Shexintong Capsule For The Intervention Of Hypertensive Myocardial Fibrosis And Its Mechanism

Objective: Study the mechanism of SXT capsule how to intervene the myocardial fibrosis caused by hypertension and made contrast with ACEI medicine(we select Tab prerindoprill). By studying with modern medical science to illuminate that the Chinese herbal prescription ,especially classic proved effective prescription, manifest the great sufficiency and superiority in the improvement of long-term prognosis of disease.Method: Strictly according to diagnosis standard of hypertension heart disease, selection 92 cases with hypertensive heart disease who were diagnosed explicitly. Before treatment we took the examination of electrocardiogram,muticolour cardic ultrasound and their blood index including ProcollagenIII(PIIIP), Hyaluronic acid (HN),laminin(LN),Endothelin-1 (ET-1), Angiotensin- II (Ang II), aldosterone(ALD) etc. Then they were divided randomly into treatment group and contrast group.The treatment group was advised to take SXT capsule(made from product center in Wu Han First Hospital) 2#,tid (each capsule contains 0.423 grams medicine-chinese-herbal) beside the foundation treatmen; the contrast group was given Tab Perindoprill(produced by France Servie Pharmacy Company)2-4 mg qd.beside the foundation treatment. After three months we investigate the variation of the electrocardiogram,the imagination of the muticolor cardic ultrosound and the index between pretreatment and posttreatment groups. In the meantime 40 healthy people was taken the examination of blood index and make observation of the security and adverse event of SXT capsule.In the animal experiment part we observe the influence of SXT capsule on the expression of TGF-β₁ in the blood vessel inner layer of the experiment rats who were hurt by ball balloon. Select 40 Sprague-Dewley(SD) male big rats, divide them randomly into 4 groups. make respectively low, medium, high concentration of SXT capsule liquid to feed three groups of big rat, the rest groups was feed 0.9% NaCl as contrast. After 6 weeks all big rats were made into models with neck artery hurt, continue to feed for 2 weeks.Afterwards all the rats were killed to measure respectively positive area ratio with immunhistochemistry.(positive reaction area/measure window area) and positive absorbency (PA).By RT-PCR we exam TGF-β. With UVP type gel density scanner to scan the density of TGF-β,β-actin expanding strap, calculate the relative value.Result: All data were analyzed with SPSS 12.0 software packages.In the clinical part,with accessing of the patients' symptom,electrocardiogram, muticolour cardiac ultrosound.the total validity rate in the treatment group is 93.48% ;in the contrast group is 95.65%.There is no statistics difference between them.The blood index including PIIIP, LN, HA, ET-1, Ang II and ALD are obviously higher than those in healthy person;The indexes in the SXT group and the Perindoprill group are evidently lower than those before treatment and reached to a statistic level.( P<0.05,0.01,0.001). There are no significant differences between SXT group and Perindoprill group.(P>0.05).In the animal experiment part, by means of immunhistochemistry,we find that there are varous express of TGF-β₁ positive protein in all the rats hurt by balloon.The positive grain located mainly in the extracellular-matrix of the reborn inner layer of the blood vessel, little amount in the cell nucleus. Whereas , the expression of the TGF-β₁DNA in the controlled group are more evident than the other three groups .There is significant difference in the high density group than in the controlled group.(P<0.01)Conclusion: Threre are myocardio fibrosis took place in the HHD cases.There are tow reason contribute to it.One is that the inner layer in the vascullar can be damaged by the high presure in hypertention.It results in a recovered progress.The expression and release of TGF-β₁ arise .But too much expression of TGF-β₁ lead to remodeling of the heart and can be a beginning cause of the heart failure.The other reason is that hypertention can cause the over-expressing of myocardial fibrosis factors and results in a metabolic confusion and accelerates the heart failure.The SXT capsule,developed from the classic prescription of TCM and dealed with moden technology ,can not only relief the symptom but also intervene the progress of cardio fibrosis to impove the prognosis and elevate their life quality.It is as safe and effective as ACEI.