Study On Blood Stasis And Pyretic Toxicity Of Acute Coronary Syndrome And Molecular Mechanism Of Anti-artherosclerosis With Detoxication And Promoting Blood Flow

Objective1.The clinical research:To discuss the correlation of sthenia syndrome of acute coronary syndrome (ACS) with coronary arteriongraphy and inflammation index, and to provide scientific evidence for pathogenesis of blood stasis and pyretic toxicity and treatment of detoxication and promoting blood flow on ACS.2. The empirical study:To observe the effect of the compatibility of detoxication and promoting blood flow on the peritoneal macrophage foaming of apolipoprotein E gene knock out[ApoE(-/-)] mice, and to discuss its mechanism.Methods1. The clinical research:Fifty patients of ACS were divided in the syndrome of phlegm, the syndrome of blood stasis, the syndrome of stagnation of QI, the syndrome of cold coagulation and the syndrome of pyretic toxicity, according to the differentiation of symptoms and signs standard of chinese medical science sthenia syndrome. Everyone was given coronary arteriongraphy, recorded numbers of coronary artery process and greatest narrow degree of coronary artery, and calculated scores of coronary artery process. Everyone was detected the inflammatory indexes such as highsensitivity C reactive protein(hs-CRP) and tumour necrosis factor(TNF). To analyze the correlation of all sthenia syndromes with coronary arteriongraphy and inflammatory indexes.2. The empirical study:The peritoneal macrophage of ApoE(-/-) mice were divided in seven groups:blank group, detoxication group (add polydatin), promoting blood flow group(add hawthorn extractive), detoxication and promoting blood flow group(add polydatin and hawthorn extractive), lovastatin group(add lovastatin), rosiglitazone group(add rosiglitazone), model group. Except for blank group, other groups were added in oxidized-LDL (ox-LDL) and lipopolysaccharide (LPS).All groups were incubated two days in incubator. To observe the ultrastructural changes in cells of the blank group, model group and detoxication and promoting blood flow group with electron microscope after 48 hours. To observe the changes of intracellular calcium concentration, the changes of intracellular total cholesterol, free cholesterol and cholesteryl esters, the mRNA express of intracellular peroxisome proliferators-activated receptor gamma (PPARγ), ATP-binding cassette transporter Al (ABCA1), cluster of differentiation antigen 36 (CD36), toll-like receptor4 (TLR4), neuclear factor kappa B(NF-κB), tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) in all groups after 0 hour,24 hours and 48 hours respectively.Results1. The clinical research:The syndrome of blood stasis and the syndrome of pyretic toxicity were more than other sthenia syndromes of ACS, their coronary artery process and scope were severer, and their scores of coronary artery process were obviously higher than the syndrome of phlegm, the syndrome of stagnation of QI and the syndrome of cold coagulation. Compared with other sthenia syndromes, the hs-CRP and the TNF of the syndrome of blood stasis and the syndrome of pyretic toxicity all raised up obviously. The hs-CRP and the TNF had a tendency of raise along with the increase of coronary artery process greatest narrow degree and process numbers. The hs-CRP and the TNF had a positive correlation with the scores of coronary artery process.2. The empirical study:The compatibility of detoxication and promoting blood flow could relieve the damage of ox-LDL and LPS on intra-cellular ultrastructure, rivalry the levels of calciumion in macrophage, degrade the concentration of total cholesterol, free cholesterol and cholesteryl esters obviously, elevate the express of PPARγmRNA and ABCA1mRNA, degrade the express of CD36mRNA and decrease the express of TLR4, NF-κB, TNF-αand IL-1β. Its synthetic effect was superior to the simple detoxication medicine or the simple promoting blood flow medicine, and was equal to or superior to the lovastatin and the rosiglitazone.Conclusion1. The clinical research:The syndrome of pyretic toxicity is another significant sthenia syndrome of ACS, the combination of blood stasis and pyretic toxicity is its major pathogenesis, the detoxication and promoting blood flow is hope to become its important treament.2.The empirical study: The compatibility of detoxication and promoting blood flow can obviously interfere in macrophage foaming and delay generation and development of atherosclerosis, which may be because it can protect the intra-cellular ultrastructure, rivalry the rise of calciumion, improve the outflow of cholesterol and cholesterol esters in macrophage, up-regulate the express of PPARymRNA and ABCA1mRNA, down-regulate the express of CD36mRNA and inhibt the secretion of inflammatory factor.