Clinical Study Of Shu-Guan Pill And Changes Of CRP, IL-6 And TNF-α On Patients With Unstable Angina Pectoris

Background: The pathologic background of coronary heart disease(CHD)is the formation of coronary atherosclerotic plaque(AP). Nevertheless, the unstable inflammatory coronary atherosclerotic plaque lead to unstable angina pectoris which is the chief and most important cause of acute coronary syndrome(ACS). However, the clear mechanism how a coronary atherosclerotic plaque develop is still unavailable. The recent idea is that the inflammation of local and whole body play an important role in the occurrence, development and complication of AP, and there is a intimate correlation between unstable AP and the development of coronary endarteritis. Inflammatory cytokines such as interleukine-6(IL-6), tumor necrosis factor-alpha(TNF- α )and C-reactive protein(CRP) play a primary role in the activation and mediation of inflammatory mechanism. So, we can take it as a index in. order to assess and predict the risk of ACS and the benefits of treatment on unstable angina pectoris.Object: We study the inflammatory mechanism of shu-Gun pill in treatment on UA by observing the changes of CRP, IL-6 and TNF- α after four weeks, treatment on 60 cases of unstable angina pectoris./ Method: 60 cases were randomized to two groups. 30 cases as treatmentgroup, in which a basic western medicine combined with Shu-Guan pills beapplied. 30 cases as control, in which a basic western medicine combined with Simvastatin be given. All data were compared after four weeks' treatment. The blood samples were drawn from venous in the morning just before and after four weeks' treatment. The concentration of CRP is determined by scatter Turbidimetry, and the concentration of IL-6 and TNF- byELISA.Results. 1.After treatment, the clinical symptoms, electrocardiogram (ECG),hemorrheology and blood lipid were significantly improved in allcases(P<0.01)2.The differences of total effective rates of ECG and clinical symptoms ofTCM between two groups were significant.(P<0.05)3.The serum concentration of CRP, IL-6 and TNF- a was lower after thanbefore treatment in two groups .The A CRP (different value after andbefore treatment) and A IL-6 in SGP group are bigger than that of controlgroup(P<0.05). The A TNF- a had no significant difference in twogroups(P>0.05)4. During following up, the inciden of acute cardiac events in treatmentgroup was lower than that of control group (6.69% VS 23.31%)Conclusion: SGP has good effects on patients with UA. After treatments, theserum concentration of CRP, IL-6 and TNF- a decreased significantly andthe incidence of acute cardiac events also decreased. All of these resultsindicate that the anti-inflammatory mechanism is one of the effectivemechanisms of SGP in treatment on UA...