Effects And Mechanism Research Into “wen Yang Yixin ” Therapy On Treating Coronary Heart Disease With Depression

Coronary heart disease(CHD)combined with depression is a severe complication reducing the quality of life and leading to poor prognosis facing the situation of low rate of diagnosis and lack of effective clinical care which could lead to worse prognosis and higher mortality.Its pathogenesis and treatment are not sure now,and there is no specific drug have been proved effective in clinic.Professor Cao Hong-xin proposed “Wen yang yi xin”therapy for treating CHD based on its pathological characteristics which is deficiency of heart Yang,as well as phlegm and blood stasis,and created the representative prescription “Wenxinfang”.According to “heart regulate emotions” and “physical-psychological holistic theory” in Chinese medicine(CM),Professor Cao use “Wenxinfang” to treat CHD patients with mental psychological disorder,and gets well curative effects.This study is going to explore the effects and mechanism of “Wen yang yi xin” therapy in treating CHD with depression.Objective: This study chose SD rats as subject,examined and observed relative index to explore the effects and mechanism of “Wen yang yi xin”therapy in protecting cardiomyocytes and relieving depression in treating CHD with depression for supporting the following researches.Methods: The rat model of CHD with depression was generated by high cholesterol diet,coronary ligation,and chronic unpredictable mild stress(CUMS)for 28 days.The rats were randomly divided in 7 groups,control group,model group,faded surgery group,high concentration“wenxinfang” group,medium concentration “wenxinfang” group,low concentration “wenxinfang” group,positive medication group.Chinese medicine we used in experiment is “Wenxinfang” decoction,the positive medicine are Fluoxetine and Atorvastatin calcium.After 28 days of treating,we tested weight,behavioral tests including sucrose preference test and open field test;using biochemical detection methods to examine serum lipid levels and calculate AI index;using HE staining method to examine the changes ofcardiomyocytes and neuron cells in hippocampus;using ELISA method to examine the expression of CORT,Brain-derived neurotrophic factor(BDNF),tropomycin receptor kinase B(Trk B)in serum;use high performance liquid chromatography method to examine the expression of 5-hydroxytryptamine(5-HT),5-hydroxyindoleacetic acid(5-HIAA),dopamine(DA),dihydroxyphenyl acetic acidand(DOPAC)and homovanillic acid(HVA)in hippocampus;use Western Blot method to examine the expression of CORT in hippocampus,adrenocorticotropic hormone(ACTH)and corticotropin releasing factor(CRF)in hypophyseal,CRF in hypothalamus,as well as BDNF,Trk B,PI3 K,MAPK expression;use Real Time-PCT method to examine PI3 Km RNA,p38 MAPKm RNA expression in hippocampus.Results: “Wen yang yi xin” therapy could improve the detection metrics we tested,the medium and high concentration groups showed the most significant effects.Compared with model group,“Wen yang yi xin” therapy can extremely promote the weight gaining,and showed visible effects on behaviour tests,as well as regulating the blood lipid(P < 0.01);protect the myocardial cells,and suppress the expression of CORT both in blood and hippocampus(P < 0.05),suppress ACTH,CRF in hypophyseal and CRF level in hypothalamus(P < 0.01);promote the expression of 5-HT and DA in hippocampus(P< 0.01;P < 0.05),and restrain 5-HIAA/5-HT rates(P< 0.01);protect the neurons in hippocampus,increase the number of neurons;improve the expression of BDNF,Trk B in hippocampus(P < 0.05);promote the expression of PI3 K and MAPK(P < 0.05),as well as suppress PI3 Km RNA,MAPKm RNA(P< 0.05).Conclusion:1.“Wen yang yi xin” therapy can treat CHD with depression by relieving the damage of cardiomyocytes and neuron in the hippocampus.2.“Wen yang yi xin” therapy can protect cardiomyocytes and neuron in the hippocampus by down-regulating overactived HPA axis,up-regulating 5-HT and DA in the hippocampus,as well as up-regulating BDNF and Trk B expression.3.“Wen yang yi xin” therapy may protect neurons in thehippocampus by inhibiting the degradation of PI3 K and MAPK proteins.