Clinical And Experimental Study Of The Effects Of The Kangxin Capsule On The Stability Of Atherosclerotic Plaque

Objectives:Traditional Chinese medicine Kangxin capsule can tonify the kidney and the spleen andcan also nourish the blood and invigorate the circulation of blood. This paper is aimed toobserve the clinical effect of Kangxin capsule on the patients who suffer from carotidatherosclerotic plaque with kidney asthenia, blood stasis syndrome. It also uses the rabbitatherosclerosis model with the balloon-injured angioplasty to study the effect of Kangxincapsule on the pathological change of the rabbit's carotid atherosclerotic plaque and theprotein expression of matrix metalloproteinase-2 (MMP-2), the vasc(?)lar cell adhesionmolecule-1(VCAM-1) and the expression of VCAM-1mRNA in order to explore the possiblemechanism of stabilizing the atherosclerotic plaque.Methods:(1) Sixty carotid atherosclerosis (CAS) patients were randomly assigned into 2groups,the treatment group (30cases) with Kangxin capsule(3pills tid) and the control group(30cases) with Atorvastatin Calcium(20mg qd).Both were treated for 12weeks. To test carotidvascular structure, plaque shape and hemodynamics of the atherosclerotic patients withhigh-resolution ultrasound. To test serum cholesterol (Tc), triglyceride (Tg), high densitylipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), high-sensitiveC-reactive protein (hs-CRP) and fibrinogen (Fib) with biochemical instrument, and to carryout correlative analysis. (2) Establish the model by injuring the rabbits' carotid intima withthe balloon-injured angioplasty, followed with high cholesterol feeding for sixweeks. Randomly divided forty healthy male New Zealand white rabbits into five groups:model group, the Atorvastatin Calcium treating group, small-dose Kangxin group, large-dose Kangxin group, and control group. To test the expression of MMP-2 a d VCAM-1 in theartery with immunohistochemistry and western blot and also the expression of VCAM-1mRNA in the artery with RT-PCR, and observe the morphology of the atherosclerotic vas andmake a pathological analysis.Results:(1) Kangxin capsule can improve the malacoplakia of the carotid atherosclerosis,significantly decrease the Crouse of the carotid plaque, intima-mediathickness (IMT),vascular resistant index, and reduce serum Tc,Tg, LDL-C, hs-CRP, and Fib, which makes asharp contrast with those before the treatment (P＜0.05orP＜0.01). The results also suggest thaths-CRP, Fib were significantly positively correlated with IMT and Area. (2) Comparedwith the model group, the ratio of the thickness of wall to the area of lumina(W/L), averageoptical density, and the percentage of positive area of Kangxin-treated group are smaller. Thelevel of the blood lipid, the protein content of artery wall such as MMP-2 and VCAM-1 andthe expression of VCAM-1 mRNA are lowered in the Kangxin-treated group. The differencesare significant (P＜0.05or P＜0.01). The effect of large-dose Kangxin group shows synergiceffects.Conclusion:Kangxin capsule can reduce Tc, Tg, LDL-C, and hs-CRP, Fib, lower the expression ofmediators of inflammation such as MMP-2, VCAM-1, hs-CRP, and improve the stability offiber hat. In this way, it can stabilize the plaque.