| In this thesis, the pathomechanism of myocardial ischemia reperfusion injury (MIRI) in TCM was firstly pointed out: Heart Qi vacuity is the root, heart blood stasis obstruction and internal turbid toxin formation are the tip. The therapeutic principles are: Boosting Qi and nourishing heart, activating blood circulation and resolving toxin, treating the root and tip simultaneously. According to this, we chose Huxinbao combined by Panax ginseng (boosting Qi) , notoginseng extraction (activating blood circulation) and Taurine (detoxifying). Pharmacologic preconditioning protections of them in MIRI were observed from 20 patients undergoing open heart surgery (valve replacement for rheumatic heart disease) during cardiopulmonary bypass and 90 MIRI rabbits models (ligation of left ventricular branches of coronary arteries). The results showed that suitable dose of Huxinbao could protect ischemic myocardium and MIRI significantly and indicated that Panax ginseng, notoginseng plus with Taurine had better curative effect than each of them or Panax ginseng plus notoginseng extraction. Thus, it tested and verified the pathomechanisrn of MIRI in TCM and the therapeutic principles, including the feasibility.. validity, rationality and superiority of its principles embodied by Huxinbao. The study expounded that the mechanism of protecting ischemic myocardium was by reducing endothelin's secreting and releasing; the mechanism of protecting MIRI was by protecting the activity of superoxide dismutase, strengthening the ability of clearing away oxygen free radical, reducing lipid oxide, activating calcitonin gene-related peptide, resisting endothelin's secreting and releasing, increasing nitric oxide and nitric oxide synthase level. The study provided scientific basis for choosing rational and highly efficient Chinese medicine dosage in MIRI from pharmacologic preconditioning angle. |
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