Clinical And Mechanistic Study On Long - Term Prognosis Of Patients With Coronary Heart Disease Treated By Yiqi Liangxue

This text includes two parts:literature survey and subject research; literature survey dividing into review of traditional Chinese medicine (TCM) and western medicine, subject research dividing into clinical investigating and experimental study on mechanism.First, literature surveyHave described the existing view about long-term effect of coronary heart disease (CHD) patients after percutaneous coronary intervention(PCI). The survey can take scientific theoretical support of the prevention and treatment of CHD and various kinds of complications.Second, clinical investigationObjective:A new study that followed CHD patients who had PCI 7.5～9.1 years later in order to invest the prevention of cardiovascular events and the improvement of long-term effect of Yiqi-Liangxue Recipe (YL).Methods:97 cases after PCI 7.5～9.1 years were divided into 51 cases of YL treatment group and 46 cases of control group on the basis of our previous research. We tried to observe these patients’cardiovascular events, secondary prevention of CHD, survival curve, etc.Results:① The incidence of cardiovascular events had significant difference between YL treatment group and the control group(P<0.05).②The two groups in regular treatment and good living habits had no statistical difference.③The YL intervention and regular treatment come into logistic regression(P<0.05), showing that the two aspects had protective effect on cardiovascular events; the YL group had a better trend of survival curve than the control group, but no statistical difference (P>0.05).Conclusions:①YL Recipe can reduce PCI patients’cardiovascular events incidence.② YL Recipe can improve the long term prognosis of PCI patients’ life.Third, experimental study on mechanismObjective:Based on trauma recovery theory of TCM, investigating the mechanism of YL Recipe on preventing cardiovascular events and improving long-term prognosis after PCI. The mechanism mainly on the vascular endothelial cell proliferation, migration and damage repair function.Methods:We prepared human umbilical vein endothelial cells (HUVECs) for injury model. The experiment had five groups:YL group, ARB medicine group, YL+ARB group, the control group, the model group. We used CCK 8 method to detect cell proliferation rate, transmission electron microscope to observe cell ultra structure changes and live cell imaging system to test cell mobility. The experiment also had detected the concentration of nitric oxide (NO), endothelin-1 (ET-1)、reactive oxygen species(ROS) and ET-1 protein gene expression level by RT-PCR. All the data was taken statistical analysis and compared between the five groups.Results:①Compared with the model group, YL group and ARB group both enhanced the proliferation of injured endothelial cells and the YL+ARB group had better effects comparing with the two groups (P<0.05).② Compared with the model group under the transmission electron microscope, YL group、ARB group and YL+ARB group had better recovery. The nucleus boundary more clear, the number of mitochondria increased, the endoplasmic reticulum more dense; YL group and YL+ARB group were better than ARB group.③Compared with model group, ARB group and YL+ARB group had significantly accelerated cell migration (P<0.05). ARB+YL group was better than ARB group, but YL group showed no significant difference (P>0.05).④Compared with model group, the content of NO increased after the drug intervention (P<0.05), the content of ET-1 decreased (P<0.05), YL+ARB group had statistically difference with YL and ARB group (P<0.05).〤ompared with model group, the -△△Ct values was decreased in the YL, ARB and YL+ARB group.The gene expression level of ET-1 was inhibited after the drug intervention, although with no significant difference.Conclusions:① YL Recipe can promote the proliferation of injured endothelial cells.② YL Recipe can reduce the ultra structural damage of vascular endothelial cells.③YL Recipe can improve the migration of vascular endothelial cells.③YL Recipe can increase the release of vascular active substances NO, reduce the concentration of cell damage factor ET-1, affect the level of ET-1 protein gene expression.⑤The therapy of the combination of Chinese medicine and western medicine has better effect for the damage recovery of vascular endothelial cells.