The Foundation And Clinical Research Of Tongguan Capsule's Effect On Blood Inflammatory Factors In Rats With High Blood Lipids And Patients With Coronary Heart Disease After Receiving PCI.

Background:Coronary Heart Disease(CHD) is one of important disease endangering human being' s health. The incidence and mortality rate of CHD are gradually increase in recent years because the living standard's raising and the insufficiency of knowledge popular of CHD. There are multitude factors participating in development of CHD. Pathophysiology of CHD has been known, medical treatment is developing at full speed. The utilization of PCI and DES started a new epoch.The high blood lipids are the primary factor of forming atherosclerosis, The blood fats advance when the chronic process of atherosclerosis forming actually is that the endothelial cell is corroded process by the massive inflammatory factors , so that the endothelial cell is destructed, the intermediate smooth muscle cell proliferate massivly, namely atherosclerotic plaque. Restonesis incidence rate is significant reducing with the use of medicine-eluting stent in recent years, and is meeting the new dawn. Medicine-eluting stent (for example: sirolimus-eluting stent, rapamycin-eluting stent and so on) suppress inflammatory factors excessively expression in intermediate-long-term after PCI, thus achieves the goal of preventing restonesis. The inflammatory factors have all acted the important role in regardless of in the initial period or after PCI of CHD.CHD is brought into " XIONG BI " category in Traditional ChineseMedicine. Its disease mechanism exists in the cxcess in origin and deficiency in superficiality. BEN XU includes deficiency of XIN QI, XUE, YIN, YANG, and BIAO SHI is that vascular skeletons are blocked by TAN RE, TAN ZHUO, YIN HAN, YU XUE, QI ZHI and so on. In BEN XU BIAO SHI syndrome, the basic is QI XU XUE YU, which is more often than other syndrome in patients after PCI by mass observertion of cilinic. Therefore, it should be cured by therapeutic law of YI QI HUO XUE, which often obtains good effects in clinilic.There have already many research regarding the coronary disease Chinese medicine dialectical treatment. But the Chinese medicine dialectical treatment still not to be many in the patient accepting PCI. In particular in inflammatory factors aspect, for instance PCI technique to inflammatory factors influence, and corresponding change of Chinese medicine intervention inflammatory factor. This research will observes the changes of Tongguan Capsule's Effect on blood plasm inflammatory factors from the foundation and the clinical two aspects. Objcetive:Firstly: Discuss the Tongguan Capsule's Effect on blood plasm inflammatory factors and lipids in rats with high blood lipids;Secondly: Discuss the Tongguan Capsule's Effect on blood plasm inflammatory factors in patients with Coronary Heart Disease after Receiving PCI.Thirdly:Preliminary analysis the PCI's Effect on blood plasm inflammatory factors in a Native Coronary Artery. Methoad:1. Foundation experiment:By using prospective randomized control study, the male SD big rats, weight 18(T220g, Carries on the pre-experiment first, summarizes the method of establishmenting the big rats with high blood lipids model initially and maintains the model at the same time (about six weeks);According to this method, establishes the big rats with high blood lipids model officially;Then we randomly divides into four groups, the blank control group, the high lipids control group, the Tongguan Capsule's group and the Lipitor group, (about four weeks);Carries on the Chinese medicine intervention after grouping, (about twelve weeks);Collecting type and analysis the changes of the blood plasma inflammatory factor IL-6, CRP, the TNF-a. Establishesthe database and uses the SPSS 11.0 software to carry on the data processing. (1-2 weeks)2. Clinical research:By using prospective Randomized^ Controlled study, we observed 50 CHD patients who treated by PCI in Guangdong provincial hospital from 2005-9 to 2006-3. According to Randomized table we drive the patients to the trial group and the control group. The control group patients take convention westen medicine, the treatment group patients take the conventional westen medicine and the Tongguan capsule (3 grain of tid). We observered the changes of the blood plasma CRP, TNF-a, the IL~6The by using enzyme linked immunosorbent assay before the operation instantly after operation and 1st month after operation. Establishes the database and uses the SPSS11.0 software to carry on the data processing. Result:1. Foundation experiment: Compared the blank control group with the high lipids control group, the concentration of TC and LDL-C increase, which hint the succeeded high lipid model ,TC (P<0. 05),LDL-C (P<0. 01) . Compared the Tongguan group with high lipids control group, Tongguan can decrease the concentration of TCn LDL-C, which have the difference (P<0. 01). Compared the Tongguan group with Lipitor group, the effect of decreasing TC is better in Lipitor than in Tongguan(P<0. 05), but Tongguan have better effect in increasing HDL-C than Lipitor (P<0.05);Compared the blood plasm inflammatory factors concentration the blank control group with the high lipids control group, the blood plasm inflammatory factors concentration significantly increase, which exists notable statics sense(P<0.01);Compared Tongguan group with the high lipids control group, the concentration of CRP and TNF-a decrease obviously in Tongguan group, the difference exists notable statics sense (P<0. 01), but the concentration of IL-6 is unchanged (P>0. 05). Compared the Tongguan group with Lipitor group, the concentration of CRP and TNF-a doesn, t exist the difference (P>0. 05);The effect of decreasing IL-6, s concentration is better in Lipitor than in Tongguan P<0. 01.2. Clinical research: Respectively compared patients, blood plasm inflammatory factors concentration in two groups preoperative with after operative instantly, the difference doesn, t exist statics sense (P>0. 05);the inflammatory factors (CRP ■> TNF-a-. IL—6) obviously increase after operative instantly (P<0. 001), and decrease after operation for 30-days. The blood plasm CRP. TNF-a. IL—6 concentration is lower in trail group than in control group after operation for 30-days CRP(P<0. 01). TNF-a(P<0. 05)? IL-6(P<0. 05). Conclusions:1. Foundation experiment: The blood inflammatory factors and lipids obviously advances after the high lipids model creating from this experiment. The Tongguan Capsule have effects of reducing the blood inflammatory factors and lipids concentration, but the intensity of reducing various inflammatory factors concentration is not same. Lipitor has also an effect of reducing the blood inflammatory factors concentration. The Tongguan Capsule has not an effect of suppressing the blood plasm inflammatory factors activity through this experiment.2. Clinical research:(1) The blood plasm inflammatory response obvious enhance after PCI instantly;(2) The Tongguan Capsule reduce remarkably the blood inflammatory factors concentration after PCI, and achieve the effect of preventing coronory arteries event recurring.