| Objective:To observe the clinical effect of Shuangyu Tiaozhi Decoction on patients with stable angina pectoris of coronary artery disease（pleen deficiency and turbid phlegm syndrome）and experimental research in rat with hypercholesterolemic model to explore its potential pharmacological mechanism.Methods:1.Clinical study:64 patients with coronary heart disease,Stable angina pectoris,spleen deficiency and phlegm turbidity were included in this study,and were randomly divided into treatment group and control group,with 32 cases in each group.The treatment method of the treatment group was the combination treatment of Shuangyu Tiaozhi Decoction and Western medicine basic treatment,while the control group only received Western medicine basic treatment.Both groups of patients should be observed for 8 weeks.During the 8 weeks,Chinese medicine syndrome,angina pectoris,electrocardiogram and nitroglycerin stopping rate should be observed before and after treatment.The levels of serum total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）and high sensitivity C-reactive protein（hs-CRP）were changed.2.Experimental study:40 SD rats were randomly divided into 5 groups:normal group,model group,low-dose group of Shuanghuangyao Tiaozhi Decoction(7.8 g﹒kg-1),high-dose group of Shuanghuangyao Tiaozhi Decoction(15.6 g﹒kg-1)and simvastatin group(4 mg﹒kg-1).The normal group was fed with normal diet,and the remaining 4groups were fed with high-fat diet to establish hypercholesterolemia model.Serum TC,TG,LDL-C,HDL-C levels were detected by biochemical method,hematoxylin-eosin（HE）was selected for staining,and the pathological changes of rat liver were recorded.Then,the low density lipoprotein cholesterol receptor（LDLR）,hepatocyte nuclear factor 1α（HNF1α）and proprotein convertase subtilisin/kexin type 9（PCSK9）in rat liver tissue was detected by Real-time PCR and Western Blot.HNF1αand PCSK9 were detected by immunohistochemistry.Results:1.Clinical study:Both groups can effectively reduce the TCM syndrome scores of patients and improve the effective rate（P<0.05）,and the treatment group performs better than the control group（P<0.05）.A comparative analysis of angina symptom score,curative effect and nitroglycerin stopping rate was made,and the analysis result was still superior to that of the treatment group（P<0.05）.The comparison result of electrocardiogram curative effect showed that the two groups had the same effect（P>0.05）.The levels of serum TC,TG and LDL-C showed a decreasing trend（P<0.05）after treatment with different methods in the two groups,and the effect of the treatment group was better than that of the control group（P<0.05）,but there was no significant difference in improving HDL-C level between the two groups（P>0.05）.The level of serum hs-CRP was significantly decreased in both treatment group and control group（P<0.05）,and the treatment group was superior（P<0.05）.There was no adverse reaction during the experiment,and the safety indexes of the two groups were normal.2.Experimental study:Shuangyu Tiaozhi Decoction can reduce the weight gain of rats caused by high-fat diet,improve the fatty degeneration of rats liver,regulate the blood lipid level,up-regulate the expression of LDLR gene and protein in rats liver,and down-regulate the expression of HNF1αand PCSK9 in rats liver.Conclusion:Shuangyu Tiaozhi Decoction plus basic western medicine can significantly alleviate the clinical symptoms of patients with stable angina pectoris of coronary artery disease,regulating blood lipid levels and improve inflammatory factors with a good safety.Shuangyu Tiaozhi Decoction can effectively alleviate rats hypercholesterolemia,regulate rats cholesterol metabolism.The study provides a new way for the treatment of Angina Pectoris of Coronary Heart and regulation of cholesterol metabolism.The study also provides a theoretical basis of Clinical promotion and use of Shuangyu Tiaozhi Decoction. |
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