The Comparative Study On Ventricle Remodeling Of Heart Failure Post Cardiac Infarction Rats With Heart Yang Deficiency Syndrome Respectively Treated By Three Warming-yang Decoctions In ShangHanLun

Chronic heart failure (CHF) is one of the most serious disease-killers. CHF after cardiac infarction is more serious, of which number continued to increase, with development of thrombolysis and interventional techniques. There are a lot of TCM (Traditional Chniese Medicine) effective prescriptions for CHF, which are some diffcult to choose for doctors.Studies on law of prescriptions compatibility and prescriptions corresponding to syndromes are the core of researches in TCM prescription, which are also hot and difficult problems now. More and more scholars agree that western medicine disease differentiation combined with TCM syndrome differentiation, under the guide of TCM theory, is relatively appropriate mode of integrated traditional Chinese and western medicine at present.Objective:The literature research:trace back to the source, summary the ancient and modern literature of warming yang in treating CHF.The expriment research:observe the therapeutic effect of ventricle remodeling of heart failure post cardiac infarction rats with heart yang deficiency syndrome respectively treated by three warming yang decoctions in shanghanlun, probe into their mechanism, evaluate the rat model of syndromes by using treatment analyze syndrome, explore the significance of Fang-zheng correlation to the prescriptions and their treatment effect.Methods:1. Establishing rat model of integrative medical disease/syndrome. Rat myocardial (heart failure) model was established by anterio-descend ing coronary arterial ligation, and treated by nitric oxide synthase inhibitor 9-12 weeks after operation to induce hypertension and aggravate heart failure. The model rat was observed 12 weeks to collect the information of four-diagnosis, for visceral qi-blood and excess-deficiency syndrome differentiation in combining with the eight-principal syndrome differentiation according to the standard of deficiency syndrome issued by Chinese Association of integrative medicine, assess the disease according to the heart failure diagnosis standard of Framingham.2. The rat models were respectively treated by three warming yang decoctions in ShangHanLun from 9 to 12 weeks after operation. We observe the rat general condition, heart rate, body temperature, urine volume, exhaustive swimming time, mortality, and cardiac function, blood flow dynamics by heart color ultrasound, heart mass index change in every group, observe pathological morphology changes with H-E staining, myocardial collagen content with masson staining. The expression of activin-a(ACT-A), Angiotensin II (AngⅡ), Transforming growth factorβ(TGF-β1)in serum were detected by ELISA, while those in myocardium detected by immunhischemical staining, and gene expression of those by Reverse Transcriptase-Polymerase Chain Reaction(RT-PCR).Results: 1. Compared with the sham operated(SO) group, the rat models were found with lassitude, cachexia, quickened heart rate, shortened swimming time, lowed cardiac function and body temperature,±dp/dtmax,LVSP drop, LVEDP rise, heart index(HI) and left ventricular index index (LVI) increased obviously, and the establishment of rat models are successful.2. Compared with the model group, the three warming-yang groups displayed better general condition, TCM Syndromes, parameters of haemodynamics, higher cardiac function, lower HI, LVI, IVS in varying degree, and they could promote the heart function, inhibit the left ventricular remodeling. They can decrease the expression of ACT-A, AngⅡ, TGF-β1 in serum and myocardium, through the machanism of upper the expression of AT2(AngiotensinⅡreceptor, type 2) mRNA, lower the expression of ACT-A mRNA, TGF-β1 mRNA. The Zhen-wu decoction, LingGuiShuGan decoction group are more effientive.Conclusions:1. The efficacy of three warming-yang decoctions, zhen-wu decoction is the best in the physical and chemical indicators, and LingGuiShuGan decoction is the best in general.2. The three warming-yang decoctions cured heart failure post cardiac infarction rats with heart yang deficiency syndrome, inhibit Ventricle Remodeling, The effect of warm-yang decoction mainly through upper the expression of AT2(AngiotensinⅡreceptor, type 2) mRNA, lower the expression of ACT-A mRNA, TGF-β1 mRNA, came into effect.3. The efficacy of three decoctions, from weak to strong is GuiGanLongmu, LingGuiShuGan, Zhen-wu decoction.4. A decoction meet the regulation of prescriptions corresponding to syndromes, then its can get good efficacy; 5. The research proved the validity of the spleen and stomach theory of TCM and the necessity of revising decoctions with symptoms, the zhen-wu decoction and GuiGanLongmu decoction had better not be long term used alone.6. The rat model's TCM syndrome type is much more likely to be related to spleen-deficiency and water retention, based on syndrome detecting from recipe used.