Based On The Principle Of Combined Disease And Diabetic Coronary Heart Disease (chd) And Chinese Medicine Intervention Mechanism Of Blood Stasis Syndrome

This study based on the National Natural Science Fund project "Yiqi huoxue bioactive component inhibit diabetic Hamster cardiomyopathy and ventricular remodeling and apoptosis mechanism"(No.81173258).Includes"Based on structured diabetes inpatient medical records law of syndrome differentiation and treatment of diabetes mellitus complicated with coronary heart disease"and"Danshen Yin on myocardial fibrosis in diabetic cardiomyopathy in rats molecular mechanism". The first part, clinical studies shows:The basic pathogenesis of diabetic coronary heart disease is holding of deficiency of both Qi and yin and blood stasis. The main treatment principle of diabetes combined coronary heart disease are supplementing qi and nourishing yin,stasis-dissolving drugs.The most used prescription of diabetes combined coronary heart disease are DAN SHEN YIN and SHENG MAI SAN. Because diabetes diabetic cardiomyopathy and coronary heart disease in Chinese medicine are such as "chest" and "PALPITATION" areas. Their contact must exist on the pathogenesis in traditional Chinese medicine. Therefore, based on the first part of the clinical findings, We use diabetic cardiomyopathy as a research object, discussion on the mechanism of the effect of danshen decoction on diabetic cardiomyopathy.Abstract One Clinical studyObject:To explore the laws of Traditional Chinese Medicine Diagnosis and Treatment of type2diabetes patients with coronary heart disease by data mining method; to develop TCM diagnosis and treatment protocols of Diabetic Coronary Heart Disease by the results; to provide ideas for the clinical diagnosis and treatment of coronary heart disease of diabetes.Method:In this study,455cases of T2DM patients with coronaiy heart were collected by Structurized Traditional Chinese Medicine Diabetes In-patent Record Information Collection System in Endocrinology, Guang An Men Hospital from January2009to January2012. Through the use of association rules, Bayesian networks, regression analysis and other methods, to explore diabetic coronary heart disease in laws of Traditional Chinese Medicine Diagnosis and Treatment, to develop TCM diagnosis and treatment protocols of Diabetic Coronary Heart Disease by the results; to provide ideas for the clinical diagnosis and treatment of coronary heart disease of diabetes.Results:1. The epidemiological characteristics of Diabetic coronary heart disease Diabetic patients with coronary heart disease incidence have a certain relationship with the following items. They include age, sex, duration of diabetes, BMI, history of smoking and alcohol consumption, dyslipidemia, blood glucose. Hypertension, HbAlc, high cholesterol, family history of diabetes, coronary heart disease, hypertension and high cholesterol.2. Glossal VenationThe Multiple Indicator joint analysis showed that the change of glossal venation of diabetic patients with coronary heart disease throughout the course as described below. Tongue and moss in this disease suggest that the disease is more common in blood stasis, heat and deficiency and often mixes with Dampness, heat, phlegm and other pathological product. The Pulse suggested that the disease is mostly Interior Syndrome, deficiency, blood stasis, followed by damp phlegm syndrome, heat syndrome.3. The main symptoms of diabetes coronary heart disease are dry mouth, fatigue, chest tightness and often accompanied by blurred vision, numbness.There are a total of3277people and64symptoms classification. Multiple Indicator joint analysis shows that the main symptoms of diabetes coronary heart disease are dry mouth, fatigue, chest tightness. The associated analysis showed that diabetic coronary heart disease late compared with earlier increased the swelling of the limbs, limb pain, left chest pain and other symptoms, compared with the Medium-term increased in the left chest pain, suggesting the Yang-deficiency, water-stagnation and Blood stasis symptoms of diabetic coronary heart disease compared with the previous increased. A number of related prompts the typical symptoms of diabetes is often associated with the symptoms of diabetes coronary heart disease, diabetic peripheral neuropathy and diabetic retinopathy, and its complications gradually increased with the duration of the extension. Diabetic peripheral neuropathy, diabetic retinopathy and diabetic coronary heart disease often occur simultaneously.4. The main therapeutic principles of Diabetic coronary heart disease were supplementing Qi and nourishing Yin, promoting blood circulation to remove blood stasis. Shengmai Powder and Danshen Decoction were the most commonly used prescription.A total number of733people used86kinds of prescription during treatment. Danshen Decoction and Shengmai Powder accounted for19.4%and18.8%respectively, were widely used prescriptions. And the main therapeutic principles of Diabetic coronary heart disease were supplementing Qi and nourishing Yin, promoting blood circulation to remove blood stasis. The associated analysis showed that the main prescriptions Danshen Decoction and Shengmai Powder is used in Diabetic coronary heart disease in the entire process, embodying the basic pathogenesis of this disease.deficiency of both vital energy and yin concurrently blood stasis. With the extension of the disease, the usage of Danshen Decoction, Liuwei Dihuang Decoctionv, Gualou Xiebai Banxia Decoction were increasing, indicating that as the course of the disease extended the pathological products like stasis, phlegm, dampness increased.5. The drugs of supplementing Qi and nourishing Yin, promoting blood circulation to remove blood stasis were most frequently used in Diabetic coronary heart disease.A total of250drugs were used in patients. The most used drugs including Poria, accounting for4.2%; Salvia, accounting for4.0%; and heterophylla, accounting for3.5%. Depending on the drugs and their functional classification, the main therapeutic principles of Diabetic coronary heart disease were supplementing Qi and nourishing Yin, promoting blood circulation to remove blood stasis. The associated analysis showed that the drugs of supplementing Qi and nourishing Yin, promoting blood circulation to remove blood stasis were most frequently used in Diabetic coronary heart disease, and increased with the duration. Correlation analysis shows that the most related common drugs were compositions of Shengmai Powder and Danshen Decoction.6. The diagnosis and treatment law of diabetic coronary heart disease with blood Stasis Syndrome.According to the associate rule of prescription to analysis,On the prescription,the diagnosis and treatment law of diabetic coronary heart disease with blood Stasis Syndrome can be concluded as follows:(1) Qi deficiency and blood stasis syndrome,Treat it by supplementing qi and activating blood circulation,with the square of BU YANG HUAN WU TANG and HUANG QI GUI ZHI WU WU TANG.(2) Yin-deficientincluded and blood-stasis syndrome,Treat it by nourishing yin and activating blood circulation,with the square of SHENG MAI SAN and DAN SHEN YIN,TAO HONG SI WU TANG and SHENG MAI SAN,LIU WEI DI HUANG TANG and DAN SHEN YIN or SHEN QI DI HUANG TANG and DAN SHEN YIN.(3) Yang deficiency and blood stasis syndrome,Treat it by Yang-Warming and Blood-Activating,with the square of JIN GUI SHEN QI WAN and DAN SHEN YIN.(4) Xue deficiency and blood stasis syndrome,Treat it by enriching and promoting blood flow,with the square of SI WU TANG and DAN SHEN YIN.(5) Phlegm accumulation and blood stasis syndrome,Treat it by dissipating phlegm and removing blood stasis method,with the square of GUA LOU XIE BAI BAN XIA TANG and DAN SHEN YIN.(6) Wet resistance and blood stasis syndrome,Treat it by dispelling wet and promoting blood flow,with the square of SHEN LING BAI ZHU SAN and DAN SHEN YIN or PING WEI SAN ang DAN SHEN YIN.(7) Toxic heat stasis blocking syndrome,Treat it by detoxification and promoting blood flow,with the square of DANG GUI LIU HUANG TANG and DAN SHEN YIN.(8) Water retention and stasis blocking syndrome,Treat it by activate blood and promote diuresis,with the square of WU LING SAN and DAN SHEN YIN.7. ECG and heart color ultrasoundECG suggest that patients with abnormal heart rate,PR iintermittent prolonged, S-T segment down,T wave abnormalities and other changes.Heart color ultrasound suggest that most of the patients had occurred reduction of diastolic function of left ventricle.Conclusion:1. The incidence of diabetes combined coronary heart disease had some relations with patient’sage,sex,diabetic duration,body mass index, smoking history,drinking history,lipid abnormality,blood glucose elevation,blood pressure elevation,hbalc increased,family history of coronary,family history of hypertension,family history of diabetes,history of hypertension,history of hyperlipidemia.2. The basic pathogenesis of diabetes combined coronary heart disease is the syndrome Type of Deficiency of Both Qi and Yin Accompanied with Stasis. Blood stasis throughout the duration of diabetes combined coronary heart disease.3. The main treatment principle of diabetes combined coronary heart disease are supplementing qi and nourishing yin,stasis-dissolving drugs,and often embrace eliminating dampness,eliminating phlegm.clearing heat.diuresis function,regulating qi,nourishing blood,warming yang.4. The most used prescription of diabetes combined coronary heart disease are DAN SHEN YIN and SHENG MAI SAN.5. The most used traditional Chinese medicine of diabetes combined coronary heart disease are DAN SHENJAI ZI SHEN,SHENG Dl HUANG,MAI DONGHUANG QI,DANG GUI,FU LING,The most used drug combination are TAI ZI SHEN,MAI DONG,WU WEI ZI,TAN XIANG,SHA REN,DAN SHEN,FU LING.HUANG QI,SIIAN YU ROU,ZE XIE.6. Syndromes of diabetes combined coronary heart disease include Qi deficiency and blood stasis syndrome,Yin-deficientincluded and blood-stasis syndrome,Yang deficiency and blood stasis syndrome,Xue deficiency and blood stasis syndrome,Phlegm accumulation and blood stasis syndrome,Wet resistance and blood stasis syndrome.Toxic heat stasis blocking syndrome,Water retention and stasis blocking syndrome.7. Diabetes combined coronary heart disease in patients prone to appeared myocardial ischemia and lowered left heart function. Abstract Two Experimental studyObject:To observe the effects of Danshen Decoction on Ang II-induced fibrosis of the myocardial cells, investigating the mechanism of antifibrosis and therapeutic effect in order to provide experimental and theoretical basis for for using of Danshen Decoction.Method:The models of fibrosis of the myocardial cells were established with Angiotensin-Ⅱ, and the random division of every experiment into ten groups,namly normal control group, Angiotensin-Ⅱ group, aminoguanidine group,Candesartan group, high-dosage Danshen multi-component group, Mid-dosage Danshen multi-component group, Low-dosage Danshen multi-component group, high-dosage Danshen Decoction group, Mid-dosage Danshen Decoction group, Low-dosage Danshen Decoction group. CFs were isolated and cultured with an improved technique of differential anchoring velocity, and cardiac fibroblasts were identified with the E-cd protein expression and HE staining, cardiac fibroblasts proliferation were assayed with MTT, expression of basic fibroblast growth factor detected by Western blotting and ELISA.Results:1. The results showed that Angiotensin-Ⅱ significantly accelerated the CFs proliferation.2. Every group with Danshen multi-component and Danshen Decoction can inhibit the proliferation of CFs induced by Angiotensin-Ⅱ,and as the decrease of the dosage,the proliferation would increased gradually.3. Every group with Danshen multi-component and Danshen Decoction can inhibit the expression of basic fibroblast growth factor induced by Angiotensin-II,and as the decrease of the dosage,the proliferation would increased gradually.Conclusion:Danshen Decoction can accelerated the CFs proliferation and inhibit the expression of basic fibroblast growth factor,and then prevent the myocardial fibrosis.