| Objective:To evaluate the clinical effect of Wenyang Huoxue Jiedu Recipe on AMI patients and its influence on the level of Th/Tregs,and to investigate the Th/Tregs main effect molecules IL-17 and IL-35 levels in patients with acute coronary syndrome(ACS)from the perspective of the immune inflammatory,and to explore the correlation between IL-17,IL-35 and cTnI,BNP,LVEF as compared with healthy people and the regularity in the distribution of TCM syndromes.Methods:A total of 89 eligible patients subjects were randomly divided into treatment group(n = 44)and control group(n = 45).The two groups were treated with routine western medicine and/or reperfusion therapy.The treatment group was treated with WenyangHuoxue Jiedu Recipe on the basis of conventional treatment,and the course of treatment was 14 days.The scores of Seattle angina pectoris,TCM symptom scores,peripheral blood IL-17 and IL-35 were observed before and after treatment in the two groups,as compared with the healthy control group.In addition to 82 patients with AMI,61 UAP patients were enrolled,and a total of 143 patients with ACS.Serum IL-17 and IL-35 levels were measured by ELISA and serum cTnI,BNP were detected by chemiluminescence.The echocardiography LVEF values were determined by Simpson method.At the same time TCM syndrome differentiation and syndrome scores was analyzed.Results:1.The scores of Seattle angina pectoris and TCM symptom scores in the two groups were improved after treatment,especially in PL,TS and DS(P<0.05).There was statistically significant in TS and DS between the two groups(P<0.05).2.The improvement of symptoms and curative effect of TCM in the treatmentgroup were better than the control group(P<0.05).3.So as to the comparison of the serum IL-17,IL-35,cTnI and EF values before treatment in each group,there was statistically significant when the treatment group and control group were compared with healthy control group(P<0.05),but the difference between the former two was not statistically significant(P>0.05).The levels of IL-35 and EF in treatment group and control group were increased,cTnI and BNP were lowered,but IL-17 was not significantly improved after treatment.The improvement degree of IL-35 and BNP after treatment in the treatment group was statistically significant than that of the control group(P<0.05).No adverse reactions related to drugs were found in the two groups.4.The syndrome scores of Yang Qi deficiency group were the highest,while the qi stagnation and blood stasis group were the lowest,the difference between them was statistically significant(P<0.05).The Yang deficiency group and phlegm obstruction group had lower IL-35 and LVEF levels and higher levels of IL-17,there was statistically significant when compared with the other two groups(P<0.05).While cTnI and BNP levels in yang qi deficiency group were obviously higher than the other three groups,the difference was statistically significant(P>0.05).5.The level of IL-35 and LVEF in STEMI group was the lowest,while possess the highest level of IL-17,there was statistically significant(P<0.05)when compared with UAP group and control group.As far as IL-35,IL-17 and the level of LVEF was concerned in STEMI and NSTEMI groups,the difference was not statistically significant(P>0.05);STEMI group was significantly higher than NSTEMI group in Troponin and BNP level,the difference between the two groups was statistically significant(P<0.05).cTnI,BNP and IL-35 level in ACS patients showed a negative correlation(P<0.05),positive correlation between IL-35 and LVEF;while the IL-17 level,cTnI and BNP were positively correlated(P<0.05),but was negatively correlated with LVEF.However,there was no significant correlation between IL-17 and IL-35(P>0.05).The correlation index was higher between IL-35 and cTnI,cTnI and IL-17 were better correlated.Conclusion:1.Wenyang Huoxue Jiedu Recipe can improve the clinical symptoms and degree of angina pectoris in AMI patients,and its mechanism may be related to theintervention of Th/Tregs and the regulation of immune inflammation.2.The levels of IL-17 and IL-35 in peripheral blood of ACS patients can reflect the severity of ACS in a certain extent,and could be used as an independent predictor of acute cardiovascular events in coronary heart disease.3.The levels of IL-17 and IL-35 in patients with ACS has a certain regularity in the distribution of TCM syndromes,which could be used as a reference index of TCM syndrome differentiation of ACS. |
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