The Comparative Study On Inflammation Mechanism Of AS Model Rats By Three Reducing-heat Decoctions In Shanghanlun

The incidence atherosclerotic diseases had showed a rising trend in our country and around the world.From the initial lipid infiltration theory to today’s inflammation theory, domestic and foreign medical workers never stopped its pathogenesis. The past and the present study agreed that the formation and development of atherosclerosis (AS) were closely related to lipid deposition, arterial endothelial injury, vascular smooth muscle cell migration and proliferation, platelet aggregation, abnormal secretion of factors.With further research, Inflammatory and immune mechanisms in the formation and development process of AS plays an increasingly important role, controlling or blocking the inflammatory mechanisms pathway and inhibiting the expression of inflammatory factors are becoming the new research directions that treating AS.In recent years, the efficacy that TCM preventing and treating the atherosclerotic diseases has been recognized by the medical profession, many classic recipe has been used in clinical treatment of atherosclerotic diseases, the basic and clinical research of treating AS had achieved some progress. But most nowaday scholars are emphasis on treatment from the blood stasis and phlegm, the reports that treating AS from the toxic heat are relatively fewer.The traditional Chinese medicine (TCM) of clearing and detoxifying have the effect of "anti-inflammatory" which is similar to western medicine, and the mechanisms of treating AS also have basic research reports.To the toxic heat and inflammation hypothesis for pathological mechanisms that the current traditional Chinese and western medicine scholars had suggested, based on the angle of the inflammatory mechanisms, while using the blood-activating drug and apophlegmatisant we use the heat-clearing and detoxicating drug, or jointing the heat-clearing and detoxicating drug on the basis of western medicine conventional lipid-lowering, which providing a new entry point for combining traditional Chinese and western medicine to treating atherosclerotic diseases.ObjectTaoHeChengQi decoction, XiaoXianXiong decoction and DaHuangHuangLianXieXin decoction are the three classical decoctions which have the effect of reducing heat as a whole.However, according to difference of their formation, the three decoctions focus on the three aspect of activating blood, phlegm and reducing heat. Previous experimental and clinical study reports indicated that the three decoctions had the effect of treating atherosclerotic diseases. The study is designed to research the effect between nuclear factor-kappaB (NF-κB) and NF-κB-mediated inflammatory factor, which ascertain the mechanism that reducing-heat classical decoctions treating atherosclerotic diseases.At the same time, from the aspect of activating blood, phlegm and reducing heat observing the difference to inflammatory mechanism and providing a theoretical basis for the prevention and treatment of atherosclerotic diseases, which have some theoretical and clinical significance.Method1.Theoretical Study:Organizing the understanding of Chinese medicine to the disease name and pathogenesis of AS through literature searching; Discussing the relationship among TCM etiology, TCM organs lesions and AS.Organizing the clinical studies in different dynasties and experimental studies that the three decoctions in ShangHanLun treating AS.2.Experimental study:Through building the rat AS model, observing the influence the three decoctions in ShangHanLun inflammatory mechanism of AS, Comparing the difference of Mechanism of action of the three decoctions.The specific method is as follows:①Observing the changing of AS rats in aortic morphology, observing the changing of aortic IT and MT;②Testing the concentration of ox-LDL, VCAM-1, IL-6in AS rat serum by ELISA;③Testing the concentration of CRP in AS rat serum by latex immune turbidimetry;④Testing the level of CD40expression in AS rat aorta by immunohistochemical method;⑤Testing the level of NF-κB expression in AS rat aorta by western blot.Result1.Through theoretical study we have found that:TCM thinks that the formation of atherosclerosis is closely related to heart, liver, spleen, kidney, lung, which attributed to primary deficiency and secondary excess; and the blood stasis, phlegm, qi stagnation, toxic heat, hot and humid are the main pathological factors of formation; the three decoctions in ShangHanLun have the effect of prevention and treatment to AS in the clinical and experimental studies.2.Through experimental study we have found that:①By observing the slices of rat aorta we have found that:the three decoctions all can protecting the arterial endothelial, significantly inhibiting the increase and migration of smooth muscle cells, inhibiting the secretion and infiltration of inflammatory cells, preventing the formation of atherosclerotic plaque.By statistical analysissing to the intima thickness (IT) and the middle thickness (MT) of the chinese medicine groups rat aortic slices we have found that:compared to the pathological model group, the difference of quantitative value of IT and MT are statistically significant (P<0.05).Compared with other medicine groups, the difference of quantitative value of IT and MT of TaoHeChengQi decoction are statistically significant (P<0.05)②By analysing the result of AS serum ox-LDL, VCAM-1, IL-6and CRP of the three decoctions in ShangHanLun we have found that:Chinese medicine groups comparing with pathological model group, the difference are statistically significant (P<0.05).Compared with other medicine groups, the difference of the level of ox-LDL of XiaoXianXiong decoction is statistically significant(P<0.05);the difference of the level of VCAM-1of TaoHeChengQi decoction is statistically significant (P<0.05); the difference of the level of IL-6of DaHuangHuangLianXieXin decoction is statistically significant (P<0.05).TaoHeChengQi decoction and DaHuangHuangLianXieXin groups comparing with XiaoXianXiong decoction group, the difference of the level of CRP are statistically significant (P<0.05); TaoHeChengQi decoction group comparing with DaHuangHuangLianXieXin decoction group, the difference is no statistical (P>0.05)③By analysing the result of AS rats aortic CD40-positive optical density values we have found that:Chinese medicine groups comparing with pathological model group, the difference are statistically significant (P<0.05).Compared with XiaoXianXiong decoction group, the difference of the level of CD40of TaoHeChengQi and DaHuangHuangLianXieXin decoction are statistically significant (P<0.05); TaoHeChengQi decoction group comparing with DaHuangHuangLianXieXin decoction group, the difference is no statistical (P>0.05)④By analysing the result of western blot of AS rats aortic NF-κB we have found that:Chinese medicine groups comparing with pathological model group, the difference are statistically significant (P<0.05).Compared with other medicine groups, the difference of the level of NF-κB of TaoHeChengQi decoction are statistically significant (P<0.05)⑤By linear correlation analysing the linear correlation coefficient (r) between NF-κB and ox-LDL、VCAM-1、IL-6、CRP、CD40of Chinese medicine groups, the result are:TaoHeChengQi decoction group:0.872、0.854、0.861、0.897、0.811(P<0.05); XiaoXianXiong decoction group:0.892、0.754、0.844、0.654、0.731(P<0.05); DaHuangHuangLianXieXin decoction group:0.677、0.737、0.878、0.891、0.802(P<0.05)Conclusion1.The three decoctions in ShangHanLun all can effectively inhibitting the formation of atherosclerosis plaque.Among them, TaoHeChengQi decoction has the relatively best protective effect to the AS rats aortic morphological changes.2.The three decoctions in ShangHanLun not only have the inhibiting effect to NF-κB、ox-LDL、VCAM-1、IL-6、CRP、CD40, but also can general inhibiting the inflammation and immune response which induced by NF-κB-mediated IL-6and other inflammatory factors. From the perspective of the inflammatory mechanisms generally regulating and treating atherosclerosis.3.From generally speaking, TaoHeChengQi decoction group improved the various indexs significantly, which proving its treating effect is the best in three decoctions in ShangHanLun.When we treating atherosclerotic diseases, on the basis of invigorating blood and reducing phlegm therapy appropriate using chinese medince of clearing heat and detoxicating, benefitting Spleen And Stomach, which can improving effect.