Study On The Mechanism Of Syndrome Evidence Of Abnormal Syndrome Of Blood Lipid And The Mechanism Of Yunpi Huayu Decoction On Blood Lipid Abnormal Rats

ObjectiveTo reveal the distribution and changing law of TCM syndrome,syndrome factors and affecting target of dyslipidemia.To introduce nine methods for the treatment of dyslipidemia with ancient formulas.To analyse compatibility law of Chinese herbal compound patent about dyslipidemia.On the basis of the above studies and individual clinical experience,exploring the mechanism of treatment of dyslipidemia rats with preparations of activating spleen to eliminate turbid.Methods1 Searching the published literature on CNKI from January 1975 to December 2015 to analyse the distribution and changing law of TCM syndrome,syndrome factors and affecting target of dyslipidemia.2 Investigating the therapeutic principles with ancient formulas of dyslipidemia through a systematic analysis of ancient literature.3 Retrieving the national patent database from September 1985 to March 2014 for Chinese herbal compound patents of dyslipidemia to analyse patent compatibility rule of Chinese herbal compounds by using drug frequency, association rules, complex networks and entropy methods of Chinese heritage auxiliary systems (V1.1).4 84 male Wistar rats were divided into normal group (group A, n=10) and the high-fat group (n=74) randomly. the rats of normal group were fed with normal diet, while the rats of high-fat group were fed with special fat diet for four weeks.Assaying the contents of serum TC, TG, HDL-C, LDL-C and analysing the lipid levels in two groups.With the establishment of dyslipidemia rats, rats in the high-fat group were randomly divided into 7 groups, named high-fat control group (group B, n= 10), pravastatin group (group C, n=10), xuezhikang group (group D, n=10), Huazhuo Tiaozhi No.1 high dose group (group El, n=11), Huazhuo Tiaozhi No.1 medium dose group (group E2, n=11), Huazhuo Tiaozhi No.1 low dosage group (group E3, n=11), Huazhuo Tiaozhi No.2 medium dose group (group F, n= 11).Rats of group A were fed with normal diet, while rats of other groups were fed with special fat diet for another eight weeks.Meanwhile gavaging the rats in different groups with different drugs. At the end of this experiment,measuring body weight, liver weight, abdominal circumference, body length of the rats,assaying the contents of serum TC, TG, HDL-C, LDL-C, AST, ALT, APN, LEP and observing their liver biopsy.Results193 Literatures and 23270 cases were included, the common syndromes of dyslipidemia are phlegm stasis,blood stasis and qi stagnation,yin deficiency and yang exuberant, yin deficiency of liver and kidney; the common syndrome factors are phlegm turbid, blood stasis, qi deficiency, qi stagnation; the common affecting targets are spleen, kidney, liver and heart. Over time,deficient patterns are decreasing,while empirical patterns are gradually increasing;such as: ①Qi Deficiency is observed with downward trend, percentages in periods of 1986-1995,1996-2005,2006-2015 (1.40%,6.38%,3.23%) are significantly lower than 1975-1985 (23.52%);② syndrome of phlegm stasis is on the rise (1975-1985:7.47%, 1986-1995:38.36%、1996-2005:18.90%、2006-2015:21.75%); syndrome of blood stasis in recent 40 years fluxs small (21.82%-26.71%); the main affecting targets transform from liver (71.43%->35.26%)、kidney (68.13%→41.82%) to spleen (33.85%→60.39%)2 Nine therapeutic principles with ancient formulas of dyslipidemia:clearing heat and resolving phlegm (Xiaoxianxiong Tang), warming yang and resolving fluids (Ling Gui Shu Gan Tang), clearing heat and eliminating dampness (Gegen Qin Lian Tang and Yinchen Wuling San), replenishing qi to resolve dampness (Fangji Hangqi Tang), activating spleen to eliminate turbid (Zhi Shu Wan), promoting digestion and relieving stasis (Baohe Wan), clearing heat and activating blood (Zhizi Dahuang Tang), clearing the liver and gallbladder (Da Chaihu Tang), warming the keydney to eliminate water (Shenqi Wan).3 The most common single drug extracted from herbal compound patents of dyslipidemia is Hawthorn 109 (44.86%),etc; the most common pair drugs are Hawthorn-Salvia 53 (21.81%), etc; the most common angle drugs are Hawthorn-Cassia-Polygonum 25 (10.29%), etc; association rules based on a combination of common drugs are Prunella-> Salvia (0.833), rhubarb, Alisma-> Polygonum (1.000), Salvia, cassia, Alisma-> Polygonum (0.929),etc; core drugs based on complex networks are Salvia, hawthorn, etc; new prescriptions extracted by entropy method are Atractylodes, licorice, Bozi, tetrandra; dried tangerine peel, Poria, Coix seed, Pinellia.4 ① Compared with the high-fat group, contents of TC, LDL-C in Huazhuo Tiaozhi No.1 high dose group were significantly lower than the high-fat control group, the difference was statistically significant (P= 0.003,0.000); contents of TC,LDL-C in Huazhuo Tiaozhi No.1 medium dose group were significantly lower than the high-fat control group, the difference was statistically significant (P=0.004,0.012); contents of TC in Huazhuo Tiaozhi No.1 low dose group were significantly lower than the high-fat control group, the difference was statistically significant (P=0.017); contents of TC,LDL-C in Huazhuo Tiaozhi No.2 medium dose group were significantly lower than the high-fat control group, the difference was statistically significance (P= 0.031,0.027). The others were not statistically significant different (P> 0.05). ②Compared with high-fat control group, contents of AST in Huazhuo Tiaozhi No.1 high dose group was significantly decreased, the difference was statistically significant (P=0.039);contents of AST, AST in the rest of the drug intervention groups were not statistically significant different compared with high-fat control group. ③Contents of APN in Huazhuo Tiaozhi No.1 high dose group, Huazhuo Tiaozhi No.1 medium dose group, Huazhuo Tiaozhi No.2 medium dose group were significantly higher than high-fat control group, the difference was statistically significant (P=0.048,0.010,0.016); the difference between Huazhuo Tiaozhi No.1 low dose group and the high fat group was not statistically significant (P=0.306). Contents of LEP in Chinese medicine treatment groups were not statistically significant different(P> 0.05) with high fat control group. ④Pathological findings of liver:the degree of fatty degeneration of liver cells is lower in the TCM treatment groups and the number of punctate necrosis is reduced compared with high fat control group.The degree of fatty degeneration of liver cells in Huazhuo Tiaozhi No.1 high dose group is lower compared with Huazhuo Tiaozhi No.1 medium dose group,Huazhuo Tiaozhi No.2 medium dose group.While the degree of fatty degeneration of liver cells aggravates in Huazhuo Tiaozhi No.1 low dosage group compared with Huazhuo Tiaozhi No.1 medium dose group and Huazhuo Tiaozhi No.2 medium dose group.Conclusions1 The empirical patterns are on the rise,syndromes of phlegm stasis, blood stasis and qi stagnation are preferred;syndrome factors of phlegm turbid,blood stasis are preferred; affecting target of spleen is preferred;while the deficient patterns are gradually decreasing, syndrome factor of qi deficiency is preferred in recent 10 years.2 Two guiding principles for the treatment of dyslipidemia:tornify, eliminating. One of the important therapeutic principles of dyslipidemia is activating spleen to eliminate turbid with Zhi Shu Wan.3 There are laws for us to follow in the treatment of dyslipidemia from the following six aspects:①single drug should be preferred:e.g. hawthorn;②pair drugs should be preferred: e.g.Hawthorn, Salvia;③comer drugs should be preferred:e.g. hawthorn, cassia seed, Polygonum;④the compatibility among drugs should be given attention, highly related drugs should be preferred:Prunella, Salvia; rhubarb, Alisma, Polygonum,etc;⑤core drugs should be dominant and compatible:e.g. in the digestion catharsis method,the core drug is hawthorn and compatible with Salvia;⑥application of new prescriptions:e.g. atractylodes, licorice, Bozi, anti-hexyl.On the basis of the above studies and individual clinical experience,prescriptions of activating spleen to eliminate turbid are formed,the main ingredients are citrus aurantium, atractylodes, lotus, castor seed, hawthorn, salvia, polygonum cuspidatum, grain insects.4 ① Lipid levels (TC, LDL-C)of dyslipidemia rats can be reduced by prescriptions of activating spleen to eliminate turbid.②Prescriptions of activating spleen to eliminate turbid showed no significant effect on the contents of ALT,AST. It is safe in this area.Prescription used in group E1 may be protective to liver.③Adiponectin levels can be elevated by prescriptions of activating spleen to eliminate turbid,but no significant effect on leptin.④The pathological morphology of the rats’ liver can be improved by method of activating spleen to eliminate turbid,it is most obvious in group El.