Syndrome Characteristics Of Coronary Heart Disease Mechanism And Total Saponin Of Aralia Elata Treatment Of Coronary Heart Disease

Objective:1In order to provide guidelines for the diagnosis、treatment and prevention of Coronary Heart Disease (CHD) using Traditional Chinese Medicine (TCM), we collected clinical data from CHD inpatients, and analyzed the symptoms using the four diagnostic methods. We also explored the relationship between the four diagnostics and coronary artery disease, and the relationship between different TCM symptoms and coronary artery disease.2To study the performance of a combined Chinese-Western medical therapy of the chest Qi obstruction, we investigated the TCM symptoms of inpatients who have had perfusion, and the mechanism of myocardial ischemia reperfusion (MI/R) injury. We have also studied the preventive effect of Aralosides on MI/R injury using Langendorff ischemia-reperfusion model with isolated rat heart.Methods1The TCM symptoms were collected from107CHD inpatients. To study the relationship between four diagnostics and coronary artery disease, the relationship between different TCM symptoms and coronary artery disease, and the change of TCM symptoms after the reperfusion, principle component analysis, factor analysis, and chi-square test were conducted respectively using SPSS17.0.2Thirty-tow healthy male Wistar rats (300g～350g) were used to establish the standard Langendorff isolated heart ischemia-reperfusion model. Different medicines were used during reperfusion and the amount of myocardial enzymes (CK、LDH) were measured. The preventive effect of Aralosides on MI/R injury was evaluated using the one-factor analysis of variance.Results Among107inpatients (70males and37females with an age range from31to90),94had coronary artery angiography or coronary computed tomography angiogram (CTA),32had clinically evident myocardial infarctions,57had evident Percutaneous Coronary Interventions (PCI) and4had evident Coronary Artery Bypass Grafting (CABG).Factor analysis revealed that1)instances of’root deficiency and syndrome excess’ were overrepresented in the TCM syndrome differentiation;2)instances of Qi deficiency were overrepresented; and3)spleen and stomach were overrepresented disease locations.The four diagnostic methods and the analysis of coronary artery disease revealed that the frequency of pectoralgia are significantly different in different affected coronary vessels. It is more prevalent in inpatients with double-vessel disease. A linear regression analysis of syndromes and coronary artery disease revealed four significant effects:1)left main coronary artery disease’s effect on the short of breath and the insomnia;2)anterior descending artery disease’s effect on the chest suppression sensation, the short of breath, the sub lingual vein stasis and the white tongue;3)circumflex disease’s effect on the insomnia, the sub lingual vein stasis and the dark tongue;4)right coronary artery disease’s effect on pectoralgia weakness, petechia tongue and white tongue. The logistic regression of syndromes and the coronary artery disease indicated that the Qi deficiency and the blood stasis are independent risk factors of the coronary artery disease. Patients with the Qi deficiency or the blood stasis have higher risks of the coronary artery disease than those without.Patients with blood stasis have higher risks of double-vessel disease. In addition, Yang deficiency is the risk factor of single-vessel disease, and Yin deficiency is the risk factors of left main artery and three-vessel disease.The comparison of patients’ syndromes with and without the reperfusion indicated that the Qi deficiencies were significantly more prevalent within patients who have had reperfusion.2, In the experiment of isolated rat heart reperfusion injury, the amounts of CK and LDH of the group treated with Aralosides were significantly less than those of the control group and the group treated with5HD+Aralosides.Conclusion1、The TCM pathogenesis of the CHD is ’root deficiency and syndrome excess’. The syndromes and the sub lingual vein’s characteristics change according to different coronary artery disease. Different syndromes and the number of vessels affected by coronary artery disease are correlated as well.2、The Qi deficiency is the dominant syndrome within patients who have had reperfusion. The Qi tonifying Aralosides have a preventive effect on MI/R injury, which may be attributed to the MitoKATP.