| Objective:To discuss on Decoction of GuanXinXiaoBan which eliminated coronary lipid plaque pharmacological mechanism and to observe the treatment effects of Decoction of GuanXinXianBan on patients with static angina pectoris, to discuss their effects on c-reactive protein (CRP)、soluble intercellular adhension molecule-1(sICAM-1) and soluble vascular cell adhension molecule-1 (sVCAM-1).Methods:1. The rabbit aortic atherosclerotic model was developed by high cholesterol feeding. They were randomly divided into three groups: model group (n=10), Decoction of GuanXinXiaoBan group (n=10) and Simivastatin group (n=10). At the same time, there were ten rabbits determined as normal group. By means of Enzyme-Linked Immunosorbent Assay (ELISA), the concentrations of serum sICAM-1 and sVCAM-1 were measured. By means of Immunoturbidimetry, the concentrations of serum CRP、apolipoprotein A1(ApoA1) and apolipoprotein B (ApoB) were measured. By means of enzymatic response mothods, the concentrations of serum total cholesterol(TC). triglyceride(TG)、high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured. The immunohistochemistry analysis were used to measure the expression of ICAM-1 and VCAM-1 in rabbit aortic atherosclerotic plaque and coronary atherosclerotic plaques. Then the aortas and hearts were harvested for morphometry observation.2. Sixty patients with static angina pectoris by TCM different the syndrom of phelgn and heat were randomly divided into two groups:the Decoction of GuanXinXiaoBan treated group and Simvastatin control group, each of them has 30 cases of patients. Both of them have the same basic western medicine combined. The therapeutic course was four weeks, and followed up two monthes, to observe the incidence of acute cardiac events.Results:1. The animal experiment study showed that:The levels of serum TC、TG. LDL-C、ApoB were significantly lower in the Decoction of GuanXinXiaoBan group than that in model group (P<0.05), but the levels of serum HDL-C and ApoA1 were detected no significant difference between them. The levels of serum sICAM-1、sVCAM-1 and CRP in the Decoction of GuanXinXiaoBan group were significantly lower than that in model group (P<0.05). The number of aortic atherosclerotic plaques and coronary atherosclerotic plaque were significantly less in the Decoction of GuanXinXiaoBan than that in the model group (P<0.05), but no significant difference than that in normal group (P<0.05), In addition, the ratio of plaque to intimal area, the intima thickness, the thickness of atherosclerotic plaque, the media thinkness, the thickness ratio of intima to media, and positive staining percentage of ICAM-1 and VCAM-1 were also significantly less in the Decoction of GuanXinXiaoBan group than that in the model group (P<0.01).2. The clinical study showed that:After treatment, the clinical symptoms, electrocardiogram(ECG)、cardiac function, sICAM-1, sVCAM-1, CRP, etc, had been obviously improved than that before treatment (P<0.05). The Decoction of GuanXinXiaoBan could markedly alleviate pain of patients with static angina pectoric, improve the ECG of patients with myocardial ischemia and significantly decrease the dosage of nitroglycerin of patients with static angina pectoris, showing significantly higher advantage over simvastatin. The Decoction of GuanXinXiaoBan could improve cardiac function and decrease the levels of CRP、sICAM-1 and sVCAM-1, were abviously superior to that in simvastatin (P<0.05). The total effective rate of the Decoction of GuanXinXiaoBan on improving clinical symptoms of patients with static angina pectoris was 86.67%, and very superior to that of simvastatin (P<0.05). Both of the Decoction of GuanXinXiaoBan and simvastatin could decrease the levels of TC. TG、LDL-C、ApoB and promote the levels of HDL-C and ApoA1, which were significant difference between before and after treatment (P<0.05), but simvastatin decrease the levels of TC、LDL-C was obviously superior to that in the Decoction of GuanXinXiaoBan (P<0.05). During following up, the incidence of acute cardiac events in treated group was lower than that of control group (5.68% VS 25.32%).Conclusion:These results indicate that the Decoction of GuanXinXiaoBan could protect myocardial, decelerate the progression of atherosclerosis and eliminate (or stablize) atherosclerotic lipid plaque by decreasing the levels of CRP、sICAM-1 and sVCAM-1, by inhibiting expression of ICAM-1 and VCAM-1 in atherosclerotic plaque, by regulating lipometabolism and the abnormality of blood lipid and improving endothelial function. The mechanism of decelerating atherosclerotic progression and eliminate the coronary lipid plaque by the Decoction of GuanXinXianBan may be related to inhibiting inflammatory reaction in atherosclerotic plaque, separating combination of CRP in body and inhibiting effect which c-reactive protein could promote inflammatory reaction. |
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