| ObjectiveComplex Diseases such as malignant cancer, cardiovascular diseases and diabetes, caused by the common interaction of multiple genes and environmental factors, are threatening human beings. In recent years scientists put forward anew way of studying the human body as one whole system. Being inspired by the new thinking, we found it extremely necessary to find out the pathogenesis and mechanism of the complex diseases from the Whole Theory point of view. This step is important in order to provide a new treatment method. It has been discovered that cancer, diabetes, hypertension and cardiovascular diseases have many differences on their diagnosis' and treatments, however all of these have pathophysiological change, prethrombotic state (PTS) in common. PTS includes the changes of vascular endothelial cells, platelets, blood clotting and anti blood clotting system. So far the relationship between PTS and complex diseases has been studied by many scientists all over the world, but only restricted to one or two types of diseases or one or two types of PTS indexes. In this research we put four types of complex diseases together, they were considered to be a unit which made the same changes in the body, we tried to prove this theory by checking the PTS indexes. We are hoping this might help us improve the diagnosis and treatment of complex diseases.Chinese traditional and Uyghur medicines always stress the importance of considering the human body as a whole unit. They also emphasize that when treating diseases we should also pay attention to improving the quality of every organ in the body. These two medicines have their own unique theories and treatment methods for complex diseases.Phlegm-blood stasis and Abnormal Savda are two different products and pathological risk factors in the human body. They can create the most serious conditions. The diseases that are related to them include cancer, hypertension, coronorey heart disease, diabetes, etc, In this study we assumed that PTS might be one of the common pathological mechanisms of complex diseases in Western, Chinese and Uyghur Medicines. We intended to find out the specific changes of PTS in complex diseases both in Western and Chinese (Uyghur) Medicine, by using this method we tried to discover the commonalities in both medicines to provide an even more effective treatment method for complex diseases.Methods69 cases of malignant cancer, 92 cases of diabetes, 68 cases of hypertension, and 55 cases of coronary heart diseases were provided by the Affiliated Hospital of Xinjiang Medical University. Patients were classified according to Chinese Traditional and Uygur Medicine fluid theory. For the control group, 33 cases of healthy individuals were checked to make sure they did not have hypertension, diabetes or other heart, liver, kidney and blood diseases. The expression of CD41, CD62p on platelets, the level of plasma tissue plasminogen activator (t-PA) and its inhibiter (PAI-1), the level of endothelin (ET-1), Activated partial thromboplastin time (APTT), Fibrinogen (FIB), Prothrombin time (PT) and Thrombin time (TT) were tested by using Flow Cytometer, ELISA method, radioimmunoassay method and auto coagulometer. Statistical analysis:SPSS13.0 was used in the study. The data was expressed as means±standard deviation (SD). Statistical significance of a comparison was determined by using ANOVA. The difference between means was considered to be statistically significant if P<0.05.Results1. Complex diseases and the prethrombotic state1.1 Prethrombotic State and the Cancer Patients:Compared to the control group, the average amount of CD62P, the level of plasma FIB, plasma PAI-1 and serum ET-1 in the tumor group were increased (P<0.05). The level of t-PA in the tumor group was decreased compared to the control group (P<0.05); APTT, PT were significantly shorter in the tumor group (P<0.05); there were no significant changes in the amount of platelet CD41 and TT in both groups.1.2 Prethrombotic State and the Diabetes Mellitus:Compared to the control group, the average amount of CD62P, the level of plasma FIB and plasma PAI-1 in the diabetes group were increased (P<0.05); the level of t-PA in the diabetes group was decreased compared to the control group; APTT, PT and TT were significantly shorter in the diabetes group; the group with angiopathy had a significant increase in the amount of platelet CD62P, the level of plasma PAI-1 and FIB compared to the group without angiopathy (P<0.05); the APTT and TT in the group with angiopathy were significantly shorter than the group without angiopathy (P<0.05); between these two groups there was no significant difference in the plasma t-PA level and PT (P>0.05).1.3 Prethrombotic State and the hypertension:Compared to the control group, the average amount of CD62P, the level of plasma FIB and PAI-1 in the hypertension group were increased (P<0.05); the level of t-PA in the hypertension group was decreased compared to the control group (P<0.05); APTT, PT and TT were significantly shorter in the hypertension group (P<0.05); there were no significant changes in the amoount of platelet CD41, serum ET-land TT in both groups.1.4 Prethrombotic State and the coronary heart disease:Compared to the control group, the average amount of CD62P, the level of plasma FIB and PAI-1 in the coronary heart disease group were increased (P<0.05); the level of t-PA in the coronary heart disease group was decreased compared to the control group (P<0.05); APTT was significantly shorter in the coronary heart disease group (P<0.05); there were no significant changes in the amount of platelet CD41, serum ET-1, APTT and TT in both groups.1.5 Comparative study of cancer, diabetes, hypertension and coronary heart diseases:Compared to the control group, the average amount of CD62P, the level of plasma PAI-1 in the complex disease groups were significantly increased (P<0.05); the level of t-PA in the complex disease groups was decreased; compared to the control group there was a significant increase in the level of serum ET-1 in the tumor group. However, there was no significant difference in the ET-1 level between the control group and the rest of the complex disease groups (P>0.05). There was also no difference in the amount of CD41 between the complex disease groups and the control group (P>0.05); there was no significant difference in the above indexes between the different groups of diseases (P >0.05). Compared to the control group, the APTT was significantly shorter in the complex disease groups (P<0.05). Compared to the control group the level of FIB was significantly increased in the complex disease groups and the change was more obvious in the tumor group (P<0.05). Compared to the control group, PT was significantly shorter in the tumor, diabetes and hypertension groups (P<0.05); there were no significant changes in APTT, PT and TT between the different groups of diseases (P>0.05).2. The classification of complex diseases in Traditional Chinese Medicine and their relationship to the prethrombotic state2.1 The proportion of phlegm-stasis syndrome in complex diseases was 76.84%, non-phlegm-stasis syndrome was 23.16%; the proportion of phlegm syndrome in phlegm-stasis syndrome was 24.66%, stasis syndrome was 19.18%, combined phlegm and stasis syndrome was 56.16%.2.2①Compared to the control group, there was no significant difference in the amount of CD41 and TT in phlegm-stasis syndrome (P>0.05). The amount of CD62p was high (P<0.01) in the phlegm syndrome, stasis syndrome, combined phlegm and stasis syndrome (P<0.01). The levels of t-PA were low (P<0.05) in the phlegm syndrome (P >0.05), stasis syndrome, combined phlegm and stasis syndrome (P<0.05). PAI-1 was high (P<0.05) in the phlegm syndrome, stasis syndrome (P<0.05), combined phlegm and stasis syndrome P<0.01). Fib was high (P<0.01) in the phlegm syndrome, stasis syndrome, combined phlegm and stasis syndrome (P<0.01). PT, APTT was shorter in the phlegm syndrome, stasis syndrome, combined phlegm and stasis syndrome (P<0.01).②Compared to the non-phlegm-stasis syndrome, the amount of CD62p and Fib in the phlegm-stasis syndrome was high (P<0.01) in the phlegm syndrome (P>0.05), stasis syndrome (P<0.05), combined phlegm and stasis syndrome (P<0.01). Although the amount of CD41, t-PA, PAI-1, PT, TT and APTT were insignificantly different between the two syndromes (P>0.05), each item in,the phlegm syndrome, stasis syndrome, combined phlegm and stasis syndrome and non-phlegm-stasis syndrome all presented certain levels of changes. The changes in the combined phlegm and stasis syndrome were very obvious.3. The classification of complex diseases in Uyghur Medicine and their relations to the Prethrombotic State3.1 There were 188 cases of Abnormal Savda patients and 97 cases of non Abnormal Savda patients among the 285 cases of complex disease patients. Among the total clinical cases, the ratio of Abnormal Savda patients was 65.95%, the ratio of non Abnormal Savda patients was 34.04%.3.2 Compared to the control group, the average amount of CD62P, the plasma PAI-1, FIB and serum ET-1 in the Abnormal Savda group were significantly increased (P<0.05). The level of t-PA in the Abnormal Savda group was decreased. There was no difference in the amount of CD41 between the Abnormal Savda group and the control group (P>0.05). Compared to the control group, the APTT and PT were significantly shorter in the Abnormal Savda group (P<0.05); there was no significant change in TT between the two groups (P>0.05).3.3 Compared to the control group, the level of ET-1 was significantly increased in both the Abnormal Savda and the non Abnormal Savda groups (P<0.05). Compared to the Abnormal Kan and the Abnormal Sapra group, the level of ET-1 was higher in the Abnormal Savda group (P<0.05). The level of ET-1 had various changes among the four fluid groups and the control group, eg:Abnormal Savda>Abnormal Sapra>Abnormal Balham> Abnormal Kan>the control group. Compared to the control group, there was no significant change in the amount of platelet CD41 in the Abnormal Savda and the non Abnormal Savda group (P>0.05). The amount of CD62P was significantly increased (P <0.05). Compared to the Abnormal Kan and the Abnormal Sapra groups, the level of CD62P was higher in the Abnormal Savda group (P<0.05). CD62P had different levels of changes among the four fluid groups and the control group, eg:Abnormal Savda> Abnormal Kan>Abnormal Balham>Abnormal Sapra>the control group. Compared to the control group, the level of plasma t-PA was significantly low in the Abnormal Savda and the non Abnormal Savda group (P<0.05). The level of plasma PAI-1 was increased significantly in these two groups (P<0.05). The level of t-PA varied among the four fluid groups and the control group, eg:Abnormal Savda< Abnormal BalhamAbnormal Balham>Abnormal Sapra> Abnormal Kan>the control group. Compared to the control group, the level of plasma FIB was significantly higher in the Abnormal Savda and the non Abnormal Savda group (P<0.05). PT, APTT were significantly shorter (P<0.05), but there was no difference in TT (P>0.05). Compared to the Abnormal Kan and the Abnormal Balham, the level of FIB was significantly increased (P<0.05). The various changes of PT and APTT were:Abnormal Savda > Abnormal Balham > Abnormal Kan>Abnormal Savda>the control group. The various changes of FIB was Abnormal Savda> Abnormal Balham> Abnormal Savda>Abnormal Kan>the control group; TT had no change among these groups.4. Comparative Studies of phlegm-stasis syndrome and Abnormal Savda 4.1 Compared to the control group, CD62p, FIB and PAI were significantly increased in patients with Tanyuhuzu Syndrome and the Abnormal Savda Syndrome (P<0.01), but there was no statistical difference between them (P>0.05). These two groups had a lower t-PA level (P<0.05), again with no difference between them (P>0.05). ET-1 was significantly increased in these two groups (P>0.05), again there was no difference between them (P<0.05). The level of CD41 in these three groups didn't show a significant difference.4.2 Compared to the control group, ET-l,CD62p, FIB and PAI were significantly increased in patients with Abnormal Savda Syndrome and non-Abnormal Savda Syndrome (P<0.05). The increase in the Abnormal Savda Syndrome group was more significant than the non-Abnormal Savda. Both groups had lower t-PA levels (P<0.05), the decrease in the Abnormal Savda Syndrome group was more significant, but when these two groups were compared there was no statistical difference (P>0.05). The level of CD41 in these three groups didn't change.Conclusion1. PTS is a common change in complex diseases such as tumors, diabetes, hypertension and coronary heart disease, PTS might be also one of the common pathophysiological basises of complex diseases. As far as the common changes of neuroen-docrine-immune pathway in complex diseases are concerned, it can be concluded that tumors, diabetes, hypertension and coronary heart diseases are systematic diseases. That is to say complex disease is not the only change in a certain organ but the overall change of the body.2. Phlegm-stasis syndrome might be an important syndrome type of tumors, diabetes, hypertension and coronary heart diseases in Chinese Traditional Medicine. PTS is more obvious in Phlegm-stasis syndrome than that of the non Phlegm-stasis syndrome in complex diseases; especially the changes of CD62p, t-PA, PAI-l,PT,Fib, APTT which are more significant in Phlegm-stasis syndrome. From that result, we might consider applying the PTS indexes to quantitative judgment of Phlegm-stasis syndrome in complex diseases.3. Abnormal Savda Syndrome might be an important syndrome type in tumors, diabetes, hypertension and coronary heart diseases in Uyghur Medicine. PTS is more obvious in the Abnormal Savda syndrome than that of the non Abnormal Savda syndrome; especially the changes of CD62p,t-PA,PAI-1,PT,Fib, APTT which are more significant in Abnormal Savda Syndrome. From that result, we might consider applying the PTS indexes to a quantitative judgment of Abnormal Savda syndrome in complex diseases.4. Phlegm-stasis syndrome in Chinese Traditional Medicine and the Abnormal Savda syndrome in Uyghur Medicine are interactive according to their importance as a syndrome; they both happen in older patients and the changes of of PTS indexes are obvious in both. From this interaction we have concluded that the Phlegm-stasis syndrome in Chinese Traditional Medicine and the Abnormal Savda syndrome in Uyghur Medicine might be a pathological state of the same disease in different medical explanations. Is PTS one of the probable material foundations of these two? Are the Phlegm-stasis in Traditional Chinese Medicine and the Abnormal Savda in Uyghur Medicine the direct causes of PTS in complex diseases? It is necessary to study these assumptions further.5. Vascular endothelial cell injury, platelet activation, increased blood viscosity and reduced fibrinolytic function are the reasons for the formation of blood clot. This process might be a common way for the Phlegm-stasis syndrome which includes Qi, gasification disorders and impaired fluid metabolism. This process also might be the one for the accumulation and burning of Abnormal Savda which eventually leads to the Abormal Savda syndrome. From that result we can assume that, prethromnotic state might be one of the material foundations of Phlegm-stasis and Abnormal Savda. Blood clot, Phlegm-stasis and Abnormal Savda are very similar, they are not only the Pathological products but also the risk factors.6. Prethromboitic state exists both in the Non Phlegm- statis syndrom and the non Abnornal Savda syndrom in complex diseases, but the level of the prethromboitic state is lower in the Non Phlegm- statis syndrom and the non Abnornal Savda syndrom than that of the Phlegm- statis syndrome and the Abnornal Savda syndrome. Although there is no obvious clinical symptoms of the Phlegm- statis syndrome and the Abnornal Savda syndrome in Non Phlegm- statis syndrom and non Abnornal Savda syndrom in complex diseases, disorders in prethromboitic state indicate that tumors, diabetes, hypertension and coronary heart diseases patients might be in the prestage of the Phlegm- statis syndrome and the Abnornal Savda syndrome. As the diseases progress, there will be clinical manifestations of Phlegm- statis syndrome and Abnornal Savda syndrome in the Non Phlegm- statis syndrom and the non Abnornal Savda syndrome in complex diseases.7. Traditional Chinese Medicine considers that "the Tongxinluo a long illness", "a long illness goes into the blood", "Abnormal Duo Tan", "Sputum causes all disease"; Uyghur Medicine considers that "black disease after a long time", "black in diseases". Phlegm-stasis syndrome in Chinese Traditional Medicine and Abnormal Savda syndrome in Uyghur Medicine happens a lot among tumors, diabetes, hypertension and coronary heart diseases. From that can we consider using Huo Xue Hua Tan and Hua Tan Bu Xu method in Traditional Chinese Medicine and Munziq and Mushil in Uyghur medicine whenever we encounter any complex diseases? Also pay close attention to the changes of TS indexes in order to increase the treatment effect of complex disease such as tumors, diabetes, hypertension and coronary heart diseases. This research has to be further researched.
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