Study On The Effect Mechanism Of Yiqi Huatan Tongluo Recipe On SICAS Of Qi Deficiency And Phlegm Stasis Type

sICAS is the most common cause of ischemic cerebrovascular diseases in China,which profoundly affects the recurrence rate and prognosis of patients.The main pathogenic mechanisms are the stenosis,occlusion and thrombosis of atherosclerotic vessels.After literature review,it is found that the western medicine treatment of sICAS is mainly blood pressure management,anti-embolism and lipid regulation.It is considered that the main pathogenesis is phlegm dampness,qi deficiency and blood stasis,which are the same as ischemic stroke and atherosclerosis.Therefore,the TCM treatment is mainly to invigorate qi,eliminate phlegm and remove collateral.Atherosclerotic plaques are classified into stable and unstable types.Unstable plaque is an important factor that determines the occurrence of ischemic events.In western medicine,the main influencing factors of plaque stability are the composition and proportion of plaque,plaque stress,inflammatory response,etc.In traditional Chinese medicine,the stability of plaque is closely related to phlegm dampness,qi deficiency and blood stasis.According to literature review,in the process of atherosclerosis,serum factors CD40L,TNF-α,MMP-9,SAA,NO and ET-1 are closely related to factors affecting the stability of atherosclerotic plaque,and their levels in blood can reflect the stability of plaque.In terms of the treatment of atherosclerotic plaque stability:At present,western medicine mainly uses statins,antiplatelet and anticoagulant drugs,and antioxidant drugs to play their anti-inflammatory,lipidolytic and anticoagulant roles to protect the stability of plaque.In traditional Chinese medicine,the syndromes of patients with unstable plaques are generally closely related to the three syndromes of qi deficiency,phlegm dampness and blood stasis.Therefore,traditional Chinese medicine mainly improves the stability of atherosclerotic plaque by supplementing qi and promoting blood circulation,resolving phlegm and clearing collaterals or removing blood stasis and detoxification,and its effect has been confirmed in animal experiments and clinical studies.At the same time,clinical studies have confirmed that yiQi Huatan Tongluo prescription has a significant effect on the improvement of cerebral perfusion in sICAS patients with Qi-deficiency and phlegm-stasis type.Therefore,this study aims to explore the effect mechanism of YiQi Huatan Tongluo prescription on the improvement of plaque stability in sICAS patients with QI-deficiency and phlegm-stasis type by measuring the level of serum factors.Clinical study:Study on effect mechanism of YiQi Huatan Tongluo Prescription on sICAS with Qi deficiency and phlegm stasis.Objective:To explore the effect mechanism of Yiqi Huatan Tongluo prescription in protecting sICAS patients with qi deficiency and phlegm stasis.Methods:50 patients were randomly divided into two groups.Both groups were treated with western medicine based intervention for hypertension,diabetes,dyslipidemia,coronary heart disease and other risk factors.The treatment group was given yiqi Huatan Tongluo decoction on the basis of basic western medicine treatment,and the placebo group was given placebo granule oral treatment on the basis of basic western medicine treatment.Both groups were treated for 3 months.The clinical efficacy and the levels of CD40L,TNF-α,MMP-9,SAA,NO and ET-1 in peripheral blood of 2 groups were observed and compared before and after treatment.Results:Due to the epidemic situation and other reasons,40 patients were finally included in the treatment group and control group,20 cases each.In terms of TCM syndrome factors,after treatment,the total syndrome scores and the single syndrome scores of qi-deficiency,phlegm-dampness and blood stasis in the treatment group and placebo group were significantly decreased(P<0.01).and the reduction degree in the treatment group was significantly greater than that in the placebo group(P<0.01).Serum factor levels:after treatment,CD40L levels in peripheral blood of the two groups were significantly decreased in the treatment group(P<0.01),but not in the placebo group(P>0.05).The curative effect of the treatment group was more obvious than that of the placebo group(P<0.01).The serum TNF-α level was significantly decreased in the treatment group(P<0.01)and the placebo group(P<0.05).but the treatment group had no more significant effect than the placebo group(P>0.05).Blood MMP-9 was significantly decreased in the treatment group(P<0.01)and the placebo group(P=0.05),and the curative effect of the treatment group was more obvious than that of the placebo group(P<0.01).Blood SAA was significantly lower in the treatment group(P<0.01)and in the placebo group(P>0.05),and the curative effect of the treatment group was more obvious than that of the placebo group(P<0.01).In terms of blood NO level,the treatment group was significantly increased(P<0.01),and the placebo group was slightly increased(P<0.05),the treatment group was more effective than the placebo group(P<0.01);Blood ET-1 level was significantly decreased in both the treatment group and the control group(P<0.01),and the curative effect in the treatment group was more obvious than that in the control group(P<0.01).Conclusion:YiQi Huatan Tongluo recipe may be effective in treating sICAS of qi deficiency and phlegm-stasis type by regulating the levels of CD40L,SAA,MMP-9,ET-1 and NO,thus protecting the plaque stability and other mechanisms.