Study On The Therapeutical Effect Of Xintongshu(XTS) On Angina Pectoris Of Coronary Heart Disease(CHD) And On Its Mechanism Of Delayed Protective Effect On Ischemic Cardiac Muscle Cell

Objective: To explore the therapeutical effect of Xintongphu on angina pectoris of CHD and its mechanism of delayed protective effect on ischemic cardiac muscle cell.Methods: Clinical part: The cases came from the first affiliated hospital of hunan college of TCM. Angina pectoris of CHD in this study was diagnosed to stagnant -qi and blood-type. The cases were randomly divided into XTS group (30 patients) and Xiaoxintong(XXT) group (30patients) group. The markers of effect determination: attack frequency and continues time of angina pectoris, the symptom Integra of traditional TCM, standard lead II of ECG, the change of ST segment and lipids in blood , etc. Experimental observation: The cardiac muscle cells of unripe rat were cultivated after detachment. The rats were reproduced ischemic reperfusion models and randomly divided into 7 groups. The guidelines of determinanting cell signal transduction were as follows: nitric oxide synthase(NOS), iducible-type nitric oxide synthase(iNOS), nitric oxide(NO), protein kinase C(PKC), gene expression of heat shock protein 70(HSP70) as well as gene expression of nuclear factor kappan, etc.Results:l.The attack frequency and continus time of angina pectoris and symptoms as well as ECG were all improved obviously after treatment in two groups ( P<0.01 ) .The change of blood lipid of XTS group was significantly lower than that of the XXT group,which certificated that XTS has better effect of decreasing lipid. The following visit discovered that the attack ratio of the acute arrhythmia was descended. The total effective ratio of symptom and ECG of treatment group were significantly higher than that of the contrast group (P<0.05). Xintongshu has good effect on angina pectoris,improving associated symtom obviously.2.The activity of LDH and CK in culture medium of cardiac muscle cells inj hypoxia reoxygen group was raised up which has significant defference compared with serum control group and drug serum group(P<0.01),respectively; The activity of LDH and CK were repressed obviously by the drug pretreatment group and ischemic precondition group(P<0.01); 8-phenyltheophylline could obviously mackedl eliminate the effect og HPC and could not completely eliminante the effect of DPC.3.The activity of PKC in the drug pretreatment group was somewhat lower than that in the serum control group, but there was no significant difference between the tow groups ( P>0.05 ) . The activity of PKC in the drug pretreatment group and hypoxia pretreatment group was raised up obviously, which was obviously higher than that in serum control group and hypoxia reoxygen group ( P<0.01 )4.The expression of HSP70 mRNA and NF- K B mRNA of cardiac muscle cells in cultured neonatal rats was examined by use of PT-PCR and gel electrophoresis. The result manifested that HSP70 mRNA and NF- K B mRNA obviously expressed in cardiac muscle cells of cultured neonatal ratsin XTS pretreatment group, which suggested that HSP70 and NF- K B might participate in the delayed protection of Xintongshu on hypoxia reoxygen injury of cardiac muscle cells.Conclusion : Xintongshu has good therapeutical effect on angina pectoris of CHD with obvious amelioration of clinic symptom . And it also has good protective effect on cardiac muscle cells with hypoxia/reoxygenation injury, preconditioning could induce delayed protection Cultured neonatal rat cardiac muscle cells with hypoxia/reoxygenation injury. The possible mechanism of the delayed cardioprotection of Xintongshu preconditioning relates to promoting the release of endogenous substance (adenosine, nitric oxide synthase, calcitonin gene-related peptide,etc.), the activating of expression of HSP70 mRNA and NF- K B mRNA by signal transducible pathofPKC.