| With the change of livestyle, Coronary Heart Disease(CHD) has become one of the common diseases to harm people's health and cause people death. Atherosclerosis (AS) is the main reason of CHD. Therefore, it's getting important to precaution, treat and even reverse the AS. In the pathogenesis of AS, that vascular smooth muscle cells(SMCs) permeate interior elastic layer and arrive at vascular intima and proliferate is the central event. But the mechanisms of migration and proliferation of SMCs are not clear now. However, inflammation doctrine is thought highly of AS Restenosis(RS) after percutaneous coronary intervention (PCI) is the main complication of interventional therapy of CHD.And the migration and proliferation of SMCs are the most characteristic cytobiology in AS.Recently people found that SMCs synthesize and secrete extracellular matrix and matrix metaloproteinases(MMPs).That MMPs degrade the ECM. Promotes SMCs'migration and proliferation. On the other hand that MMPs degrade the fabric cap leads to AS plaque disruption, causing angina pectoris (AP).CHD is belong to the chest pain category in TCM. In prevention and control chest pain TCM has accumulated rich experience. The occurrence of chest pain are no more than the internal and external cause.In internal cause there are emtion injuries, organs weak, air&blood disorders. In external cause there are spleen injuryed diet, over-weary, endogenous phlegm. Internal cause play a decisive role and external causes play an important factor in CHD.There are several metheds in treating Chest Pain. The temporary treating metheds are aromatic Warming, promoting blood circulation, dissolving phlegm and activating blood.the essential therapy are supplementing qi and nourishing yin, reinforcing kidney&supporting the healthy energy.1. The Experience of therapying chest pain of Liu zhi-ming the famous TCM doctorThe famous doctor Liu zhi-ming has practiced medicine for 70 years.on the basic of previous experience,Liu zhi-ming has Formed a unique theoretical system of Chest Pain Treatment. He pointed out that The basic mechanism of Chest Pain is the root deficiency and branch excess. Explanation in detail,the root deficiency are Zong Qi deficiency,Heart Yang deficiency, Kidney Primary deficiency. The branch excess are endogenous phlegm and blood stasis. Although the lesion of chest pain is in heart,there are has some relationship with Kidney,spleed and liver.the main methed of therapying chest pain are strengthening body resistance, Conditioning zang-organs and excitation heart Yang. In treating chest pain he always focus on Organs, Qi Blood and Body Fluids.His prescription fining,blends is precise and appropriate,the medication is gentle in clinical.when treating chest pain,he likes to use drugs in pairs,such as Ginseng & Rehmannia, Kirilowii & Allium, Salvia & Pseudo-ginseng. He good at use Kirilowii Allium and Pinellia Decoction,Sheng Mai Granule&Shouwu Yanshou Dan.2. The clinical research of Guan Xin Shuang Mixture in treating CHD which is a famous TCM doctor prescriptionsObjective:To investigate the clinical effete,security of Guan Xin Shuang Mixture on angina of coronary heaat disease of Kidney Yin deficiency and Heart Yang stagnadion Syndrome. Investigating the effect of Guan Xin Shuang Mixture on the hs-CRP,MMP-9 and TIMP-1 in patients'plasma.then explain what is the possible mechanism of Guan Xin Shuang Mixture in treatmenting of angina pectoris.At last to provide a effective and security way of treating CHD.Methods:from April 2009 to December 2009,56 cases of angina of coronary heart disease with Kidney Yin deficiency and Heart Yang stagnadion Syndrome were observd and randomly and averagely devided into treatment group and control group,in these cases 26 are male,the other are female.but at the end of the test,2 cases were lost,so the control group had 26cases,the treatment group had 28 cases.Afer 1 month treatment,the efficacy of TCM Syndrome, clinical symptoms, angor pectoris, ECG and SAQ score were observd. At the end of the test we also calculated Withdrawal rate of nitroglycerin and Detected the hs-CRP,MMP-9 and TIMP-1.Results:(1) The effection of TCM Syndrome of treatment group was 92.86%,the control group was only 76.92%(P=0.00).For further, In improving chest pain, chest tightness,shortness of breath, weak waist, dizziness& ringing in the ears of treatment group more better than the control group(P<0.05).Furthermore,in Shorting the duration of angina and reducing the amount of nitroglycerin,treatment group is more better than control group(P<0.05).By investigating the SAQ scale,the treatment group can significantly improve the body's activities in patients with limited extent, stable angina condition, reduce angina frequency and increase patient treatment satisfaction, to improve the quality of life of angina patients(P<0.05). ECG ST-improvement of the two guops had no difference. Before and after treatment the two groups of blood, urine,liver and kidney function had no change(P>0.05).(2)afer treating 1month, the hs-CRP of the two groups values were significantly lower before(P<0.05), however, the extent of the treatment group was more significantly the control group (P<0.05).After 1 month treatment, MMP-9 of treatment group was significantly decreased (P<0.05); while the control group was not decreased After treatment, TIMP-1 values of the two groups did not change significantly.Conclusion:(1)Guan Xin Shuang Mixture can improve chest pain, shortness of breath, weak waist, dizziness, tinnitus and other symptoms, short the time of angina pectoris, reduce enitroglycerin amount of CHD patients with kideny yin deficiency, heart yang stasis.Guan Xin Shuang Mixture has no Adverse effects on Liver and kidney function, blood, urine. Guan Xin Shuang Mixture was Safe and effective in treating CHD.(2) Guan Xin Shuang mixture can significantly reduce coronary heart disease patients plasma hs-CRP, MMP-9 levels. Guan Xin Shuang mixture have the effect of significant anti-inflammatoryand stable arterial plaque. This may be the treatment of Guan Xin Shuang mixture treating angina pectoris one of the mechanisms. |
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