Theoretical And Experimental Investigation On Treatmenting Pediatric Viral Myocarditis With Tong Xinkang Mixture

Objective: To investigate the theory evidence and immunologic mechanism of Tong Xinkang Mixture on treating Pediatric Viral Myocarditis.Methods: Developed Tong Xinkang Mixture according to the therapeutic principle of disintoxicating and promoting blood circulation and supplementing Qi and nouris hing Yin by analysing the research overview of pathogeny, treatment and prescription and discussing the theory of toxin and blood stasis and Qi-Yin deficiency by collecting and organizing the ancient and modern literature based on TCM inheritance support system. Established the model of experimental autoimmune myocarditis in Lewis rats by injecting porcine cardiac myosin. Lavaged rats with Tong Xinkang Mixture and observed the myocardial pathology and level of cardiac troponin T, brain natriuretic peptide, γ-IFN,IL-2,IL-4,IL-6 in serum by ELISA and the expression of IL-2,IL-2 re ceptor and STAT5 by immunohistochemistry on the 21 st day and observed myocardial fibrosis by Masson staining and MMP-9/TIMP-1 by immunohistochemistry on the 56 th day.Results: Proposed the basis of viral myocarditis in children is toxin and bloods tasis,the key of morbidity is Qi-Yin deficiency and pathogenic and vital contention lead to the complex of viral myocarditis in children. Established the therapeutical principle of disintoxicating and promoting blood circulation as well as supplementing qi and nourishing yin and develop the Tong Xinkang Mixture.Experiment showed that Tong Xinkang Mixture could significantly improve the weight loss of experimental autoimmune myocarditis model rats and reduce myocardial necrosis and inflammation,decrease the level of cardiac troponin T which can reflect the damage of myocardium and brain natriuretic peptide which is the marker of heart failure.Tong Xinkang Mixturecould also decrease the expression of γ-IFN、IL-2 and raise the expression of IL-4、IL-6 in serum and down-regulate IL-2,IL-2 receptor,STAT5 on the 21 st day.Tong Xinkang Mixture had the effect of suppress myocardial fibrosis and could upregulate the expression of MMP-9 and downregulate the expression of TIMP-1.Conclusion: This study found that the important pathogenesis of viral myocarditis in children is toxin-blood stasis and Qi-Yin deficiency,and present the principle of treatment of promoting blood circulation and supplementing Qi and nourishing Yin.Experiment showed that Tong Xinkang Mixture could reduce myocarditis in experimental autoimmune myocarditis model rats and regulate the imbalance of Th1/Th2 by reducing γ-IFN、IL-2which is secreted from Th1 cells and improving the level of IL-4 and IL-6 which is secreted from Th2 cells.It could also adjust the signal transduction of IL-2 and signaling pathway of STAT5,all these may be one of the mechanisms.Tong Xinkang Mixture can protect myocardium through the effect of suppress myocardial fibrosis by upregulating the expression of MMP-9 and downregulating the expression of TIMP-1.These provided experimental basis for the new strategy of disintoxicating and promoting blood circulation and supplementing Qi and nourishing Yin.