| Objective: To study the effects of tongguan capsule on the morphological changes and ultrastructure of carotid artery after balloon injury in rabbits. And then discussthe curative effect of Tongguan Capsule for the patients with Coronary Heart Disease after receiving PCI and its related mechanisms.Methods:1. Foundation experiment:Twenty--four healthy New Zealand white rabbits were randomly divided into 4 groups: normal control group, model group, Tongguan Capsule --treated group and atorvastatin group. Normal control group received normol chow. Carotid arteries were injured with PTCA ballon in the others experiment groups, and they had received high lipid diet for 6 days. Tongguan Capsule --treated group received high lipid diet plus Tongguan Capsule. Atorvastatin group received high lipid diet plus atorvastatin. All the rabbits were fed in different cages and not limited drinking. The levels of serum totaI cholesterol(TC),triglycerides(TG) , high density Iipoprotein cholesterol (HDL-C),Iow density Iipoprotein cholesterol (LDL-C) were tested in each group at the begining of the experiment and different times after baloon injury. And the morphological changes and ultrastructures of the iliac artery were also observed by an electron microscope at different times after baloon injury.2. Clinical research:By using prospective Randomized, Controlled study, we observed CHD patients who treated by PCI in Guangdong provincial hospital from 2006-5 to 2006-12. According to Randomized tablewe drive the patients to the trial group and the control group. The control group patients take conventional westen medicine the treatment group patients take the conventional westen medicine and the Tongguan capsule (3 grain of tid).On the day before PCI and in the month afer PCI we observe andcompare the curative effect parameters changes of each group before trial and after trial and evaluating clinical symptoms effect changes between two groups. The data putted into computer and statisticed by SPSS10. 0.Results:1. Foundation experiment:Compared with model group ,Tongguan Capsulegruop and Atorvastatin group could reduce the levels of TC, TG, LDL--C(P＜0. 05), and compared with Tongguan Capsule group and atorvastatin group could reduce the levels of LDL--C (P＜0.05) The neointimal formed and continuously thickened in model group, compared with Tongguan Capsule group and atorvastatin group. There were greater extent of lumen stenosis in model group than the one in Tongguan Capsule group and atorvastatin group. The results observed by electron microscope showed that,as compared with the model group, the restenosis of carotid artery in the Tongguan Capsule group and atorvastatin group were lighter. And it was found that there were few lipid droplet vacuoles in cytoplasm of the endothelial cells, and various cell organs and elastic membrane were existed in the Tongguan Capsule group and atorvastatin group. And there were small vessel smooth muscle, cell body and nucleus , less organelles and more myofilament contents ,better cell differentiation , and less lipid droplet were phagocyted in the Tongguan Capsule group and atorvastatin group. Results Electron microscope showed the morphilogic characteristics of VSMC changed from contractile to synthetic after balloon injury. VSMC showed less organelles and more myofilament when exposed to Tongguan Capsule.2. Clinical research:There were 47 patients who have finished the trial. They all came from Cardiac centre of Guangdong province hospital of traditional Chinese medicine. 24 patients were in treatment group and the others were in control group. After 1 month's treatment, every curative effect parameters were observed and recorded. Using statistical way, the research results show:There are significant differences in the curative effect parameters compared with the ones before treatment in each group(P＜0. 05). The angina pectoris clinical efficacy rate has significant differences between two groups (P＜0.05) for the treatment group is 95.8 % and the control group is 82.6%.Tongguan Capsule exerts a better effect in improving the syndromes of TCM, especially in improving syndromes of QI-deficiency and blood stasis than only PCI, which is related with the action of reinforcing QI and activating Blood.Conclusion: Tongguan Capsule can influence the phenotype transform of vessel smooth muscle cell(VSMC), and reduce the degree of neointimal hyperplasia caused by balloon angioplasty in rabbits, lt is an effective Chinese patent medicine which can improve clinical symptom of the patients with Coronary Heart Disease after receiving PCI. rongguan Capsule can achieve the effect of preventing coronory arteries event recurring. Tongguan Capsule may play an important role in the restenosis. |
PDF Full Text Request