The Evaluate Of Effect Tongguan Capsule On Inflammation And Cardiac Function After Acute Myocardial Infarction

BackgroundAcute myocardial infarction is a severe type of coronary heart disease. It is part of the lasting and severe myocardial ischemia which result of acute myocardial necrosis. Treatment of acute myocardial infarction in recent decades has made a series of significant progress. It is mainly to the stent implantation, In conjunction with other medical treatment and medication. The application of these treatments provide a more powerful means to save the lives of patients. Traditional Chinese Medicine assisted the prevention and treatment of acute myocardial infarction, to prevent restenosis after stent implantation, reduce inflammation, protect the damaged myocardium and improve cardiac function and quality of life in patients are the current areas of concern. The Tongguan capsule has been used in clinical for many years. It has a certain Efficacy. This research is to observe the Tongguan capsule on the inflammation and cardiac function in myocardial infarction from basic and clinical research.Object ive1. To observe the treatment effect of different doses of Tongguan Capsule on inflammation and cardiac function after acute myocardial in rats.2. To observe the treatment effect of different doses of Tongguan Capsule on cardiac function after myocardial in Patients.Methods1. The animal research40healthy prague dawley rats (avoirdupois:200±20g) which are randomly divided into4groups:(1) control group (n=15):Ordinary feeding, with saline lOml/kg/d, no feeding Tongguan capsule.(2) AMI group (n=15):built into AMI model by the left coronary artery legations after Ordinary feeding one week, with saline lOml/kg/d, no feeding Tongguan capsule.(3) conventional dose of Tongguan Capsule group (n=15):built into AMI model by the left coronary artery ligations after Ordinary feeding with Tongguan capsule(500mg/kg/d) one week, continue to feed Tongguan capsule(500mg/kg/d)6weeks.(4) large dose of Tongguan Capsule group (n=15):built into AMI model by the left coronary artery ligations after Ordinary feeding with Tongguan capsule(650mg/kg/d) one week, continue to feed Tongguan capsule(650mg/kg/d)6weeks. Observations: one day and six weeks after modeling each group of rats’s echocardiography LVD、LVDs、IVSd、LVEF、LVFS;Test in rats blood CRP, IL-6levels after modeling24h.2. The clinical study77cases of patients with acute myocardial infarction were randomly divided into conventional dose of Tongguan capsule group (n=26), large dose of Tongguan capsule group(n=26)and control group (n=25). The control group was received appropriately conventional western medicine therapy, ineluding treatment of thrombolysis, coronary artery expansion, anticoagulant, fat adjusting, speckle stabilization, nourishment sustainment and so on. The conventional dose of Tongguan capsule group service Tongguan capsule0.075g/kg/d on the basis of the control group, with a course of three months; The large dose of Tongguan capsule group service Tongguan capsule0. lg/kg/d on the basis of the control group, with a course of three months; We observed the targets of ultrasonic cardiogram sueh as LVEDVI, LVESVI, LVDD, LVDS, LVEF, LVSD, LVPWD on the first day and90th day after surgery, assessed the heart function of AMI sufferer, and then compared between two groups.Results1. After myocardial infarction24h, blood CRP and IL-6levels difference was statistically significant (P<0.05) in each experimental group compared with control group. Blood CRP and IL-6levels in Conventional/large dose of Tongguan capsure group compared with AMI group, the difference was statistically significant (P<0.05).2. After6weeks for AMI rats, the experimental group’s LVDd, LVDs, IVSd, LVEF, LVFS compared with the control group the differences were statistically significant (P<0.05). Conventional/large dose of Tongguan capsure group’s LVDs, IVSd, LVEF, LVFS compared with AMI group, the difference was statistically significant (P<0.05). 3. There is no statistical difference(P>0. O5) on the every index by comparison of the two test groups and the control group on the1st day after surgery. The groups of patients before and after treatment with contrast, after90days treatment, LVEDVI, LVESVI, LVDd, LVDs, IVSd, LVPWd, LVMI, LVEF had statistical significance (P<0.05) compare to the1st day after surgery. After90days treatment, the two Tongguan capsure groups’s LVEDVI、 LVESVI、LVDd, LVDs、 IVSd、 LVPWd、LVMI、LVEF had statistical significance (P<0.05) compare to the control group. After90days treatment, compare with Conventional dose of Tongguan capsule group and large dose of Tongguan capsule group, The two group could improve the cardiac function. Large doses of Tongguan capsule group tended to be better, but There is no statistical difference(P>0.05) between these two groups.Conclusion1. Effects of Tongguan capsule can effectively reduce the inflammatory reaction led by myocardial infarction, and reduce the cytokines expression levels, then improvements in myocardial infarction of rats echocardiography index (LVDd, LVDS, IVSd, LVFS, LVEF). Thus this prompt that the Tongguan capsule can improve cardiac systolic and diastolic function after myocardial infarction in rat. Large doses of Tongguan capsule group compared with conventional dose groups have a trend that it can further improve these index.2. In base on conventional western medicine treatment, Effects of Tongguan capsule can effectively reduce LVESVI, LVDd LVEDVI, LVDs, IVSd, LVPWd, LVMI, increase LVEF in myocardial infarction. Combined with Tongguan capsule has an effect of reduce myocardial infarction cardiac enlargement, cardiac hypertrophy, improve cardiac systolic and diastolic function. Large doses of Tongguan capsule group has a trend that it can further improve cardiac function than conventional dose group.3. Tongguan capsule via down-regulation of cytokines expression levels in myocardial infarction, reduce inflammatory reaction, inhibit apoptosis. Thereby it can protect myocardial cell and inhibit ventricular remodeling. That is one of the important mechanisms why Tongguan capsure can Improve cardiac function and echocardiography index after myocardial infarction.4. Clinical recommend to evaluate myocardial infarction patients Comprehensive, and then through the use of appropriate doses of Tongguan capsule, so as to play the greatest clinical benefit of Tongguan capsule.