| Dyslipidemia is the abnormality of plasma lipid in quality and quality.Lipid deposition in blood vessel always leads to atherosclerosis and cardiovascular diseases.It is an effective method to prevent dyslipidemia to treat cardiovascular and cerebrovascular diseases.Dyslipidemia is attributed to vertigo or headache in traditional Chinese medicine(TCM),also to lipid turbidity and phlegm fat.Dyslipidemia is due to improper diet,spleen dysfunction,emotion disorder,liver dysfunction,or old age and infirmity,kidney deficiency,leading to disorder of function of liver,spleen and kidney.Stagger of Qi,deficiency,phlegm,and stasis leads to deficiency in origin and excess in superficiality.TCM constitution theory believes that the constitution can be identified,adjustable,and related to diseases.It is benefit to timely treat dyslipidemia to investigate the distribution law of TCM constitution of patients with dyslipidemia,preventing the occurrence of cardiovascular and cerebrovascular diseases.In recent years,with the gradually increas of incidence of dyslipidemia,it is urgently needed to develop TCM compound prescription viable to clinical practice.Our group believes that the deficiency in origin is an important pathogenesis of dyslipidemia.It is important to nourish kidney and strengthen spleen to prevent and cure hyperlipidemia.Decoction of reducing turbidity and regulating fat(DRTRF)is formulated by Professor Shao Xiang Xian on the basis of many years of clinical experience,with the effect of nourishing kidney,reinforcing spleen,promoting liver and expelling turbidity,suitable for the type of spleen and kidney deficiency of hyperlipidemia.The effect and mechanism of DRTRF in reducing and regulating plasma lipid were discussed in this study from two aspects of clinical case investigation and animal experiment.The first part:the investigation of constitutiona types in TCM of patients with dyslipidemiaObjectiveTo study the distribution of TCM constitution type of patients with dislipidemia to provide a reference for clinical and scientific research of TCM.MethodTo analysis the constitution characteristic of patients with dislipidemia,data was collected in the form of questionnaire by TCM constitution standardization scale in center of preventive treatment of disease of the first affiliated hospital of Guangzhou university of traditional Chinese medicine.Results of blood biochemical examination were analyzed,too.ResultTotally,1547 patients were selected.There were 1057 which were abnormal in blood lipid and 490 normal,attributed to two groups.There was significant difference between two groups in the aspects of gender,age,culture degree,body mass index,metabolic disorders,and blood pressure etc.The first five biased constitutions of dislipidemia were Qi deficiency constitution,dampness heat constitution,qi stagnation constitution,yin deficiency constitution and phlegm dampness constitution.There were no significant difference in the kinds of dyslipidemia and lipid levels among patients with different type of constitution.Multivariate logistic regression analysis showed that phlegm dampness constitution,dampness heat constitution and blood stasis constitution were positively related to dyslipidemia,which were risks to dyslipidemia.Peace constitution,yang deficiency constitution and yin deficiency constitution were risks to cholesterol.Phlegm dampness constitution was a risk to triglyceride.The study also found that qi stagnation constitution was a protective factor of dyslipidemia,and yin deficiency constitution was a protective factor of serum high density lipid(HDL),the reason and accuracy of which needed to be further researched.There was no constitution relative to low density lipid(LDL)in this study.ConclusionYin deficiency constitution,yang deficiency constitution,phlegm dampness constitution,dampness heat constitution and blood stasis constitution are the main influence factors of dyslipidemia.The second part:the study of the mechanism of the decoction of reducing turbidity and regulating fat in regulating plasma lipidObjectiveTo research the mechanism of the decoction of reducing turbidity and regulating fat(DRTRF)in regulating plasma lipid.MethodExogenous hyperlipidemia animal model was duplicated by feeding high fat diet,consisting of 1%cholesterol,4%vegetable oil and 95%basic feed for 4 weeks.Rabbits were randomly divided into six groups,that was normal group,model group,positive medicine group,low dose of Chinese medicine group,middle dose of Chinese medicine group and high dose of Chinese medicine group.Medicine intervention began after the model was built.There were two successively stages in intervention.In the first stage,medicine was given to animals while high fat diet was feeding in the same time for 4 weeks.In the second stage,medicine was given but no high fat diet for 4 weeks.Serum lipids were detected after 8 weeks intervention.Gene expression of HMG CoA reductase and LDL receptor in liver was detected through rt-PCR.HE staining of coronary was made.Then the effect and mechanism of DRTRF in regulating plasma lipid was analysed.ResultsThe animal model of hyperlipidiema was successfully duplicated by feeding high fat diet for 4 weeks.Total cholesterol(TC)and LDL in serum significantly raised.And TC and LDL-C continued to rise in the process of the first stage.TC increased respectively by 42.8%and 83.4%in positive drug group and high dose group.LDL-C of two groups increased respectively by 126.6%and 100.9%.While TC and LDL-C decreased gradually in the second stage.TC decreased significantly by 83.39%and 81.04%in positive drug group and high dose group,respectively,LDL-C of two groups decreased by 90.44%and 86.81%,respectively.At the end of the second stage,there was significant difference in level of high density lipoprotein cholesterol(HDL-C)between high dose group and groups of normal group,model group and positive drug group(P<0.05).Serum triglyceride of had not significantly changed.After administration,the sequence of expression of hepatic HMG CoA reductase(HMGR)mRNA from low to high was followed by normal group,positive drug group,high dose e group,middle dose group,low dose group and model group.The sequence of expression of hepatic LDL receptor(LDLR)mRNA from low to high was followed by model group,low dose group,middle dose group,high dose group,positive drug group and normal group.Level of ox-LDL decreased after administration.The difference in the treatment of positive medicine group and high dose group were significant(P<0.05).The level of serum CETP decreased after administration.Compared to normal group,there was no significant difference in positive drug group,middle dose group and high dose group(P>0.05).The difference in the treatment of model group,positive drug group,middle dose group and high dose group was significant(P<0.01).HE staining showed that there were only a few foam cells and inflammatory cells in coronary of positive medicine group,high dose group and middle dose group,no lipid plaques found.Pathological changes of those groups were lighter than that of the model group.It was available for middle and high dose of DRTRF to resist atherosclerosis.ConclusionExogenous TC hyperlipidemia and high LDL-C hyperlipidemia rabbit model could be duplicated by feeding high fat diet for 4 weeks.DRTRF helps to decrease the level of TC and LDL-C in serum,increase the level of HDL-C.The possible mechanism of regulating lipids maybe by reducing the expression of HMGR mRNA and increasing the expression of LDLR mRNA in liver.DRTRF is beneficial to reduce ox-LDL and CETP blood concentration,and has some effect of resisting atherosclerosis.High does of Chinese medicine maybe more effective. |
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