the control group (P<0.01) 7.After tanshinone ⅡA sodium treatment, endothelial function changed significantly (p<0.01)Conclusion:1.Patients with Qi deficiency and blood stasis group,and with phlegm and blood stasis,have severe endothelial dysfunction..FMD levels in TCM syndrome is the most closely related with blood stasis type.2.Tanshinone IIA sodium can significantly improve endothelial function.3.Coronary artery lesions and vascular endothelial function is negatively correlated;Postmenopausal female patients’FMD level has no difference with male patients’;Smoking can damage the vascular endothelium.