Phlegm And Promoting Blood Circulation Side Decomposed Formulas On Lipid Metabolism And Their Regulation Mechanisms Of Hyperlipidemia

Objective To enhance the recognitions and the rules of differentiation of syndromes upon the diseases concerned with hyperlipidemia (HLP) through reviewing ancient and modern medical literatures. To explore the influences on lipometabolism and its effective factors of the drugs for resolving phlegm and the drugs for promoting blood circulation by dividing the formula for resolving phlegm and promoting blood circulation, as well as their roles and mechanisms in treating hyperlipidemia caused by stagnation of phlegm and blood.Methods Reviewing literatures and statistic analysis were used to develop the theoretic research. In experimental research, the rats were divided into five groups: normal group, model group, whole formula group, group administered drugs for resolving phlegm, group administered drugs for promoting blood circulation. The hyperlipidemia rats were modeled by feeding high fat forage. Subsequently, the experimental results were obtained as follows: (1) the enzyme method was used to measured the contents of serum TC, TG, LDL-c, HDL-c and HDL₂-c; (2) the contents of serum ApoAâ… and ApoB₁₀₀ were measured by immunoturbidimetry; (3) the blood rheological apparatus was used to detect the whole blood and plasma viscosity; (4) the RT-PCR was adopted to measured the levels of LDL-RmRNA, SR-Bâ… mRNA, PPARαmRNA, MCP-1mRNA; (5) the expression of MCP-1 and NF-κB was observed by immunohistochemistry.Results Theoretically, the term 'grease' in Traditional Chinese Medicine is approximately similar to the term 'blood-lipid' in modern medicine. When the essence from food-stuff in human body transforms wrongly and remains stagnant to cause the formation of phlegm and blood-stasis, hyperlipidemia will occurs. All of above is due to improper diet, surfeit of rich fatty diet, less movement, overindulgence of comfort, disorder of emotion and qi, oldness and weakness, functional deficiency, which could bring the disorder of visceral function, fail to disperse the qi, blood and body fluid, and make them stagnant to produce phlegm and block the channels and their collateral branches during a long period. Our experimental research shows that the whole formula and its divided components, drugs for resolving phlegm and drugs for promoting blood circulation, exert positive effects on the regulations of blood-lipid, lipoproteins and their receptors, and lipometabolism-regulatory factors. But the whole formula appears best, as well as the other two components have its own advantages for different targets. (1) The whole formula could decrease the levels of serum TC, TG, LDL-c, ApoB₁₀₀, increase the level of HDL-c, HDL₂-c, and ApoAâ… . Both of drugs for resolving phlegm and promoting circulation could decrease the levels of serum TC, TG, LDL-c, increase the level of serum HDL-c, but the effect of drugs for resolving phlegm was better than that of the other. Both of two drugs have no apparent influence on the levels of serum ApoAâ… and ApoB₁₀₀; (2) The whole formula and drugs for promoting circulation showed the better effects than drugs for resolving phlegm on improving blood rheology and decreasing the levels of whole blood and plasma viscosity of hyperlipidemia rats; (3) The whole formula could promote the transcription of LDL-RmRNA, showed evident differences compared to the drugs only for resolving phlegm or promoting blood circulation respectively for the transcriptive levels of LDL-RmRNA of the two drugs groups were lower than that of the whole formula group(P<0.01); (4) The whole formula and drugs for resolving phlegm could upregulate transcription of hepatic SR-Bâ… mRNA sharper than drugs for promoting blood circulation(P<0.01); (5) The whole formula and drugs for resolving phlegm could increase the level of hepatic PPARαmRNA equally, whereas drugs for promoting blood circulation could not; (6) The whole formula and drugs for resolving phlegm could downregulate the level of hepatic MCP-1mRNA equally(P>0.01), but both be better than drugs for promoting blood circulation(P<0.01); (7) Pathologic observation showed that the whole formula and drugs for resolving phlegm could improve hepatic steatosis and decrease the expressions of MCP-1 and NF-κB, but in group administered drugs for promoting blood circulation, there was no evident changes on hepatic steatosis with more fat vacuoles and were apparent differences on the expressions of MCP-1 and NF-κB compared with the whole formula group and group administered drugs for resolving phlegm(P<0.01).Conclusions Theoretical research showed that phlegm and blood stasis not only were pathologic products of the stagnation of body fluid and blood, but also became the pathogenic factors of hyperlipidemia. Thus, the method to resolve phlegm and promote blood circulation is the basic cIinic therapeutic principle for hyperlipidemia. The experimental results showed that the whole formula and its divided components could regulate blood-lipid, improve blood rheologic targets, modulate genetic expressions concerned with lipometabolism to meliorate lipodystrophy and hepatic steatosis caused by lipidosis. In general, the whole formula appears best, moreover, the two divided components have its own advantages on different targets respectively. The results implies that two categories of drugs play their roles on different effective sites and their cooperation bring an enhancement on treating hyperlipidemia. Our research demonstrates the reasonableness and necessity for treating hyperlipidemia by the therapeutic method to resolve phlegm and promote blood circulation.