The Effect Of Qishenyiqi Dripping Pill On High Density Lipoprotein Subclasses And Inflammatory Cytokines Of Patients With Coronary Heart Disease

Objective:High density lipoprotein(HDL) as an important lipoprotein in human blood plasma,plays significant roles in reverse cholesterol transport, anti-inflammatory,anti-oxygen,anti-atherosclerosis.High density lipoprotein subclasses have closer relations with coronary artery disease than high density lipoprotein,HDL can be divided into 2 species of pro-P-HDL andα-HDL, pro-β-HDL contains pro-β1-HDL,pro-β2-HDLand pro-β3-HDL,α-HDL contains HDL2b,2a,3a,3b,3c,et al.Although there are many researches about HDL2,HDL3,there is no coherent conclusion about their relationship with coronary heart disease because the multiplicity of its composition,metabolism and function,so it is valuable of doing some researches about this.Inflammatory reaction is running though all process of atherosclerosis(AS),and correlates closely with acute heart and cerebral vessels event,so anti-inflammatory therapy of coronary heart disease(CHD) is thought highly by doctors.Chinese crude drugs are used in clinic because of its anti-inflammatory effects.Qishenyiqi dripping pill of Tianjin Tasly Medicine Distribution Group Co.LTD can accommodate CHD patients' lipid metabolism of deficiency of vital energy and blood stasis type,can degrade significantly the level of C-reactive protein(CRP),and has the function of anti-inflammatory,can delay and inhibit the process of AS.Because researches about Qishenyiqi dripping pill's influence on HDL2,HDL3,TNF-αare rarely reported,so it is valuable of doing some research about that.The aims of the trial are to explore the influence of Qishenyiqi dripping pill on HDL2,HDL3,CRP,TNF-α,and to compare the therapeutic effect of Qishenyiqi dripping pill with probucol,to explore the relations among HDL2,HDL3 and CHD.Method:We randomly choose 40 subjects who fit specified conditions from hospital patients of Department of Cardiology,the Second Hospital of Tianjin Medical University.The patients were randomly divided into 3 groups,which were designated atorvastatin group(A group) contained 12 patients,atorvastatin and probucol group(B group) contained 14 patients,atorvastatin and Qishenyiqi dripping pill group(C group) contained 14 patients.A group was given atorvastatin in addition to conventional therapies,B group was given atorvastatin and probucol and C group was given atorvastatin and Qishenyiqi dripping pill in addition to conventional therapies,therapy time is 4 weeks.The aims of the trial are to observe all patients' clinical symptoms and the changes of electrocardiogram(ECG) of pre-therapy and post-treatment;to observe the changes of all patients' total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),HDL-C,HDL2,HDL3 of pre-therapy and post- treatment;to and to explore three groups' differences of therapeutic effect.Results:1.Numbers of angina pectoris attacks of all groups were reduced, effective power of A group is 66.67%,B group is 85.71%,C group is 92.86%,C group is predominate than A group in effective power,it has statistical significance(P＜0.05).Effective power of A group is 58.33%in ST-T backswing, effective power of B group in ST-T backswing is 64.29%,and C group is 57.14%,there is no statistical significance between 3 groups(P＞0.05).2.Changes of TC,TG,LDL-C and HDL-C.In pre-therapy,there were no statistical difference among 3 groups of LDL-C,TC,TG,HDL-C(P＞0.05).Post treatment,the TC,TG and LDL-C were decreasing(P＜0.01),and HDL-C were increasing(but it has no statistical significance,P＞0.05) in group A,In group B,the TC,TG and LDL-C were decreasing(P＜0.0l),and HDL-C were increasing,but it has no statistical significance(P＞0.05),In group C,the TC,TG and LDL-C were decreasing(P＜0.01), and HDL-C were increasing significantly(P＜0.01).3 groups therapeutic effects comparison.Group B decreasing the lever of LDL-C,TC is better than group A,it has statistical significance(P＜0.01),there is no significant difference of TG,HDL-C between group A and B(P＞0.05).Group C decreasing the lever of LDL-C,TC is predominate than group A(P＜0.05),increasing HDL-C is predominate than group A,too(P＜0.01).There is no statistical difference of the level of LDL-C,TC,and TG between group C and B(P＞0.05),but group C increasing HDL-C is superior to group B(P＜0.05).There is no statistical difference of the level of TG among 3 groups(P＞0.05).3.Changes of HDL2,HDL3.There were no statistical difference between 3 groups of HDL2 and HDL3 before treatment(P＞0.05).3 groups were all increasing the level of HDL2,it has statistical significance(P＜0.05),the level of HDL3 has no change after treatment(P＞0.05).There is no statistical difference of the level of HDL2 between Group A and B after treatment(P＞0.05),Group C has the significant effect in increasing HDL2,better than group A and B(P＜0.05).HDL 3 correlates negatively with albumin,coefficient correlation is -0.422,P=0.012.HDL 3 correlates negatively with HDL-C,coefficient correlation is -0.321,P=0.044.HDL2 of post-treatment correlates positively with HDL-C,coefficient correlation is -0.315,P=0.048.4.Changes of TNF-αand CRP.There were no statistical difference among 3 groups of TNF-αand CRP before treatment(P＞0.05).3 groups were all decreasing the level of TNF-α,it has statistical significance(P＜0.05),the level of CRP has no change after treatment(P＞0.05).There is no statistical difference of the level of TNF-αbetween group C and B after treatment(P＞0.05),Group C and B have the significant effect in decreasing TNF-α,predominate than group A(P＜0.05).Conelusions:1.3 treatments are all good for decreasing the numbers of angina pectoris attacks and ST-T backswing,among the total,atorvastatin and Qishenyiqi dripping pill has better therapeutic efficacy than lipton alone.2.After treatment,3 groups are all decreasing the level of LDL-C,TC and TG,group atorvastatin and Qishenyiqi dripping pill can increase the level of HDL-C significantly.There is no statistical difference in decreasing the level of LDL-C and TG between group atorvastatin and probucol and group atorvastatin and Qishenyiqi dripping pill,but their effect is better than group atorvastatin.So the therapeutic alliance of atorvastatin and Qishenyiqi dripping pill has the ability of increasing HDL-C significantly,group atorvastatin and Qishenyiqi dripping pill 'effect is better than other 2 groups,the therapeutic alliance of atorvastatin and Qishenyiqi dripping pill is benefit for the treatment of CHD.Therapeutic alliance is better than single drug.3.3 treatments are all increasing the level of HDL2,the level of HDL3 has no change after treatment.Group atorvastatin and Qishenyiqi dripping pill can increase significantly the level of HDL2,its effect is better than other 2 groups.HDL2 correlates positively with HDL-C,HDL3 correlates negatively with HDL-C,so HDL2 is benefit for treatment of CHD,HDL3 is harmful for treatment of CHD.4.After treatment,3 groups were all decreasing the level of TNF-α.The effect of therapeutic alliance is superior to the effect of single drug treatment.