| Clinical ResearchObjective:Study of therapeutic angiogenesis mechanism in coronary heart disease according to the relationship between qi and blood and according to "treatment of transporting qi and blood"Method:Based on the TCM four diagnostic methods, Information of 111 out-patient cases with coronary cardiopathic angina pectoris was collected from clinic of Professor Jiang Liang Duo, and was typed by extracting common factors, the information is processed by frequency-statistical method in Excel 2007 tabulation.Result:1,In 111 coronary heart disease casese,88.2% patients aged from 40-79 yeas old; 2,89% patients had other base lesions,57% patients even had 3 kind of other basic lesions.3, Chief complaint included chest tightness,short of breath,chest discomfort; 4, Primary tongue, including dull tongue,reddish tongue, accounted for 69.3%; 5, Thin white coating, yellow sticky coating, thin yellow coating and greasy coating accounted for 77%; 6, Mainly Single pulse inlcuded wiry pulse, slippery pulse, which accounted for 77.8%, while wiry-slippery and wiry-thin pulse accounted for 77.8% in mainly complex pulse.7,The most frequency elements of a single syndrome factor included blood stasis syndrome factor,Qi deficiency syndrome factor,syndrome factor of liver yang haperactivity, Yin asthenia syndrome factor, Qi stagnation syndrome factor, and the triple energizer Congestion syndrome factor; 8, Complete pathogenesis in all of 111 out-patient cases, wer made up of over two single syndrome factors, and most cases had three or four single syndrome factors.9,Based on syndrome differentiation and treatment. the most frequency basic Chinese medicine composed of:Gualou, Zhjiaoshi, Yujin, Chibaishao, Danshen, Xuanfuhua, Quanxie, Huangqin, Tianma, Sanqi, Shudahua, Maidong, Lingyangjiaofen, Chaihu, Huangqi, Gegen.10, The basic prescription is clinical applied for Qi deficiency and blood stasis syndrome, accompanied by syndrome factor of liver yang haperactivity.Conclusion:The method, bsaed on "treatment of transporting qi and blood "and "smooth ing meridian means meridian Regeneration", not only emphasizes on stagnation of heart blood, deficiency of heart Qi, but also streeses on concept of integrity, itemphasizes on Qi and blood ransporting easy and smooth in our body. normal flow of qi ensures normal circulation of blood, and it is the mechanism of "smoothing meridian means meridian Regeneration". my tutor emphasizes on complete pathogenesis of the patients, and emphasizes on the fluency of qi in five zang organs and the six fu-organs, especially streeses on the fluency of qi in the triple energizer. The method, "treatment of transporting qi and blood"and"smoothing meridian means meridian Regeneration", has its clinical significance.Experimental studyObjective:To investigate the mechanism of therapeutic angiogenesis mechanism in coronary heart disease by replenishing qi,and activating blood circulation.Method:After successfully established rats myocardial infarction model,I introduced immunohistochemistry staining methods and RT-PCR technique into experimental study to measure rats myocardial infarction size,MVD in infarct marginal zone, VEGF and VEGFmRNA in infarct marginal zone, bFGFand bFGFmRNA in infarct marginal zone, then.based on the basic pathogenesis of Qi deficiency and blood stasis syndrome in coronary heart disease, I observated different intervention effect of the three methods:activating blood circulation, replenishingqi,replenishing qi and activating blood circulation.Result:Experimental study had four parts.In experimental study 1, I mainly established rats myocardial infarction model successfully. Compared with the preoperative, ECG of rats in sham group had no change, whi le ECG of rats in myocardial infarction model had significant changes:ECG leadâ… ,â…¡lead ST segment arched upward elevation abnormally. Under naked eye,Heart volume of rats in sham group were normal, and their heart color was red, and their heart surface was smoothly and had no spot. while Heart volume of rats in myocardial infarction model were significant larger,and there was gray aneurysm in left ventricular.After HE staining methods, under ordinary light microscope, myocardial cells of rats in sham group lined normally, and had no largement, while myocardial cells of rats in myocardial infarction model was significant larger,and their myocardial fiber thickenned significantly, and their cytoplasm color Deepened. these signes verified establishment of rats myocardial infarction model successfully.In experimental study 2, I measured MVD in rats infarct marginal zone throughâ…§ factor immunohistochemistry staining methods, the groups, including rats in sham group, rats in myocardial infarction model, rats in Betaloc group, rats in activating blood circulation group, rats in replenishing qi group,rats in replenishing qi and activating blood circulation group, had neovascularization.however,rats in sham group had least few neovascularization,rats in myocardial infarction model had few neovascularization, the two had Significant difference (P<0.01); Compared with model group,rats in Betaloc group,rats in activating blood circulation group, rats in replenishing qi group,rats in replenishing qi and activating blood circulation group had more neovascularization, the result had Significant difference (P<0.01).Experimental study 3 concentrated on effect on expression of VEGF,bFGF in myocardial infarction model by medcine, which was made of replenishing qi and activating blood circulation, through immunohistochemistry staining methods. the groups, including rats in sham group,rats in myocardial infarction model,rats in Betaloc group,rats in activating blood circulation group, rats in replenishing qi group,rats in replenishing qi and activating blood circulation group, had expression of bFGF. however,rats in sham group had least few expression of bFGF,rats in Betaloc group and rats in replenishing qi and activating blood circulation group had the most expression of bFGF. Compared with sham group, modelgroup had more expression of bFGF, both had Significant difference (P <0.05); Compared with modelgroup, Betaloc group and replenishing qi and activating blood circulation group had more expression of bFGF,they had Significant difference (P< 0.05);Compared with Betaloc group,replenishing qi and activating blood circulation group had more expression of bFGF, both had Significant difference (P<0.05); Compared with modelgroup,replenishing qi group and activating blood circulation group had a little more expression of bFGF,however,they had no Significant difference.Compared with sham group,model group had more expression of VEGF, both had Significant difference (P<0.05); Compared with modelgroup, Betaloc group, replenishing qi and activating blood circulation group, replenishing qi group and activating blood circulation group had more expression of VEGF, they had Significant difference (P< 0.05); Compared with replenishing qi group and activating blood circulation group,Betaloc group replenishing qi and activating blood circulation group had more expression of VEGF, they had Significant difference (P<0.05); replenishing qi group and activating blood circulation group had no Significant difference.In experimental study 4, I investigated effect on expression of VEGFmRNA,bFGFmRNA in myocardial infarction model by replenishing qi and activating blood circulation medcine through RT-PCR technique. Compared with sham group, modelgroup, replenishing qi and activating blood circulation group, and ctivating blood circulation group had more expression of VEGFmRNA, they had Significant difference (P<0.05); Compared with model group, replenishing qi group and activating blood circulation group and ctivating blood circulation group had more expression of VEGFmRNA,they had Significant difference (P <0.05); replenishing qi group and model group had no Significant difference.Compared with sham group, ctivating blood circulation group and model group had more expression of FGFmRNA, they had Significant difference (P<0.05), whlie between ctivating blood circulation group and model group, there was no Significant difference. replenishing qi and activating blood circulation group replenishing qi group had no Significant difference compared with model group on expression of FGFmRNA.Conclusion:1, treatmen of coronary heart disease trough replenishing qi and activating blood circulation medcine has curative effect. The theoretical basis is the relationships among qi and blood and Treatment of transporting qi and blood, ie, "smoothing meridian means meridian regeneration",Qi and blood ransporting affluent not only means qi and blood in heart, but also means the fluency of qi in five zang organs and the six fu-organs, especially the fluency of qi in the triple energizer.2, the mechanism of therapeutic angiogenesis mechanism in coronary heart disease trough replenishing qi and activating blood circulation medicine is:replenishing qi and activating blood circulation medicine can improve expression of VEGF,bFGF,can improve expression of VEGFmRNA,can improve myocardial ischemia zone MVD, can promote conformation of myocardial collateral circulation.Innovation:According to the relationships between qi and blood and according to the view of "treatment of transporting qi and blood" and"smoothing meridian means meridian Regeneration", this artical investicated therapeutic angiogenesis mechanism in coronary heart disease by replenishing qi and activating blood circulation medicine it has clinical innovation;According to the relationship between qi and blood, this artical investicated therapeutic angiogenesis mechanism in coronary heart disease by replenishing qi and activating blood circulation medicine through immunohistochemistry staining methods and RT-PCR technique.
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