| Background and objective: Hyperhomocysteinemia is recently regarded as a risk factor of such vascular diseases as coronary heart disease and stroke. According to Professor Zhang, s previous research, the level of serum homocysteine (Hcy) can be used as an important evidence for the differential diagnosis of syndrome marked as kidney deficiency, blood stasis and phlegm turbidity. On the basis of rich clinical experiences, Professor Zhang thinks that, in the theory of TCM, angina pectoris often occurs manifested as deficiency in origin and excess in superficiality .So the treatment aiming at nourishing kidney, activating blood and resolving phlegm can effectively prevent angina pectoris. Yishenhuoxue Capsule has been prepared for this kind of pharmacological effect. This study aims at the effects of the capsule on Hcy, lipid and the balance between coagulation and anticoagulation and the observation of its clinical curative effects on angina pectoris.Methods: Sixty patients with angina pectoris, who were also differentiated as the type of kidney deficiency and blood stasis, were selected and divided randomly into two groups, therapy group and control group. In addition to same routine therapy to both groups,the former was administered folic acid and Vitamin B6,while the latter Yishenhuoxue Capsule. The observation was made for changes of clinical features and signs including serum Hcy and lipid, plasm D-D, GMP-140 and AT â…¢ .Electrocardiogram, routine test of blood, urine and shit, liver function and renal function were examined respectively before and after treatment.Result: (1) The serum level of Hey ,in both groups,declined remarkably after treatment (P<0.05 or P<0.01), but there was no distinctive difference between the two groups(P>0.05); (2) The total effective rate for angina pectoris and TCM syndromes in therapy group were 93.34% and 93.33% respectively, which were both superior to those of control groups (P<0.05);(3) The total effective rate of ECG was 60% in therapy group, which was superior to that in control group with no statistic significance (P>0.05); (4) After treated, the patients in therapy group took fewer nitroglycerin tablets than those in control group; the frequency and period of angina pectoris decreased more in therapy group than those in control group (P<0.05); (5) For medium severity of angina pectoris and TCM syndromes,therapeutic effects on therapy group were superior to that of control group (P<0.05) ; (6) Compared with control group, changes of plasm D-D, GMP-140, ATIII and AI in therapy group were statistically different (P<0.05 or P<0.01);(7)No side effect was found in the process of the study.According to the above analysis, we recognize the therapy mechanism of Yishenhuoxue Capsule as follows: (l)the drugs contain folic acid, betaine, VitC and VitE, which can reduce the level of Hey and the oxide stress caused by it; it can promote the expression of enzyme associated with the metabolism of Hey, and it can also accelerate the elimination of Hey through kidney;(2)it decreases AI and modulates the metabolism of the lipid;(3)it balances the anticoagulation and coagulation directly or indirectly through enhancing the activity of antithrombin, suppressing the activiton of platelet and stopping fibrin from synthesizing or promoting fibrin to degradate. Taken together, Yishenhuoxue Capsule interferes, from several aspects, with pathophysiologic course of atherosclerosis.Conclusion: The effect of the combined treatment (including Yishenhuoxue capsule and routine medicine) on Hey proves to be obvious; and the combined , treatment for angina pectoris is superior to the treatment with western medicine alone (including VitB6, folic acid and routine medicine).
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