Clinical And Experimental Research On Ren Shen Jian Xin Capsule Improving Insulin Resistance In Coronary Heart Disease.

Study purposeTo explore the mechanism of curative effect of Ren Shen Jian Xin Capsule for coronary heart disease(CHD) ,which is based on improving insulin sensitivity and the related lipid metabolism , inflammation, coagulation。To find effective medicine for CHD and insulin resistance(IR) .Study methods1.Clinical study :Angina patients were randomly divided into two groups: Ren Shen Jian Xin Capsule group(40 patients, treated by Ren Shen Jian Xin Capsule and common western medicine )and metformin group (40 patients, treated by metformin and common western medicine ).Observe clinical curative effect and the changes of blood glucose , insulin sensitivity index (ISI) , prothrombin time(PT) , activated partial thrombopilastin time ( APTT ), fibrinogen(FIB) , plasminogen activator inhibitor-1(PAI-1).2.Experiment study : The model of IR was established by feeding highfat laboratory chow. The model rats were divided into several groups:high dose Ren Shen Jian Xin Capsule group, low dose Ren Shen Jian Xin Capsule group, metformin group, the model group. After six weeks ,observe endothelial cell in slice aortic arch and compare weight of adipose tissue , blood glucose ,insulin sensitivity index (ISI),lipid, free fat acid (FFA),tumor necrosis facter-a (TNF-a),c-reaction protein (CRP) between groups.Study results1.clinical study(1) the ISI of CHD group is higher than the comparative health group and the difference is significant.(2) Comparing the score of clinical symptom of TCM, the marked rate of treatment group is 55.00%, the total effective rate is 87.50%, and the improving the symptoms much better than the control group(p<0.05). On alleviating the angina pectoris , the marked rate of treatment group is 30.00%,and the total effective rate is 65.00%; the marked rate of electrocardiogram alter of treatment group is 29.62%, and the total effective rate is 70.37%. there is significantly difference between the treatment group and the control group (p<0.05).(3) Ren Shen Jian Xin Capsule has similar effect with metformin in lowering insulin,ISI and lipid, while it has better effect in improving coagulation.2.Experimental study(1) The models are successful with significantly low ISI.(2) Blood glucose ,insulin sensitivity index (ISI),lipid, FFA,TNF-a,CRP in high dose Ren Shen Jian Xin Capsule group,low dose Ren Shen Jian Xin Capsule group, metformin group, are much lower than in model group . The result is significant.(3) The endothelium of slice aortic arch in model group is hurt heavily, while the endothelium of high dose Ren Shen Jian Xin Capsule group, metformin group, are generally normal. There is little dysfunction in the endothelium of low dose Ren Shen Jian Xin Capsule group.Study conclusion1.Ren Shen Jian Xin Capsule has favorable clinical curative effect on angina of coronary heart disease,2. Ren Shen Jian Xin Capsule has similar effect with metformin in improving insulin resistance.3.The effect in improving IR is related with the effect in improving lipid ,inflammation, coagulation ,protection of endothelium。4. Ren Shen Jian Xin Capsule is effective medicine for CHD and IR .