| Coronary heart disease is a serious threat to human health. Aspirin is widely used in the two grade prevention of it. In recent years, Chinese doctors use some traditional Chinese medicine to treat coronary heart disease. Therefore, this study include two parts:1. A Meta-analysis on efficacy of aspirin combined with blood-activating and stasis-resolving drugs in the treatment of coronary heart disease; 2. Effects of aspirin combined with Ginkgo Biloba Extract on the production of inflammatory index in endothelial cells induced by activated platelets.Section 1:A Meta-analysis on efficacy of Aspirin Combined with Blood-activating and Stasis-resolving Drugs in the Treatment of Coronary Heart DiseaseAim:To evaluate the clinical therapeutic effects of aspirin in combination with blood-activating and stasis-resolving drugs on coronary heart disease in order to provide reference for clinical rational use of above drugs.Methods:Studies about the clinical therapeutic effects of aspirin in combination with blood-activating and stasis-resolving drugs on coronary heart disease were searched from PubMed, CNKI full-text database, VIP and CBM. The studies included were assessed by the quality evaluation standard of randomized rontrolled trials (RCT) in Cochrane. Odd ratio (OR) or Std. mean difference (SMD) was used as the effective variable to undertake Meta-analysis. The heterogeneity of the studies was analyzed by chi square test. The source of the heterogeneity was analyzed by Meta-regression in Stata12.0 software.Results:A total of 20 studies were included, of which 18 studies were involved in clinical efficacy and 11 studies involved in the efficacy of ECG The results of meta-analysis indicated that aspirin in combination with blood-activating and stasis-resolving drugs was significantly associated with better clinical efficacy of angina pectoris [OR=3.19; 95%CI (2.43-4.19), P<0.00001]; the efficacy of ECG [OR=2.61; 95%CI (1.94～3.51), P<0.00001]. There were 16 studies about the reduction of total cholesterol (TC) and triglyceride (TG) level,15 studies about the decrease of low-density lipoprotein (LDL) level and 14 studies about the improvement of high-density lipoprotein (HDL) level. Meta-analysis of these studies showed that aspirin in combination with blood-activating and stasis-resolving drugs was significantly associated with the reduction of TC level[SMD 1.18; 95%CI (0.69～1.67), P<0.00001], significantly with the reduction of TG level [SMD 1.02; 95%CI (0.50～1.54); P=0.0001], significantly with the reduction of LDL level [SMD 1.22; 95%CI (0.70～1.74), P<0.00001],and significantly with the improvement of HDL level [SMD 0.88,95%CI (0.47～1.28); P<0.0001].Conclusion:The clinical therapeutic effect of aspirin in combination with blood-activating and stasis-resolving drugs on coronary heart disease may be more effective than that of aspirin alone.Section 2:Effects of Aspirin Combined with Ginkgo Biloba Extract on the Production of Inflammatory Index in Endothelial Cells Induced by Activated PlateletsAim:In this study, we used HCAECs stimulated by activated platelet in vitro to built the oxidative stress model, then to explore whether aspirin, Ginkgo biloba extract or their combination can synergistically inhibit the production of IL-6 and VAP-1 and phosphorylation of NF-kappa B (p-p65).Methods:We cultured HCAECs and selected the 5th-7th generation of cells for experiment. Activated platelets 2×108/ml was used to stimulate HCAECs, then divided the cells into 4 groups:Activated platelets, Aspirin (1,2 or 5 mmol/L), Extract of Ginkgo biloba (4,40 or 400 μg/ml) and their combination (aspirin 1 mmol/L and EGB 40 μg/ml). In addition, HCAECs were set to control group. The treatment time of drug was 12 hours. Cell culture supernatant was collected to measure the amount of IL-6 and VAP-1 by enzyme linked immunosorbent assay (ELISA), and total protein was extracted to examine the expression of NF-κ B p-p65 by Western Blot.Results:The results of ELIS A showed that, after HCAECs were stimulated by activated platelets, the secretion of IL-6, VAP-1 in culture medium increased significantly (p<0.05 vs. control). Aspirin and EGB can inhibit generation of IL-6, V AP-1, in a mmaner of dose dependent (p<0.05 vs. activated platelets). The combined use of aspirin and EGB synergistically inhibit the generation of VAP-1, IL-6 (p<0.05 vs. EGB or aspirin group). Results of Western blot showed that, the expression of NF-kappa B p-p65 increased significantly (p<0.05 vs. control). Aspirin and EGB can inhibit the expression of p-p65 dose dependent (p<0.05 vs. activated platelets). The combined use of aspirin and EGB synergistically inhibit the expression of p-p65 (p<0.05 vs. EGB or aspirin group).Conclusions:The combination of EGB and Aspirin may synergistically attenuate the generation of IL-6, VAP-1 through inhibiting the expression ofNF-kappa B (p-p65), to defer development of atherosclerosis. |
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