| Objective: To study and analysis the experience of academician Chen Ke-ji in treating coronary heart disease by means of activating blood to remove stasis, and discuss the mechanism of vulnerable plaque and the theoretical basis of the intervention with toxin-resolving and blood-activating. To observe the efficacy of combination with toxin-resolving and blood-activating on the atherosclerotic vulnerable plaque in apolipoprotein E gene knockout ( ApoE(-/-) ) mice and discuss its mechanism.Methods: Through studying and analyzing the cases data-base, to summarize the academic experience in treating CHD by means of activating blood to remove stasis, and discuss the mechanism of"toxin and stasis"and the intervention of combination with toxin-resolving and blood-activating on atherosclerotic vulnerable plaque. 110 ApoE (-/-) mice of 13-week old were assigned into two groups, 98 mice in Group A which were fed with hyperlipidemic diet, 12 mice in Group B which is fed with normal diet. Besides, a normal control group was set up with 12 C57BL/6J mice. After 19 weeks, 2 mice in Group A were randomly collected to confirm the formation of vulnerable plaque, the remaining in the group was divided into 8 subgroups: Lovastatin group was fed with lovastatin of 3.3 mg/kg.d as one dose (ten times than that for human-being of 0.33 mg/kg.d); Xuezhikang group was fed with Xuezhikang of 0.2 mg/kg.d as one dose (ten times than that for human being of 0.02 mg/kg.d);Toxin-resolving group was fed with polydatin (PD) of 26.6 mg/kg.d as one dose (ten times than that for human- being of 2.66 mg/kg.d); Blood- activating group was fed with Xiaongshao capsule of 110 mg/kg.d as one dose (ten times than that for human being of 11mg/kg.d); group in low dose was fed with PD of 13.3 mg/kg.d and Xiongshao capsule of 55mg/kg.d as one dose (5 times than that for human being's); Combination of toxin- resolving and blood-activating group in medium dose was fed with PD of 26.6 mg/kg.d and Xiongshao capsule of 110mg/kg.d as one dose(10 times than that for human being's); Combination of toxin-resolving and blood-activating group in high dose was fed with PD of 52.2 mg/kg.d and Xiongshao capsule of 220mg/kg.d as one dose (20 times than that for human-being's); Normal saline of 0.4ml/d was given to mice in hyperlipidemia model group, normal diet group as well as normal control group. Forage at SPF level and PH2.8-3.0 acid water was provided to the above mentioned 10 groups of mice. After 17 weeks of intervention, to observe the effect on TC, TG, LDL-C, HDL-C and VLDL. Hs-CRP, MCP-1 and CD40L were detected with ELISA method. To take aorta and take pathomorphology observation and assay the expression of NF-κB, MMP-9.Results: 1. It manifests that Professor Chen is superior in treating CHD with activa- ting blood to remove stasis method, and Xiongshao Capusle that comes from Xuefuzhuyu Compound Formula is an important basis of this study. 2. Bring forward the toxin and sta- sis mechanism of vulnerable plaque, and combination of toxin-resolving and blood- activating is one of new methods in treating vulnerable plaque. 3. Experiments shows that (1)Combination of toxin-resolving and blood-activating herbs could reduce blood lipid level of ApoE(-/-) mice; (2)Combination of toxin-resolving and blood- activating herbs could reduce hs-CRP,MCP-1 and CD40L level in serum; (3)Combination of toxin-resolving and blood-activating herbs could reduce the expression of NF-κB and MMP-9 in aorta of ApoE(-/-) mice;(4)Combination of toxin-resolving and blood- activating herbs has the effects for anti-proliferation of SMC, anti-athrosclerotic plaque formation, protecting configuration structure of aorta, and stabilizing plaque. Combination of toxin-resolving and blood-activating herbs in high dose is superior to medium and low dose, and is superior to lovastatin group, Xuezhikang group, toxin-resolving group and blood-activating group in some indexes.Conclusion: The experience of Professor Chen in treating CHD with activating blood to remove stasis method has important clinical and academic significance. Toxin and Stasis is an important mechanism of vulnerable plaque and acute coronary syndrome (ACS) in Chinese medicine. Combination of toxin-resolving and blood-activating herbs possess the exact effects for lipid-reducing, anti-inflammation, anti- atherosclerosis, stabilizing vulnerable plaque, and is superior to individual toxin-resolving or blood-activating herb. It could be one of the effective TCM methods in treating and preventing atherosclerosis, stabilizing atherosclerotic plaque and ACS.
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